547: How to Take Control of Your Health With Low-Cost Tools and Testing | Darshan Shah, MD

What up, everybody? It's episode 547 of The Genius Life. Let's go. What's going on, everybody? Welcome back to The Genius Life. I'm your host, Max Lugavere. And today's episode comes with a bit of a reminder. Your body isn't a rental car. You don't just hand the keys to someone else and hope it hits 100,000 miles without maintenance. My guest on today's episode is Dr. Darshan Shah. He is a board-certified surgeon and the founder and CEO of Next Health. And in this conversation, we get into a mindset shift that could change the way that you think about healthcare forever. Stop treating the system like it's a wellness plan and start treating it like what it actually is, catastrophe insurance. Incredible when you've been hit by a bus, but not designed to keep you from getting hit by the bus in the first place. We talk about why symptoms are a lagging indicator, meaning by the time you feel something is wrong, the story has often been unfolding quietly for years. And then we get super practical on how to become the CEO of your own biology, what to track, what matters, and how to use simple check engine lights to stay ahead of the curve without turning your life into a full-time biohacking hobby. Darshan also breaks down some surprisingly affordable tools. And then we also get into the promise and pitfalls of AI and healthcare, why biohacking doesn't outrank the basics, and how to think about supplements without going broke or buying into snake oil. Listen all the way through to the end. You're not going to want to miss a beat. And as always, don't forget to share this episode with friends and loved ones that you think may benefit from it. And if you enjoy the show, leave a rating and review, subscribe wherever you listen, and on YouTube. And also, quick plug, my weekly newsletter is a tight, no-spam resource with research breakdowns, expert insights, health tips, and occasional product discounts loved by over 120,000 high performers. Grab it now at maxlugavere.com slash newsletter. And now with all that out of the way, here's episode 547. Let's rock. Darshan Shah, what's going on? Welcome. Hey, thanks for having me. Of course. This is fun. Love it. I know. I loved when I was on your show recently. Thanks for having me on. Of course. Fantastic conversation. We covered all things dementia prevention and And you guys, you've been a very early adopter of my work, a longtime supporter. So thank you. You were there at the opening of our locations. Many of them. I love it. Yeah. Next Health, shout out. Next Health in LA and soon all over the world. But I love your approach to personalized health care, to medicine. You implore patients to become essentially the CEO of their own biology. Yeah. How can we, I know we don't, we only have, you know, an hour or so, but I want everybody listening to this by the end of this conversation to feel as though they are on the path towards becoming the CEO of their own biology. Absolutely. You think we can achieve that? I think so. I think we at least give them some really good picture concepts to form this idea around. It's really a mindset shift more than it is actual tactical tools. I mean, there are some tactics that we're going to give people, but having the mindset shift is critical. You got to start with that. Yeah. So let's start there. What does it take to shift one's mindset towards an internal locus of control? Right. So, you know, because you and I live in this space, I feel like we talk to a lot of people that are already totally understanding their biology from the inside out. But I see hundreds of patients every single week, sometimes a month that are just getting started on their journey. And what they've done for many years is they've outsourced their health to the Western sick care system. Now, this system, you and I both know, it was never meant to promote health or to reverse chronic disease or to be something that understands how to keep the average individual healthy. It was there to basically diagnose a disease and give you a pharmaceutical or a surgery or figure out how to manage a chronic disease process or to treat emergencies. Like if you get hit by a bus, you have a heart attack, God forbid, you know, you diagnose a stage four cancer. Thank God we have this system. And so there's this kind of disconnect between our expectations of the system and what we actually get. And that's what creates all the frustration. Right. And so I think the first mindset shift we have to have is the Western medical system and the insurance system. Think of it as insurance for your car. You don't use your car insurance to wash, get your car washed, to get an oil change. You use it when you get into an accident. That's what that system's there for. So you need another system to maintain your vehicle. You need another system to keep your vehicle clean. You need another system to really promote health, right? And so first of all, just mindset shift number one, creating a new system and not relying on the old system. Yeah, we so well said. We're handicapped in so many ways today, I think, in society because we've normalized outsourcing so many aspects of what it means to be a self-sufficient human today, right? Like we outsource our culinary literacy to Postmates. We outsource our health literacy to our healthcare providers. And thank God they're there when we need them, right? We outsource our financial literacy to specialists. And it's just like, you know, I think we're less off as a result. Absolutely. And I think health is where we've outsourced the most the last five decades. And actually a system was part of creating this problem because people never got their data, right? I mean, you couldn't even get data on yourself without asking a doctor. A doctor had to decide whether you were worthy to get a lab test and whether you were worthy or not to actually get the results. They can actually hold the results back from you or tell you like, no, I don't think you need that blood work. You're not going to get it. And so this is a problem that was created by the Western medical system too. So, I mean, they're not totally they meaning me too. I was part of that. You know, I'm an MD. I trained in medicine 30 years ago. I was part of the problem. You know, it's like we would, someone would ask me for blood work and be like, why do you want that? That's not something that we would test for you. You don't have symptoms. And now we know, mindset shift number two, symptoms are a lagging indicator in what's actually going on in your biology. By the time you feel a symptom, something has been going wrong for years, if not decades, by the time you develop a symptom. So mindset shift number two is don't wait to feel bad before you check under the hood. Explain what you mean by that. It's so important, a lagging indicator. What is a lagging indicator? Let me use an example like diabetes. So diabetes is something that you and I talk a lot about. It starts off with metabolic health issues. And metabolic health issues start off with insulin being hyper secreted and then you're getting a resistance to insulin. That insulin resistance for most people that are diabetic right now has started in adolescence, if not childhood. And by the time you start feeling symptoms of diabetes, whether that be visual changes, urinating too much, or the biggest symptom is putting on too much fat and not being able to take it off. By the time you feel those symptoms or start having symptoms and your doctor actually checks a fasting insulin level, it takes a long time. This is happening from adolescence. Most people get their first fasting insulin level at 50 to 60 years old. Wow. Yeah. And so there's a massive time period that goes by. Why? Our bodies are incredibly resilient. We are resilient to biochemical changes. We have backup system after backup system to prevent symptoms from actually manifesting themselves. So when you start feeling symptoms, things are going wrong for a while. And sometimes it's hard to now reverse the disease process, right? So having the data, which we know for decades, we have blood work. We have both physical measurements of our body that we can use. There's genetic data. Having the data way ahead of time can avert these symptoms before they even start. It's kind of like, you know, the Titanic, right? If it had sailed one degree in an opposite, in a different direction from the very beginning, it would have never hit that. It would end up in a different country, nevermind anywhere near the iceberg. It's the same thing. Wow. It's so true. Yeah. I mean, it reminds me of that famous JFK quote that the time to fix the roof is when the sun is shining. Yes, exactly. That's absolutely true. Man. Absolutely true. But so how do you get this into, you know, how do you, how do you Trojan horses into the public consciousness without instigating hypochondria or food fear or, you know, because people, I feel like they spend their lives until they have that big crisis moment. Like for me, it was really my, it wasn't even my own health. It was my mom's health. But sometimes, or most of the time, I would say it takes that big crisis moment, but we want to get ahead of that. Yeah. Yeah. I think, you know, a lot of people live in fear of the data because they feel disempowered because they feel like once they have data, they won't know what to do with it. Right. And that's where we need to bridge that gap between having the data, creating the knowledge, and the empowerment to know there's so much you can do about this way before you need to have a medical intervention, right? And, you know, your story is a really good one, too, with your mom. Like, kind of like those symptoms when they came about jolted you into action. But I bet like thinking about the whole process now, if you had known things were going to go in this direction 20 years ahead of time and you felt like, OK, we know things are going in this direction. Here are the changes that we can make to at least slow the progression or even reverse course. You would have been appreciative to have that data from the very beginning. And so we're all fearful of a car crash, but keeping your eyes closed and not wearing your seatbelt until you get there is not the solution. It's knowing where the route is at the beginning. So the second mindset shift is awareness of the fact that these conditions don't just begin overnight. Exactly. Wow. How many are there? How many foundational tenets are there? Yeah. So there's one more, really. And that one more is, so we said number one was creating a new system that's health-focused. Number two is understanding that there's time in between changes and symptoms from developing, and you have power in that time. And third is taking personal responsibility. All right. So now you embody that you do have control and you will be responsible for your own body because no one else cares about your body more than you do. Right. You're living in it every single day. Asking a primary care doctor that has 15 minutes with you every six months or a year. They just can't do it. Right. And so who else is going to do it for you? Your spouse, your trainer. Still, they don't have the time or they're not living in your body. so they don't feel the consequences of it. So you have to care and you have to take personal responsibility for your actions and how they affect your body and understanding what the data means, how you can change it, and then putting into place routines and habits that affect that change. I love it. Yeah. What are the subjective and objective check engine lights that people should be mindful of? Right. So subjectively, like we were talking about, we have symptoms that we can feel over time. But obviously, a lot of times, like we talked about earlier, is those symptoms are lagging indicators. But many times as well, we have symptoms that are ignored. And these are symptoms such as brain fog, tiredness, things that we kind of normalize due to our stressful modern day environment. So kind of the opposite flip side is true subjectively, is to listen to your own biology. Listen to what your body is telling you. If you don't feel your optimal self, there's definitely a reason to be looking under the hood. Now, objectively, this is what I love talking about. Objectively, there's about 15 biomarkers of our health that I believe are critical, check engine lights that are critical, that everyone should know what they are, understand why they're important, and also what is the optimal range, right? We don't just want to know when things are really wrong. I talk a lot to like CEO groups. I say, you know, you're the CEO of your business. You follow KPIs how often? Once a year? No, no one. You're not running a business following a key performance indicator once a year. You don't check every December 31st, will we profitable or not? You want to know like every week, did we make a profit every month? Same goes for your biology. Check more frequently and understand what those numbers mean and what is the optimal range. So every biomarker has a range that is a disease diagnosis, has a range that is abnormal, and has a range as optimal, where your body's going to function at its best, know what that range is. So what are the big levers? I mean, we don't have to go through all 15 of them, but what would you say are the more common ones? Yeah. So basically, there are two different categories. Some are blood tests, and the others are physical measurements that you can do with simple, cheap devices that anyone can buy and have access to. If you're feeling more sluggish than usual or your workouts aren't hitting the way they used to, the issue might be deeper than just sleep or stress. As we age, our mitochondria, the tiny power plants inside our cells, naturally decline, and that can have a real impact on energy, strength, and recovery. 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All you got to do to try out the Just Thrive probiotic is head to justthrivehealth.com and use promo code Genius Life to save 20% on your first bottle. Again, that's justthrivehealth.com. Promo code Genius Life will save you 20% off of your first bottle, the Just Thrive probiotic, because your gut shouldn be the boss of you Enjoy Those devices are a bioimpedance scale a grip dynamometer and even a continuous glucose monitor Those are my favorite kind of devices There are other physical measurements that you can do on yourself just at home that cost zero, things like a sit to stand test, for example. And then lastly, our biomarkers, blood tests. And these blood tests are, there's probably like 20 you should ask your doctors for, probably about 10 of them. you should really understand what they are and know what they mean and why they're important. And these are blood tests that are checking for what I call the foundations of health that functional medicine calls the root causes of disease. These are inflammation, metabolic health disturbances. We have hormone deficiencies and also cardiovascular biomarkers like ApoB, for example. Got it. Okay. So you mentioned bioelectrical impedance, body composition skills. Okay. So like my gym has an in-body? Yeah. Is that what you're talking about? Okay. So your gym has an in-body and I don't know about you, but like I go to the gym not sometimes like on a daily basis. Sometimes I'll go in a week, I'll work out at home, I'll work out outside. You have to get access to this at home where you can get true longitudinal measurements. So they make bioimpedance scales for home for 30 to $40 that are very accurate compared to even the ones at the gym, like the in-body. In fact, in-body does make some that you can buy for your home as well. I actually like this one called Renpho, R-E-N-P-H-O. This is a scale that costs about $20, $25. And just for your audience, what a bioimpedance scale is, what I tell all audiences, if you have a regular scale that tells you what your weight is, just throw it away. It's not valuable information to know what your weight is, unless you're an insurance company or whatever. So a bioimpedance scale sends a slight electrical current through your feet. And it measures the amount of free fat mass that you have in your body. Okay. And this is very important because it can tell you what is your skeletal muscle doing. It can tell you what is your fat mass doing. And those two numbers are incredibly important because as skeletal muscle goes up, as we know, fat mass comes down. You don't want to just lose weight because you could be losing muscle mass, which is even worse. That sets you up for even further metabolic disease. So this bioimpedance scale, $20, $30, you follow your skeletal muscle mass and fat mass and forget about your weight. Wow. I didn't realize that they were A, so inexpensive and B, that they were so reliable. I mean, I've always heard, like, how do they compare to, you know, calipers and DEXAs that like DEXA scans often come up? Calipers are the most unreliable because they're so dependent upon the user who's using them. So I don't like calipers. I think that the DEXA scan to the Renfo, because I measured this on myself and test it. There is some discrepancy, but directionally, they're very accurate, especially if you use them the first thing you do in the morning before you get in the shower. Do the same time, be very consistent about it. You don't have to do it every day if you don't want to. What I would do is do it every day, but look at it once a week, see what the trend line is doing over time. That trend line is critical because the first thing that you're going to notice after you get back from a vacation for two weeks is there was a dip in your skeletal muscle mass. There's an increase in your fat mass. And then you can do something about it. You know what you have to do then. You know, it's fascinating. This totally checks out with, I was just reading a review, looking at the key behavioral, psychological characteristics that lead to one sustaining weight being lost over time. Because it's not that, I mean, it can be difficult, but generally like most people can lose weight initially. The most difficult thing is to keep that weight off. And one of the, the, um, the data points to emerge in this or to that I, that I, um, found in this review was that self-monitoring weight and body composition, um, was one of the key. There's like strong evidence for that predicting long-term weight maintenance. Exactly. I read the same study you did. I think it's PLOS or something that said the people that measure their weight every day had a very significant advantage in keeping the weight off for the long term. Amazing. It works. So, you know, obviously there's been this huge movement about, you know, body positivity. And I'm a big believer in being positive about whatever body you live in. But the reality is to obtain good health, you need more skeletal muscle mass. You're not going to know at all what your skeletal muscle mass is unless you check it either with a DEXA scan, which is hard for a lot of people to get. There's a little bit of radiation involved. Not a lot. I check a DEXA myself once a year. But this bioimpedance scale that most people can afford a $30 to $40 scale at home is a critical part of the journey, I believe. Wow. Renpho? That's the name of it? Yeah. R-E-N-P-H-O. I had no idea. Amazing. I'm going to look into that. Renpho, InBody, Withings, they all make good scales. I like to go with what I find to be the least expensive for something that's going to get you a good amount, a good piece of data. And I've tested all of them and, you know, they're all very accurate. And this one is the lowest cost one. Well, the key, what you said is like, it's not necessarily the data to emerge from it should be taken as gospel, but directionally, very helpful. Directionally, right. Exactly. Wow. Okay. And then you mentioned grip dynamometers. Yes. Have you ever used one? Maybe once or twice, but like it's not, yeah. I'm going to buy you one. Okay. So useful. So useful and critical, in my opinion. So muscle has two qualities. You have muscle mass and muscle strength. More important than muscle mass is your muscle strength, okay? Especially when it relates to key determinants of long-term disease risk and especially your longevity. So there's huge studies that show a direct correlation between your grip strength and your longevity and the time you spend disease-free. Big studies, irrefutable, just like VO2 max, okay? And so a grip dynamometer is a device that you can buy on Amazon for $14, okay? And they all work really well. You squeeze it. It tells you how many pounds of weight you're able to squeeze with your grip. Now, your grip strength is a very good proxy for your upper body strength, which is also a very good proxy for your total body strength. And you can compare your grip strength to the strength of another male of your age group. And, you know, they have women and males, any age group, they have really good charts that tell you where you're supposed to be. And, in fact, the electronic ones tell you if you're low, average, or high for grip strength. So it's super easy. And, like, you've probably only done it once or twice in your life, you said. I really believe everyone should buy one and do this themselves every month at home. Because it tells you, number one, how efficacious your workouts are. Number two, if you go away for a while or if you have an injury or something, how much it affected your grip strength. And critical over the age of 42 to 47, we know that we're all genetically programmed to start losing muscle mass. There's a dip that happens in muscle mass in that age group. and with perimenopause and also with andropause, we have a dip in muscle mass. So this is just another piece of that feedback to develop muscle mass, that critical data point that you can check. You know, I do mine once a month. There are people that do it every day, actually. They just want it to keep getting better and better. And so there's different ways of improving your grip strength. The best way to improve your grip strength is actually total body exercise. It's not just training your grip, right? I love that you said that. Yeah, exactly. So, you know, a lot of people talk about hanging as a test of longevity. Well, that's because of grip strength. A lot of people talk about pharma's carry. That's also grip strength. So these are all ways that you can track what is your muscle strength doing over time. I love that the two tools that you've mentioned so far are so inexpensive. I mean, there's this misconception that health, wellness is this privilege afforded to the few. But I mean, these are super cheap things that you can pick up easily on Amazon. I mean, I'll just throw my own addition into the mix. I mean, one of the things that I use the most multiple times a day, every single day, is a digital food scale in my kitchen. It's always out. Why is it always out? Because it reduces the friction that I'm going to actually use it. And I weigh pretty much everything on it. Not that I'm necessarily tracking, but it's just a... It's a mental check. portion control, mental check. Yeah. I mean, it's like you and I can measure out two tablespoons of peanut butter and there could be a 200 calorie differential in between your tablespoon and my tablespoon. I love peanut butter. So mine is going to be huge. It's probably going to be huge. Yeah. But 15 grams of peanut butter is 15 grams of peanut butter. Exactly. Exactly. Yeah. I love, I have that too. I have one, you know, at home. I also have one at work, believe it or not. And so I, I love, I love these little devices that are super inexpensive that really add to the directionality of your health. Because, you know, health is not a once a year doctor's visit. It's not even like, you know, a once or twice a week visit to the gym. It's really a daily practice of the little routines and little wins you get every day and the little losses you experience every day. And you can mitigate those little losses and get more wins by cheap devices like this. I love it. Okay. So moving on, you mentioned CGMs. Yes. So this is kind of like more of an advanced version, and not everyone needs a CGM. So what I do is I start with blood work, and there's a few critical indicators of your metabolic health that everyone needs to know from their blood work. And those are, number one, fasting insulin, number two, triglyceride, and number three, hemoglobin A1C. If any of these three are off, especially hemoglobin A1C, and by off, I mean not in the optimal range, I then recommend a continuous glucose monitor to a patient while they're trying to normalize their hemoglobin A1c. You don't have to wear one forever, but it is incredible feedback for the impact of your sleep, your food choices, your exercise regime, and also your habits around food, snacking, food order, etc., how it's impacting your glucose levels. And we know that the number of hours you spend in a spike situation within the number of spikes as well adds up to a worsening of your metabolic health over time. And so this is how we get people normalized again, because it's basically a learning tool. So learning tool about what's working for your body on an NF1 basis. Now, so I'm curious, like, have you, you're a clinician, have you in the clinic, clinical setting ever seen labs come back and presented a false negative that somebody is normal glycemic, has healthy blood sugar, and then you slap a CGM on them, and then you see actually based on the CGM data that they've got metabolic dysfunction? Well, I think it's important for practitioners to know that a snapshot of one fasting glucose level doesn't give you a full indication of what's really going on under the hood over the course of the day. So yes, I mean, the idea is just one set of blood work doesn't give you the full picture. But what I really look at is a fasting insulin level. Fasting insulin is above 10, especially, then we start doing some more investigation. Now, that all being said, and I know I said I only use a CGM if someone has blood work abnormality. That's for most people so they don't get overwhelmed initially. I do think the CGM is an incredible tool to just learn about how your body's managing blood glucose anyway, whether you have metabolic health disturbances or not, because the learning kind of journey you go through about your own body is amazing. Like, for example, like I could eat a banana and my blood glucose will spike for like two hours as a banana for some reason, just doesn't do well with my microbiome with with the way I need to be eating. And so I replace bananas with like berries for fruits. But my my son doesn't have to do that. He can eat a banana. He's completely fine. He's like, no, no blood glucose spike at all. And so it's, you know, it's everyone has different glycemic reactions and different glycemic indexes to food. You know the whole concept of glycemic index, right? And that glycemic index chart that they put forth was good, but it was different from person to person to person. They just gave us the averages. You need to know what your own glycemic index to foods are. So you know what foods are good for you, what foods are bad. And by bad, I mean like what foods are going to spike your blood glucose. No food is bad except for ultra processed food. Yeah. Yeah. So, well, I'm torn because it's like on the one hand, yeah, there's the Hawthorne effect, right? So it's like by just merely observing your own behavior, it's you're going to you're going to change your behavior. And that change often occurs for the better. But on the other hand, how do you prevent people from sliding into food fear where they suddenly start fearing otherwise healthy foods? Right. Exactly. And so, you know, my my whole theory on this is I've seen for every hundred people in clinical practice, get a continuous glucose monitor. I probably only seen one person get kind of a food fear or an anxiety around the numbers and those kinds of things. And I have resources for those people. My best resource for that is just pairing them with a nutritionist. I don't even have them look at their data. I'm like, just wear this, have the data go to the phone. Don't even like look at the app. Let's then sit down weekly with a nutritionist who can review the data with you, talk with you about it, and kind of mitigate the anxiety of the minute to minute data kind of a thing. And I do the same with sleep, with the sleep trackers and with HRV as well. Some people just has too much data, you shouldn't look at it, but the data is still very valuable. And so that's where having someone in between, like a human in the loop, can be very helpful. Super, yeah. I mean, I remember I tried to see Jim for two weeks and it spiked when I sat in a sauna. I sat in a sauna and it spiked. And I was like, what is going on here? And that happens. And that's because of a cortisol release can cause your sugar to elevate. But see, this is where a human in the loop is very helpful because that's fine. Your body is doing what's right. And so that's normal. And that's going to be very helpful to have someone interpreting the data with you. What do you think about what's your take on AI? Because recently there was a tweet that went viral that indicated that chat gpt is now launching i believe it's open ai health or chat gpt health or something like that um and the the reaction was was polar you know there it was polarized like some people were like oh my god like is this going to violate hipaa laws like what's what you know is our data being protected but then a lot of people were like actually this is pretty damn cool because like one clinician sees only the cases that that clinician has seen whereas ai has access to all of human knowledge, essentially. Yeah. So I think that AI is forcing the modernization of how we think about many different systems. The best modernization that we need as a society right now is how we think about healthcare and how we administer healthcare in this country. The way we administer healthcare in this country is incredibly inefficient. You have to wait months to get a doctor's office visit. He or she only has 15 minutes with you. They have zero access to the amount of data that AI has. And like you said, they also have their own experience and their own education, not the education of thousands and thousands of individuals throughout human history. You know, it's a completely different paradigm. And obviously, we worry about privacy, which is HIPAA, as you explained. You know, we have to keep things private. However, we need to rethink all of our systems about how AI fits in. Because I could tell you as a physician, I've been using AI since the first few months that ChatGPT came out. And even back when it was hallucinating, it got me to think about diagnoses and problems that I personally, and I'm deeply educated in medicine, didn't even think about. And right now, there is the need for a human in the loop to make sure it's not hallucinating, to make sure the full context is being taken into account. But the context that AI will have about what's going on in your individual body, it's gonna be way beyond what your doctor has because it's gonna be taking your continuous glucose data, your wearable data, all your blood work for your entire life and understand everything and your genetics all in one. And so I think it gonna massively revolutionize healthcare exactly when it most Yeah I really bullish about it It like Pluribus Have you seen Pluribus No Oh the show No. The Apple TV? Yeah. Apple TV shows from the maker of the creator of Breaking Bad. OK. It's basically like everybody. There's this viral infection that occurs in the on a global scale. Yeah. Where suddenly everybody's consciousness is united and becomes one. So it's like one entity, this like massive hive mind. and uh and as a result you get like you know a teenager who suddenly has access to all of the world's medical information can fly a plane can like perform open heart surgery wow and so there is this it's not explicitly stated in the show but many people have thought that you know there have been think pieces that this is basically like what ai is is kind of doing in the sense that it's it's linking all of the world's knowledge into one sort of cohesive, verbal, interactive framework. And so that's the promise is like that. I mean, and the promise is, I think, pretty great that, you know, that you used to rely on the clinical experience of your local town physician. Yeah. But now thanks to AI and the internet more broadly, you have access to like every clinician's knowledge and experience. Yeah. And you know, I'm in a group of doctors that are longevity focused. There's about a thousand of us in this group. And we talk about this every single day and we evaluate every single tool out there. I can tell you universally there's excitement rather than fear. There is an excitement more for what we went into medicine for. We want to help people get better. And there's just not enough time in the day to help everyone get better. And especially getting better really means doing something every day, every minute, every time you have a new piece of data. How is any doctor going to do that? You just, obviously there's no way. But AI can do this. And especially enabled by wearable data, our phones being in our pocket with us, giving us constant feedback. And we're going to see more of this come very rapidly. So if somebody listening to this is feeling deflated, feeling hopeless about their health, about the interactions, recent interactions that they may have had with their health care providers, what kind of solutions, how might they think about this new sort of framework of health care that you're describing? I mean, I can tell you what they should do, which is I think will give them a new way of thinking about the new framework of health. And this is exactly what they should do. They should call their primary care doctor or wherever they have health records and request them. Just say, I want all my health records. Get them. Then they should go and get a fresh new set of functional blood work done. And you can do this either, like our next health business, Function Health does this as well. You can go to any lab and ask for a set of blood work. Get those results. and then put them into a tool like Claude or ChatGPT Health and just start talking to them. Ask it a prompt like, give me a big picture summary of my health and what are the things I should focus on? What are my blind spots? What am I doing well? Simple question. And then see what happens. And then you have a introduction into the power of this technology. And then ask it questions like, what should my day-to-day diet be based on all of this and why? What do you think I should be doing for my exercise regime and why, you know, and just start interacting and see, see what kind of advice it gets you. And, you know, obviously don't follow anything about like taking a medication without asking a doctor. You can't even do that anyway without a prescription, but you'll, um, you'll see that AI enabled with your data is incredibly powerful, especially if you have symptoms, right? Before you were just Googling, I have brain fog. What could it be? And brain tumor pops up and you're like, Oh my God, you know, but once it has the data, it can give you a differential diagnosis that is probably more expansive than most doctors can give you. It's so true. Yeah. It's remarkably powerful. The, um, the new dietary guidelines just came out and, uh, and very, you know, very optimistic, very excited. I think, I think they're good. They're wonderful. Um, but you know, there was this like a pushback, this screeching online that it's impossible to hit the, there's like this contradictory information. It's 10, there's a 10% saturated fat guideline, but there's red meat. Oh my God, at the base of the upside down food pyramid now. How could the two possibly be reconciled? Oh my God. Well, the first thing that I did was I went to Chachi PT and I asked Chachi PT to make me a six day meal plan, maximally including red meat. Not that anybody is maximally going to, I mean, unless you're like a carnivore diet or I'm not like trying to, my goal is not to maximally include red meat in my diet, but just to prove the naysayers wrong. I said, give me a six day meal plan maximally, including red meat that fits comfortably below the 10% saturated fat dietary guideline. And within seconds, I had a six day meal plan and it was balanced. It was totally nutrient dense. It's a diet that anybody could adhere to and would get them probably leaner and more jacked and healthier than 99% of the population. And it's just like, it's amazing. You just have to know that it's available to you. That's it. Exactly. That's it. You know what's available. And what's great is like, you know, the models now have access to the new food pyramid. So you could just go to your chat GPT that has all your data and say, based on the new food pyramid, what is my optimal diet? And you're done. And then, you know, also, like I think our biology is constantly changing, right? And so checking blood work on a frequent basis, I'm a huge believer in even quarterly blood work testing and just feeding it into the model and saying, what changed? what changed, what changed. Number one, it'll tell you what changed. Number two, it'll tell you why. But number three, now it has that longitudinal data on you as well that it can then tie into the overall picture over years and months and years and decades. Because it has memory. It has memory. It's amazing. Yeah. What would you say are the biggest challenges facing patients today that come into NextHealth, your clinics? Yeah. I'm really, really optimistic right now because I think people in general have less challenge than ever before in getting their health in order. Okay. And the reason I say that is because we're finally in a place where number one, the thing we're talking about AI, number two, you have access to getting biomarkers and testing on your own. And number three, so much access to good information. Your podcast, my podcast, Extend, Peter Atiyah. There's so many people out there that are putting out incredibly good, balanced, scientific, sound information. And so the combination of information about yourself, information just in your brain about knowledge and AI has created an environment where people are coming in asking really, really good questions. The challenge they face is finding a provider or a doctor, even like a nutritionist that really fully espouses things like the new food pyramid, functional medicine and hormone testing, et cetera. So people are getting good information. They just don't know where to go to now take action. And so one of our goals at NextHealth is to give people that place to go. We provide people with access to some of these therapies that they're reading about. at a high level of safety and discernment so that they can finally access. So things like peptides, hormone replacement therapy, stem cell therapy, et cetera, that's the goal of our business and what we're doing. So I think the biggest challenge is really finding, where do I go now? Now that I have the information, what do I do with it? Yeah, but that answer, I mean, it's never been more clear. Yeah, like the barrier to entry to real valuable personalized health information, maybe not precision like guidance necessarily, although I think we're getting there, but you still need to, obviously it's wise to have a healthcare provider at your disposal. But yeah, I mean, the disempowerment of decades past where there were gatekeepers to knowledge and information and even your own labs as you described, I mean, that's long gone. Long gone. It's done. It's done. And that's why healthcare, medicine 4.0, needs to like completely reform how we think about our role in a patient's journey now. It's really the more you empower people, the more they can take care of themselves and become disease-free or at least slow the progression of disease. And then healthcare should just become the treatment of emergencies and anything that gets out of control. And if we can do that, We will save this country trillions of dollars over the long term, trillions and trillions. And people will just be happier and healthier and more productive. So we'll make trillions more. It's just it's just such an important piece of the puzzle that we need to solve right now. Amen. It's so true. All right. So you've already you've already revealed some of the big levers for us. But what are some of the deeper cuts when it comes to procuring a longer and healthier life? I mean, you guys are so like ahead of the curve. You always have been at Next Health. What are some of the deeper cuts? Yeah, like what are some of the things that you can do once you've got the basics in place that you're asking me? Okay, so I look at health as also like a pyramid. You have to have the base very solid. The base is obvious things that you and I talk about, but empowered by new technology. So get your diet, your sleep, your exercise routine, your stretch management, stress management, right? Using new technology, getting your own biomarkers, becoming the CEO of your own health, enabling with AI. Step one, that might take you three to six months, right? Then you add in layer number two, which is functional medicine. This is root cause medicine. Now you're getting a little bit more scientific by looking at biomarkers and affecting change at the root cause of biological systems that you might not know a lot about right now. Those are your hormones, right? Your detoxification systems, because we're exposed to a lot of toxins now, so we need to detoxify your gut health and your microbiome as well, right? And so understanding those systems and how they work together, interact and optimizing on those levers requires a practitioner and requires additional data. But that's definitely kind of like step two of the journey. Got it. Yeah, like the microbiome, there's only so much that you can do to, you'll still probably need to do a stool test. you'll still probably need to get hormone labs drawn and, you know, with the guidance of a skilled clinician, you know, titrate up your whatever, your the exogenous hormones that are recommended. But what about, okay, so like a lot of people now are talking about NAD. We just had an expert on the podcast to talk about NR and, you know, the really incredible science. You have Dr. Chris on? No, he wasn't. We didn't have a physician on. He was the he's the CEO of True Nijin. Yeah. Yeah. I know. So N-R nicotinamide riboside. It's been shown to boost N-R to boost N-A-D. But I think questions remain about, you know, is the decline in N-A-D that we see with aging? Is that just correlated or is there is there causally a connection where if we titrate, if we somehow boost N-A-D, are we actually like reducing? our biological age. Yeah. So now you're talking about the tip of the pyramid. Like what are the molecules we can add to our body that can mitigate the effects of aging right now and potentially even reverse, right? And so that's a really interesting topic to me because we do have therapies and molecules that we can use for this at this moment in time. And there's a lot more coming. The next 10 years are going to be mind-blowing to all of us. So let's use NAD as example, right? We know huge studies show that there's an age-related decline in NAD. This decline also occurs in people when they're in stressful situations. There's a drop-off of NAD as well. And so when something has an age-related decline and also a stress-related decline, what it generally means is like this is a critical substance for our body that because of us living longer, we're just losing it. There's other molecules like that, like testosterone, for example. Estrogen falls off a cliff for women. There's also growth hormone. All of these things we lose as we age, right? And that was natural aging. However, if we add these molecules back in, we can slow the aging process or maybe even arrest pieces of it, right? And so NAD, in my opinion, is one of those molecules. We know through decades and decades of science that this is the critical precursor molecule for our mitochondria to create energy. And if your mitochondria has enough NAD to work with, then it can create the energy it needs to for that particular cell to do what it needs to do. And I'm a big believer in NAD and it's different forms. Nicotinamide riboside, NMN is also another form. And I don't know if your previous guests got into this, but the difference between those I think is important too. NAD is a molecule that's typically inside the cell. That's where mitochondria live and they can use NAD to make energy. It doesn't really function well outside of the cell. So when you get NAD IV, for example, your body recognizes it as a molecule that's not supposed to be there outside of the cell and it creates an immune reaction. And that's why when a lot of people get IV NAD, they get like that chest pain, they feel sick a little bit, that's an immune flare-up that's happening to the NAD molecule being in the wrong place. So some of these newer molecules like nicotinamide riboside, NMN as well, they exist outside of the cell and they're converted to NAD inside the cell. And so they're absorbed so much better and so much faster. And I love TruNiagen and their products because I take it every day. Because first of all, it doesn't make me sick when I do an IV. Secondly, there's studies that they've done that show reliable intracellular increases in NAD, which is a good thing. Yeah. I did an NR IV, and it was the weirdest sensation. I didn't get the, because I think in the past I'd done an NAD infusion, and yeah, you get that nausea and whatever. I think I remember you and me doing one together maybe at some point. We must have, yeah. Yeah, it was like a long time ago. But NR, no, I felt great with the exception of like your face hurts. Yeah, you have a little bit of jaw pain. Yes. What was that about? Yeah, it's interesting. I think we're trying to figure out what that is, but I think it has something to do with the nerves of this area. It's weird. It's so odd. I mean, it was totally transient. It went away. But yeah, that's super interesting. And there's other great molecules out there now too. If you're interested, there's eurylithin A, for example. Have you heard of this one? Yeah. Yeah. But tell us. Yeah. So eurylithin A is a compound made by our gut microbiome that only 30% of us make anymore. And this is a molecule that increases the number of mitochondria inside of every cell. And so I'm really excited about this one because, once again, there's good science behind it. And increasing the number of mitochondria, just like NAD, you just produce more energy. And so this is a fantastic compound that's coming out. We also are able to find the gut bacteria that are game-changer keystone bacteria that can really improve the quality of our health and specifically our metabolic health. And so that one is called acromantia. So now not just taking a probiotic that has a bazillion strains of stuff that you don't even know what it is, now getting like really specific and using strains that we know can accelerate your health. And so this is what I talk about. Like we all have a multi-billion dollar pharmaceutical factory in our gut. It's our microbiome. and being able to harness that. So all that is coming now too. It's amazing. Well, how do you as a clinician triage your approach to these exogenous molecules? Like, you know, we don't all have unlimited money to spend. We don't all have unlimited time. Not all of us have access to facilities like Next Health. You know, we don't all live in Los Angeles. So where do you then begin if you want to start experimenting with these other kinds of molecules? I mean, there are so many now, right? Like urolithin A there NR I mean I a huge fan of astaxanthin I take that every day but like I don wanna take a bajillion supplements every day I not like Dave Asprey I not trying to be you know Yeah exactly So you know what a bell-shaped curve is, right? Yeah. Yeah, so I have a bell-shaped curve in my office and it's laminated. And this bell-shaped curve, I have like 10 of them for all different topics. And one of them, the title is supplements. And so the bell-shaped curve, it looks like a bell shape. on the left is a certain percentage of the population that want zero supplements. So like, I'm not going to take anything. I only want what I can get in my diet and that's it. And then you have another bigger portion, like 63% of the population that will take only the required basics that have some pretty good science behind them that we know we need to take. And then you have another 63% of people that will take that plus more. Good science, good quality, we know it works. And then you have this 13% that are like, I'll take anything. Like, just give me, give me the Dave Aspey protocol. Give me the, you know, Brian Johnson protocol. Right. And so I asked people, I pulled this out. I'm like, where are you on this? And most people are in the basics plus. And to me, the basics plus is that's where I live. I live in the basics plus. I'm not taking a million supplements, you know, and every once in a while, I'll try something else. A lot of times is a leap of faith, right? I track my data to see if I'm making an effect. By the way, another great way to use ChatGPT is just let it know when you're starting a new supplement. Just tell it, I'm gonna start astroxanthin today. I'm gonna check my biomarkers in three months. Let's see if it made a difference. Smart. It'll rip our back to you, yeah. Whoa. So what are the basics plus that you take? Yeah, basics plus is, basics are these. A good omega-3 supplement, well-sourced omega-3s, vitamin D3, K2, creatine is a big one for me, a methylated B vitamin as well. And then I take a multivitamin combo packet called IM8 that I just like. Now, not everyone needs a multivitamin, but I love IM8 because great science behind it, great concentration of products that I know, like for me, like I travel a lot. I have a very intense life. Like I'm not getting in all the nutrition I need every day for my food. And that's it. That's my basics. And then the plus is urolithin A, which comes in a company called Timeline Nutrition, the nicotinamide riboside from Truniogen. And then I also take Acromansia for my metabolic health from Pendulum. That's my stack. I love that you listed creatine as foundational. Foundational. Do you recommend that for everybody? Everybody. Everybody. Women, men, across the age spectrum. I think women almost more than men, to be honest with you. I mean, I think that unfortunately women have a higher rate of Alzheimer's disease than men do. And there's lots of good research showing that the women who take creatine have a much lower rate of Alzheimer's than the women that don't. Interesting. With creatine. With creatine. Yeah. I'm aware of that. Yeah. That pilot study that came out a year ago now at this point, maybe longer, looking at creatine in an Alzheimer's population. Yeah, no, there's another one that came out with creatine in, I think, cognitive impairment and the rate of progression towards Alzheimer's disease. Yeah. I'll send you that one too that I found. Yeah, I'd love to check that out. No, creatine's awesome. I've been a fan of creatine for a very long time. And yeah, it's kind of awesome to see that now everybody's like talking about it. Yeah, exactly. And you know, creatine has so many benefits. I mean, it used to be like a bro kind of thing you took if you went to the gym and working. I remember going to the gym in college and everyone was like pumping creatine, 20 grams of creatine. I think the dose is a lot less than that. It is probably 8 to 10 grams is somewhere where someone needs to be. Oh, another great study that came out is creatine in sleep. So if you're sleep deprived, four hours of sleep, creatine improves your cognition by 30% after a poor night of sleep. Whoa. Yeah. What dose? Yeah. I think that was eight milligrams as well. Eight grams. Sorry, eight grams. Yeah. Wow. Yeah. Yeah. Yeah, that's super important stuff. Do you get like the patients that you see, do they tend to be obsessed with their health? Because I think that's one of the challenges with, I think the wellness, just the oversaturation of wellness content these days is that it gives the impression that you've got to be obsessed with your health in order to move the needle in a meaningful way. I mean, most of the people that I see are not obsessed. In fact, they're time poor. They want the 20% of the information that's going to give them 80% of the result. And they want someone to just tell them what it is with no BS and personalize what it is as well based on their own biology. So I think there is a danger of people getting obsessed with their health. I think a lot of people that do get obsessed that I see get obsessed for a small amount of time until they can't do it anymore, or they see the negative consequences of becoming overly obsessed. So yeah, I think there's a danger. You just got to be able to understand that that is there and not get too far down the rabbit hole. I agree. As somebody who's at the forefront of longevity medicine, as you are, what are the biggest myths that you see circulating on social media regarding longevity and, um, yeah, longevity and, yeah, and, uh, and wellness. Okay. So I think the biggest myth that I would say right now is that there is a supplement or any supplement that is able to add years to your life. I just don't think that exists right now. Um, I think supplements can keep you in a state of health longer. Okay. And potentially even reverse some of the negative consequences of chronic disease. But I don't think we have a supplement that can increase your longevity. So the whole category of longevity supplements, I think a lot of times you have to be very suspect when someone puts that down as a claim. Secondly, I would say that biohacking trumps lifestyle. That's another huge myth out there. There's so many people I see that are smoking that go into a sauna five times a week, yet there's still smokers you know it's like come on it just doesn't make sense right so i think i think the the biohacking pendulum has swung towards number one more science-based evidence-based technology i think a lot of people wasted a lot of money on things that didn't work and they found that didn't work and you know you can ebay and just search any biohacking technology and and see the number of people trying to sell their stuff. It's like, it's crazy. Yeah. It's crazy. Yeah. I feel like if you are not strong and relatively lean, I'm not talking about like single digit, no visible six pack. But if you're like carrying extra weight and you're debating with yourself, which non-caloric sweetener is the most virtuous, it's like you're missing the point. Completely. You know, it's sort of like a smoker. Like, yeah, there's like a lot of things that you could do to, you know, to like inch your health towards the better, you know, as a smoker. But nothing is going to have as big of an impact on your health as quitting smoking. Exactly. Like it's just where it's just like splitting hairs at the end of the day. Right, right. Yeah, I think there's a lot of majoring in the minors that is happening right now. I hate the question about non-caloric sweeteners. it's just such a question of like, don't ask me about non-caloric sweeteners unless you're like Lance Armstrong or somebody, right? Like it doesn't matter. You're just majoring in minors for the most part. Now, you know, as far as sweeteners go, like obviously if someone asked me like, should I have this one or this one? I'll be like, yeah, go for Stevia, you know, Allula or something else instead, that's going to be better for you. Because when you're making a purchasing decision, then it makes sense. But if that's your health strategy is to pick the right non-caloric sweetener, that's a big problem. Yeah. What are some other, when it comes to grocery shopping, to take homes for my listeners? You know, I think everyone knows probably the big picture ones, which are shop on the outside, buy organic if at all possible. If you can't buy organic, definitely look at the EWG's list of the dirty dozen. But otherwise, I think that some of the things that are non-intuitive are frozen vegetables and fruits can be a really low-cost way to get very nutritious food, right? And so this is especially important in places that are like food deserts, right, where you can buy a large quantity of frozen fruits and vegetables and store them in your own freezer for a while and have really good access to good quality food for a long time, you know. And so I think that's important. I think certain companies are doing a good job at really focusing in on healthy crops and also healthy produce. Sorry, healthy crops and also healthy meat versus other companies. And so don't get tricked by the marketing as well. I just think, you know, an educated consumer is just going to be able to make good choices without it severely affecting their pocketbook. Yeah. Yeah. I think that's one of the things that is a little bit not so intuitive because we're told a lot of times that eating healthy is expensive, but it doesn't have to be. Doesn't have to be. No, not at all. What are the keys to making it less expensive? Number one is realizing that if you start off with a protein and plant forward diet and you eliminate ultra processed food, you're not going to be as hungry. So you actually need to purchase a lower quantity of food for the long run. You're going to just start eating less, right? And so that's something that's, I think, a realization that people should consider when they go to a supermarket. Because a lot of times people go to a supermarket thinking, I need to load up on snacks because what if I get hungry? Well, those snacks are designed to keep you hungry. So the less you load up on those snacks, the better. Amen. Yeah. Yeah, you can't major in the minors. I mean, that's definitely true. I went to Target the other day and I put the video up on my YouTube. I did like a shopping haul from Target. And because, you know, like I think most people think of Target as being a place to just like buy the latest like young adult novella, appliances, cleaning supplies, toilet paper, whatever. And and it's shocking. Like you could find like such healthy food. Yeah. Whole foods. Yeah. At Target. And and I did the math. I bought like three dinners worth of meat. I bought a dozen eggs. I bought dark leafy greens. I bought some berries. I bought coffee, like cold brew, organic coffee. And the bill came out to like $51. So I did the math and that breaks down if you like say, okay, it's about six and a half meals worth of food. It was like $7. Yeah. Incredible, right? Like at Target, that's, that's amazing. And we're in LA. So I don't even know like if Target is just like more expensive here as compared to somewhere else. Yeah. But yeah, like, I mean, $7 for like super high quality, lean red meat, eggs, dark, organic, dark leafy greens, organic berries, organic coffee I bought. Right. I love that. You know, I think too, because of the massive variety in a supermarket, people think sometimes they need a massive variety of food in their home. The reality is the more simple you keep it, the easier it's going to be for you to get healthy. Pick 20 things that you buy every time you go to the supermarket and that's it. and find the best versions of those, guaranteed to go in the right direction on your health. Yeah. What are some staples on the Dr. Darshan Shaw shopping list that you're always keeping your fridge and pantry stocked with? I mean, there's broccolis, peas. We have peppers. We actually buy a lot of whole fat milk, actually. We love lean cuts of meat, obviously, salmon, chicken, nuts. There's always, you know, we're buying nuts all the time. What else is there? We are big fans. Oh, olive oil, of course, you know, by buying the olive oil. Eggs, so many eggs. You know, there's no limit to the number of eggs that we put on ourselves at home. And that's pretty much it. Yeah, we keep it super simple. How much weight do you put on food sensitivity tests? Do you guys test for food sensitivities? I only use food sensitivity tests now if someone is exhibiting symptoms of food intolerances or inflammation, brain fog, anything where they're feeling tired, brain fog, etc. Food sensitivity testing is part of my kind of testing repertoire. But otherwise, I feel that food sensitivity testing is probably comes after cleaning up your diet. So let's clean up your diet first. was get a lot of the crap out of your diet so that when we do the food sensitivity test, we get better resolution about what you're having a reaction to. When you're eating a crappy diet and just shotgunning a food sensitivity test in there, it's just very confusing, you know? Yeah. Man, very empowering and helpful stuff. Thanks for coming out. Yeah. I know we've just like barely scratched the surface, but people should definitely check out the interview that I did with you. That was like one of my favorite interviews that I've done. Thank you, man. I love it. Yeah, we had a great conversation. On the Xtend podcast, you should search Max Lugavere on the Xtend. Yeah, it just came out a few weeks ago, I think. So it's amazing. Totally. Yeah. And we're like neighbors. I see you all the time here in LA. Definitely if you're in LA, you want to check out one of the more cutting edge healthcare facilities, Next Health. You've got how many now? We have 20 open and then we're probably going to open another 10 or 15 this year. So we're scaling pretty rapidly. All of the US, Canada, and we have one in Dubai at all as well. Wow. Amazing. Well, I've got one last question for you before we get to that. Where can people, how can they learn more about your practice? How can they connect with you on social media? Sure. So, you know, one piece of information I want to empower people with so they feel empowered is these biomarkers that I think everyone should test for themselves. And I don't care where you get them from. You can get them from us. You can get it from your doctor or get them yourself from a lab and get the scale, get the grip dynometer. I have a guide, drshah.com slash biomarkers, and you can download the PDF for free there. And then once you have it, you will take agency over your health again. That's step one. Then I have my podcast, Extend. I'm on social media, Darshan Shah MD. And if you go there, you can get even more information from me. And I'm always wandering around in Excel somewhere in the world. Amen. Love it. Well, the last question that gets us everywhere on the show, what does living a genius life mean to you? Living a genius life to me is creating the bandwidth in your life to feel that you have the time for the things that are important. That's really it. Love it. Very simple. Very simple. I'm still working on it. And so I will call myself a genius when I get that right. No, it's, well, it's simple. It's not always easy. And I think people, we conflate the two, you know, what is, what is simple is not always necessarily easy, but there's real value to be gained from, from, from doing just as you described. So thanks for coming out. Thanks for sharing your wisdom with us. Thank you, man. It's awesome. It's an honor. Of course, your own genius. Thank you guys for listening. Share this episode and sending love. I'll catch you on the next one. Peace. Hey guys, thanks so much for listening to this episode of the show. if you enjoyed it, hit subscribe and leave a rating and review. It really does help. And don't forget to grab my free weekly newsletter at maxlugavere.com slash newsletter for science-backed insights, expert interviews, and exclusive discounts. No spam, just good stuff. Catch you next time.