Medicine Redefined

Dr. Tanuja Sharma is a board-certified family and integrative medicine physician and the Medical Director of Integrative Medicine and Arts at Tampa General Hospital. She completed her integrative medicine fellowship through the Andrew Weil Center at the University of Arizona and is leading one of the most ambitious hospital wellness overhauls in the country — from redesigning the patient menu with a Michelin-rated chef to running evidence-based mindfulness, acupuncture, and music therapy programs at the bedside. TOPICS COVERED  •   Why Tampa General Hospital partnered with a celebrity chef to rebuild their patient menu from scratch •   Music therapy, massage, acupuncture, art therapy, reiki, and how TGH gets buy-in across a Level 1 trauma center •   98% patient improvement in pain and anxiety scores, preliminary opioid reduction data, and the research pipeline ahead •   Tampa Well's food pharmacy, community garden, and free produce programs targeting food insecurity •   MBSR and mindfulness programs: evidence-based stress reduction for staff and patients, and why experience is the best recruitment tool •   Fiber vs. protein: the deficiency most patients have, Blue Zones longevity foods, and how to counsel patients at different performance goals RESOURCES & LINKS MENTIONED •   Tampa General Hospital (https://www.tgh.org) •   TGH Integrative Medicine and Arts Program (https://www.tgh.org/services/integrative-medicine-and-arts) •   Tampa Well (TGH Community Wellness Initiative) (https://www.tgh.org/tampawell) •   Geoffrey Zakarian — Celebrity Chef (Iron Chef, Chopped) (https://www.geoffreyzakarian.com/about) •   Mediterranean Diet — Wikipedia (https://en.wikipedia.org/wiki/Mediterranean_diet) •   Anti-Inflammatory Diet — Hopkins Medicine (https://www.hopkinsmedicine.org/health/wellness-and-prevention/anti-inflammatory-diet) •   Mindfulness-Based Stress Reduction (MBSR) — Wikipedia (https://en.wikipedia.org/wiki/Mindfulness-based_stress_reduction) •   Andrew Weil Center for Integrative Medicine (U of Arizona) (https://integrativemedicine.arizona.edu) •   American College of Lifestyle Medicine (https://www.lifestylemedicine.org) •   Blue Zones — Wikipedia (https://en.wikipedia.org/wiki/Blue_zone) •   Sarcopenia — Wikipedia (https://en.wikipedia.org/wiki/Sarcopenia) •   Dietary Fiber — Wikipedia (https://en.wikipedia.org/wiki/Dietary_fiber) •   Food as Medicine — ASN (https://nutrition.org/food-as-medicine/) •   Refining Health & Performance — refininghealthrx.com (https://refininghealthrx.com) GUEST SOCIAL LINKS •   Instagram:@tjasharmamd (https://www.instagram.com/tanujasharmamd?igsh=cXprNW04bGt2Zzhr) •   TGH Provider Profile (https://www.getcare.tgh.org/providers/tanuja-sharma-1598133233) •   TGH Integrative Medicine (https://www.tgh.org/services/integrative-medicine-and-arts) Ready to stop guessing and start performing? Dr. Raja is now seeing patients through his telemedicine practice — limited founding member spots available at refininghealthrx.com

Dr. Altamash Raja and Dr. Darsh Shah sit down with Amy Morin, LCSW, to discuss how to turn pressure into strength, build resilience through small wins, and navigate burnout in today’s work culture. Morin gives us simple tools and a practical approach to manage anxiety, dread, and difficult situations. We talk about significance of self-awareness, focusing on what you can control, and how using actionable strategies like a “motivation buddy,” clearer communication, and adapting to others can help you perform better without burning out. TOPICS COVERED Genes upbringing stress Pandemic burnout cycle Grinding vs strength Busyness as numbing Showing up in grief Anxiety spills into work Dread anxiety rumination How to use 50 tools Motivation buddy hack Measuring mental strength Overrated vs underrated mental resilience hacks RESOURCES & LINKS MENTIONED 13 Things Mentally Strong People Don’t Do: https://amymorinlcsw.com/books/ Cognitive Behavioral Therapy (CBT) Overview: https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral The Happiness Curve (Arthur Brooks–related concepts): https://www.youtube.com/watch?v=G7Z0MyRsm9M Emotional Avoidance (Psychology Today): https://www.psychologytoday.com/us/blog/overcoming-destructive-anger/202603/the-harmful-consequences-of-emotional-avoidance Motivation Buddy/Accountability Importance: https://www.npr.org/2025/01/15/nx-s1-5217975/the-secret-to-doing-hard-things-and-getting-stuff-done Connect with Amy Morin: Website: https://amymorinlcsw.com/ Instagram: @amymorinauthor LinkedIn: https://www.linkedin.com/in/amymorinlcsw/ Ready to stop guessing and start performing? Dr. Raja is now seeing patients through his telemedicine practice—limited founding member spots available at refininghealthrx.com.

Darsh and Altamash unpack the first major ACC/AHA lipid update since 2018, now reframed as a dyslipidemia guideline expanding beyond LDL to include triglycerides, ApoB, and lipoprotein(a). They highlight earlier prevention, the new PREVENT risk calculator, return of numeric LDL and non-HDL targets, routine Lp(a) screening, stepwise therapy beyond statins, and greater use of CAC imaging. Using a “trucks and cargo” analogy, they clarify lipid markers, review therapies from statins to PCSK9 inhibitors and inclisiran, compare CTA vs CAC, and explain why most supplements show no benefit. TOPICS COVERED • What changed in the new cholesterol guidelines • Why earlier prevention matters for lifetime risk • New PREVENT calculator for estimating risk • Understanding LDL, ApoB, and “bad cholesterol” markers • Lipoprotein(a): the genetic cholesterol risk to check once • New LDL targets and when to treat more aggressively • Medication options beyond statins • When to use calcium score (CAC) scans • CTA vs CAC: which heart scan to choose • Do supplements actually help cholesterol? RESOURCES & LINKS MENTIONED ACC/AHA Dyslipidemia Guideline Update: https://www.acc.org/latest-in-cardiology/journal-scans/2026/03/13/15/20/acc-aha-release-new-clinical-guideline-for-managing-dyslipidemia PREVENT Risk Calculator: https://professional.heart.org/en/guidelines-and-statements/prevent-calculator Lipoprotein(a) [Lp(a)] Overview: https://www.heart.org/en/health-topics/cholesterol/genetic-conditions/lipoprotein-a Apolipoprotein B (ApoB) Explanation: https://en.wikipedia.org/wiki/Apolipoprotein_B Coronary Artery Calcium (CAC) Scan: https://www.mayoclinic.org/tests-procedures/heart-scan/about/pac-20384686 Coronary CT Angiography (CTA): https://www.mayoclinic.org/tests-procedures/ct-coronary-angiogram/about/pac-20385117 PCSK9 Inhibitors Overview: https://en.wikipedia.org/wiki/PCSK9 REDUCE-IT Trial (Icosapent Ethyl/Vascepa): https://www.brighamandwomens.org/campaigns/physicians/reduce-it-clinical-trial AHA Life’s Essential 8: https://www.heart.org/en/healthy-living/healthy-lifestyle/lifes-essential-8 SPORT Trial (supplements vs statin): https://www.jacc.org/doi/10.1016/j.jacc.2022.10.013 Connect with Us: Instagram: @draltraja, @doctordarsh LinkedIn: https://www.linkedin.com/in/altamash-raja-do-rmsk-cscs-0b1a8039/; https://www.linkedin.com/in/doctordarsh/ Ready to stop guessing and start performing? Dr. Raja is now seeing patients through his telemedicine practice—limited founding member spots available at refininghealthrx.com.

We welcome back sleep expert Jade Wu to discuss practical sleep strategies for high performers, especially around travel, naps, and sleep technology. Dr. Wu suggests we may be over-relying on technology for our sleep, making the case for simplicity when it comes to sleep scores, managing jet lag, and even mattresses. Jade Wu, PhD, DBSM, is a board-certified behavioral sleep medicine psychologist, founder of Thrive Sleep Clinic, and author of Hello Sleep: The Science and Art of Overcoming Insomnia Without Medications. She trained at Cornell, Boston University, and Duke University School of Medicine and specializes in helping high performers build a sustainable, resilient relationship with sleep without medications, gadgets, or rigid optimization. TOPICS COVERED Jet lag, circadian rhythms, and how light shapes your body clock Naps as a performance and recovery tool Sleep debt, sleep banking, and limits of “catching up” Wearables, sleep metrics, and avoiding score obsession Understanding fatigue vs true sleepiness and when to seek help The future of sleep tech while learning to trust your body RESOURCES & LINKS MENTIONED Book: Hello Sleep: The Science and Art of Overcoming Insomnia Without Medications by Jade Wu Clinic: Thrive Sleep Clinic — thrivesleepclinic.com Practice: Refining Health & Performance — refininghealthrx.com Concept: Acceptance and Commitment Therapy (ACT) (https://en.wikipedia.org/wiki/Acceptance_and_commitment_therapy) Concept: Cognitive Behavioral Therapy for Insomnia (CBT-I) (https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy_for_insomnia) Concept: Circadian Rhythm (https://en.wikipedia.org/wiki/Circadian_rhythm) Concept: Social Jet Lag (https://en.wikipedia.org/wiki/Social_jet_lag) Concept: Chronotypes (https://en.wikipedia.org/wiki/Chronotype) Concept: Adenosine & Sleep Pressure (https://en.wikipedia.org/wiki/Adenosine) Concept: REM Sleep (https://en.wikipedia.org/wiki/Rapid_eye_movement_sleep) Concept: Sleep Efficiency (https://en.wikipedia.org/wiki/Sleep_efficiency) Tool: Light Therapy (10,000 lux light boxes) (https://en.wikipedia.org/wiki/Light_therapy) Concept: Sleep Tracking & Wearables (https://en.wikipedia.org/wiki/Actigraphy Practice: Refining Health & Performance — refininghealthrx.com GUEST SOCIAL LINKS Website: drjadewu.com (https://www.drjadewu.com/) LinkedIn: linkedin.com/in/drjadewu (https://www.linkedin.com/in/drjadewu/) Clinic: thrivesleepclinic.com (https://www.thrivesleepclinic.com/) Ready to stop guessing and start performing? Dr. Raja is now seeing patients through his telemedicine practice—limited founding member spots available at refininghealthrx.com.

Behavioral sleep psychologist Dr. Jade Wu returns for round three to explain why sleep is the ultimate performance enhancer — not a cost to be paid. She breaks down sleep's role in physical repair, cognitive function, and emotional regulation, and shares why both neglecting sleep and over-optimizing it backfire. Practical strategies for high performers: daytime light exposure, strength training, sensory-based wind-downs, and treating sleep like a friend — not an engineering problem. Jade Wu, PhD, DBSM, is a board-certified behavioral sleep medicine psychologist, founder of Thrive Sleep Clinic, and author of Hello Sleep: The Science and Art of Overcoming Insomnia Without Medications. She trained at Cornell, Boston University, and Duke University School of Medicine, and specializes in helping high performers build a sustainable, resilient relationship with sleep — without medications, gadgets, or rigid optimization. TOPICS COVERED Why high performers wreck their sleep — neglect and over-optimization Sleep's three buckets: physical repair, memory consolidation, emotional regulation Daytime levers that beat nighttime hacks: light, strength training, intentional rest Chronotype, social jet lag, and finding your biological sleep window Seasons of life, values-based living, and the Five Senses wind-down Treat sleep like a friend — not an engineering problem or a resource to extract RESOURCES & LINKS MENTIONED Book: Hello Sleep: The Science and Art of Overcoming Insomnia Without Medications by Jade Wu, PhD Clinic: Thrive Sleep Clinic — thrivesleepclinic.com (https://www.thrivesleepclinic.com/) Concept: Acceptance and Commitment Therapy (ACT) (https://en.wikipedia.org/wiki/Acceptance_and_commitment_therapy) Concept: CBT for Insomnia (CBT-I) (https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy_for_insomnia) Concept: Non-Sleep Deep Rest (NSDR) (https://en.wikipedia.org/wiki/Yoga_nidra) Concept: Social Jet Lag (https://en.wikipedia.org/wiki/Social_jet_lag) Concept: Chronotypes (https://en.wikipedia.org/wiki/Chronotype) Concept: REM Sleep & Emotional Processing (https://en.wikipedia.org/wiki/Rapid_eye_movement_sleep) Concept: Growth Hormone & Deep Sleep (https://en.wikipedia.org/wiki/Growth_hormone) Concept: Circadian Rhythm (https://en.wikipedia.org/wiki/Circadian_rhythm) Practice: Refining Health & Performance — refininghealthrx.com GUEST SOCIAL LINKS Website: drjadewu.com (https://www.drjadewu.com/) LinkedIn: linkedin.com/in/drjadewu (https://www.linkedin.com/in/drjadewu/) Clinic: thrivesleepclinic.com (https://www.thrivesleepclinic.com/) Ready to stop guessing and start performing? Dr. Raja is now seeing patients through his telemedicine practice—limited founding member spots available at refininghealthrx.com.

Dr. Lauren Spivack is a board-certified OB-GYN, Menopause Society Certified Practitioner, and fellowship-trained minimally invasive gynecologic surgeon. She treats patients in South Jersey and through the evidence-based telehealth platform Alloy (https://www.myalloy.com/). In this episode, we break down the Women's Health Initiative, the FDA's 2025 removal of the black box warning from estrogen products, the newly named musculoskeletal syndrome of menopause, testosterone in women, and why the formulation you choose matters more than most providers realize. What We Discuss: 00:00 HRT Timing Window 00:25 Meet the Hosts 01:19 Dr Spivack Background 02:47 Pelvic Pain to Menopause 03:34 Menopause Care Gaps 09:19 Defining Menopause Stages 11:01 WHI Study Breakdown 19:37 Why Age Matters 21:59 Recognizing Symptoms 25:32 Musculoskeletal Links 27:57 Team Based Referrals 31:33 FDA Label Update 34:23 Bioidentical vs Compounded 36:51 Vaginal Estrogen GSM 39:43 Systemic Options and Risks 45:54 Dosing and Expectations 46:57 HRT Starting Doses 48:08 Progesterone Dosing Basics 48:53 Perimenopause and HRT 51:16 Breast Cancer Risk Talk 55:12 When HRT Is Not Right 58:39 Lifestyle and Sleep Focus 01:01:46 Progesterone Only Option 01:03:04 Testosterone for Women 01:07:13 Labs and Monitoring 01:11:56 HRT Hype and Telehealth 01:20:51 Overtreatment and Pellets 01:23:33 Fixing Menopause Care 01:26:25 Putting Health Back 01:28:43 Wrap Up and Disclaimer Studies & Literature Mentioned: WHI Original Trial: Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women (https://pubmed.ncbi.nlm.nih.gov/12117397/) (Rossouw et al., JAMA 2002) WHI 30-Year Review: The Women's Health Initiative Randomized Trials and Clinical Practice (https://pubmed.ncbi.nlm.nih.gov/38691368/) (Manson et al., JAMA 2024) Musculoskeletal Syndrome of Menopause: The Musculoskeletal Syndrome of Menopause (https://pubmed.ncbi.nlm.nih.gov/39077777/) (Wright et al., Climacteric 2024) FDA Announcement: HHS Removes Misleading FDA Warnings on Hormone Replacement Therapy (https://www.fda.gov/news-events/press-announcements/hhs-advances-womens-health-removes-misleading-fda-warnings-hormone-replacement-therapy) (November 10, 2025) HHS Fact Sheet: FDA Initiates Removal of Black Box Warnings from MHT Products (https://www.hhs.gov/press-room/fact-sheet-fda-initiates-removal-of-black-box-warnings-from-menopausal-hormone-replacement-therapy-products.html) Veozah (Fezolinetant): FDA Safety Communication on Liver Injury Risk (https://www.fda.gov/drugs/drug-safety-and-availability/fda-adds-warning-about-rare-occurrence-serious-liver-injury-use-veozah-fezolinetant-hot-flashes-due) Concepts & People: Dr. Vonda Wright (https://www.womensportsforummd.com/) — Orthopedic surgeon, lead author on the musculoskeletal syndrome of menopause paper Dr. Mary Claire Haver (https://thepauselife.com/) — OB-GYN, author of The New Menopause (NYT Bestseller) Dr. Lisa Mosconi (https://www.lisamosconi.com/) — Neuroscientist, Director of the Women's Brain Initiative at Weill Cornell, researching estrogen and Alzheimer's risk The Menopause Society (https://menopause.org/) — Professional organization and certified menopause provider directory Mark Cuban Cost Plus Drugs (https://www.costplusdrugs.com/) — Affordable medication option for uninsured patients Connect with Dr. Spivack: Alloy Profile: Dr. Lauren Spivack (https://www.myalloy.com/expert/lauren-spivack) Virtua/Rowan Medicine: Provider Profile (https://doctors.virtua.org/provider/lauren-spivack/2136705) LinkedIn: Lauren Spivack, MD (https://www.linkedin.com/in/lauren-spivack-937b8210/) Connect with Medicine Redefined: Website: medicineredefined.com Instagram: @medredefined (https://www.instagram.com/medredefined/) Twitter/X: @medredefined (https://x.com/medredefined) Newsletter: The Progress Note Work with Dr. Raja: Refining Health & Performance: refininghealthrx.com Dr. Raja's musculoskeletal and longevity practice (Telemedicine available in NJ, NY, PA, FL).

In this episode, Dr. Altamash Raja and Dr. Darsh Shah break down the newly released 2025–2030 U.S. Dietary Guidelines, explore new research on exercise variety and longevity, and discuss how rapid advances in artificial intelligence are reshaping healthcare, clinical workflows, and the future of medicine. From nutrition policy controversies to BMJ research insights and real-world AI tools saving physicians time, this conversation examines how policy, science, and technology intersect with everyday clinical practice and personal health decisions. What We Discuss: 00:27 Catching Up: Surgery Leave, Back to Work, and Practice Updates 01:21 AI Avatars & Social Media: When the Prompt Makes You Too Real 01:52 2025–2030 Dietary Guidelines: The Inverted Food Pyramid Explained 04:12 How the Guidelines Were Made: Rejected Report, Expedited Panels & Conflicts 07:38 What’s Good vs. Contradictory: Protein, Sugar, Saturated Fat, and the Visual Problem 09:51 Affordability & Access: SNAP/WIC, Schools, and the Real Cost of “Eat Healthy” 14:53 Practical Takeaways + Seasonal Fruit, Frozen vs Fresh, and Berry Prices 17:17 New BMJ Study: Does Exercise Type & Variety Matter More Than Zone 2 Hype? 22:17 Why Sports Win: Tennis, Zone Mixing, Coordination, and Training Variety 23:22 Study Caveats: Observational Data, Self-Report & Healthy User Bias 24:25 Actionable Takeaway: Diversify Your Training Portfolio (80/20) 25:07 Wearables Talk: WHOOP Metrics & Eight Sleep “Performance Zone” 26:23 DeepMind & The Road to AGI: ‘The Thinking Game’ + Protein Folding Breakthroughs 28:39 AI in the Hospital: Cerner/Oracle Note-Writing That Saves 40 Minutes a Day 30:27 Dictation Tools & Being Trained by Tech: WhisperFlow vs Dragon 31:35 Which LLM Is ‘Best’? Workflow Benchmarks, Hallucinations & Model Whiplash 34:14 Patients, Privacy & AI ‘Gaming’ the System in Rehab/Insurance 35:47 Productivity Addiction & Education: When AI Makes Us Do More, Not Less 38:46 AI Wars & Tesla’s Bet: Super Bowl Ads, FSD, Optimus Robots + Closing Thoughts Connect with Us: Instagram: @draltraja, @doctordarsh, LinkedIn: https://www.linkedin.com/in/altamash-raja-do-rmsk-cscs-0b1a8039/, https://www.linkedin.com/in/doctordarsh/ Studies & Literature Mentioned: 2025–2030 U.S. Dietary Guidelines for Americans (https://cdn.realfood.gov/DGA.pdf) Hans et al., BMJ Medicine (2026): Exercise Type, Variety, and Mortality Outcomes (https://pubmed.ncbi.nlm.nih.gov/41574252/) Podcasts & Videos Mentioned: The Thinking Game - DeepMind documentary: (https://www.youtube.com/watch?v=d95J8yzvjbQ) Want to personally work with Dr. Raja? Refining Health & Performance is opening a limited number of founding member spots for Dr. Raja’s telemedicine practice. We focus on healthspan, longevity, and performance using an data-driven, evidence-based, proactive approach. Apply at RefiningHealthRx.com.

Today, Dr. Priya Jaisinghani joins us to cut through the headlines. We move beyond the "cheating" narrative and explore the biology of obesity as a chronic disease. We discuss the phenomenon of "Food Noise"—the constant mental static about eating—and why silencing it is a matter of brain chemistry, not willpower. We get into the weeds of patient selection, explaining why BMI is a broken metric (especially for South Asian populations) and why being "skinny" doesn't mean you’re metabolically healthy. We also tackle the serious risks: the "muscle crisis" (sarcopenia), the dangers of unregulated compounding pharmacies, and what happens when you stop these drugs. What We Discuss: The "Food Noise" Phenomenon Patient Selection & The Broken BMI The Muscle Crisis: Quality vs. Quantity Safety, Side Effects & The Compounding Trap The Future of Metabolic Medicine Resources & Links: Connect with Dr. Jaisinghani: NYU Langone Profile: Dr. Priya Jaisinghani Instagram: @DrJ_NYU LinkedIn: Priya Jaisinghani, MD Studies & Literature Mentioned: SURPASS-3 MRI Sub-study: Reduction in Liver Fat and Muscle Fat with Tirzepatide SELECT Trial: Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (The "MACE" reduction data) FLOW Trial: Semaglutide in Patients with Type 2 Diabetes and Chronic Kidney Disease GRAMS Trial (Upcoming): GLP-1s and Musculoskeletal Outcomes Medscape Article: Do GLP-1s Have Deleterious Effects on Muscle? Podcasts & Videos Mentioned: Podcast: Drug Story by Thomas Goetz (Episode on GLP-1s) TEDx Talk: Dr. Melanie Jay: Weight Bias in Medicine Concepts & People: Dr. Gabrielle Lyon: Muscle-Centric Medicine Dr. Spencer Nadolski: Lipidologist & Obesity Physician Want to work with Dr. Raja? Refining Health & Performance is opening a limited number of founding member spots for the telemedicine practice. We focus on health span, longevity, and performance using a Medicine 3.0 approach. Apply at RefiningHealthRx.com. Guest Bio: Dr. Priya Jaisinghani is a triple-board certified physician in Internal Medicine, Endocrinology, and Obesity Medicine, and currently serves as a Clinical Assistant Professor at NYU Grossman School of Medicine. She completed her training at Weill Cornell and New York-Presbyterian Hospital before becoming a key architect at NYU Langone, where she helped build their official obesity clinical care pathway. Dr. Jaisinghani is a leading voice in the cardiometabolic space, specializing in the intersection of hormonal health and metabolic dysfunction. She is deeply passionate about treating obesity as a chronic, complex disease rather than a willpower failure. Beyond her clinical practice, she is a dedicated educator who has secured grant funding to develop tools that teach residents how to dismantle weight bias in the exam room. She serves as a vital bridge between endocrinology, bariatric surgery, and sports medicine to treat the whole patient.

In Part 1, we established that psychiatry often treats a metabolic crisis as a simple chemical imbalance. Today, Dr. Matt Bernstein returns to give us the solution. This episode is a masterclass on the ketogenic diet—not for weight loss, but as a critical medical intervention for serious mental illness. We explain why a "starving brain" (insulin resistance) leads to psychiatric symptoms and how ketones serve as a clean-burning alternative fuel that bypasses broken glucose pathways. We break down the specific clinical protocols used at Dr. Bernstein’s residential program, Accord, including the "therapeutic zone" for ketone levels, how to balance protein intake to prevent muscle loss without breaking ketosis, and the role of GLP-1 agonists (like Ozempic) as a temporary bridge to metabolic flexibility. What We Discuss: The "Starving Brain" Mechanism: Why neurons become insulin resistant and how ketones bypass this blockade to restore energy to the brain. The Therapeutic Zone: Dr. Bernstein’s specific targets for blood ketone levels (1.5 to 4.0 mmol/L) for bipolar and schizophrenia recovery, versus lower thresholds (0.5 mmol/L) for anxiety or ADHD. The Protein Paradox: How to eat enough protein to maintain muscle (1.2–1.6g/kg) without kicking yourself out of ketosis via gluconeogenesis. Exercise as Medicine: Why resistance training outperforms aerobic exercise for depression, and the shocking efficiency of High-Intensity Interval Training (HIIT) for metabolic health. The GLP-1 "Bridge": A fascinating strategy where Dr. Bernstein uses drugs like Ozempic temporarily to curb "food noise" and help patients transition into a ketogenic lifestyle before tapering off the drug. The Truth About Brain Scans: Why Dr. Bernstein believes SPECT scans (like those from Dr. Daniel Amen) are not yet clinically actionable for specific treatment protocols. Resources & Links: Connect with Dr. Bernstein: LinkedIn | Accord Mental Health Reference: Dr. Mike & Dr. Daniel Amen Debate (The Checkup Podcast) Reference: Nature Paper on HIIT Volume vs. Moderate Cardio (Discussed in context of Rhonda Patrick) Work with Dr. Bernstein: Accord Comprehensive Metabolic Psychiatry Work with Dr. Raja: Refining Health & Performance: Limited number of founding member spots for telemedicine practice. We focus on health span, longevity, and performance using a Medicine 3.0 approach. Apply at RefiningHealthRx.com. About the Guest: Dr. Matt Bernstein is the Chief Medical Officer at Ellenhorn and the creator of Accord’s Comprehensive Metabolic Psychiatry program.1 A graduate of Columbia University and the University of Pennsylvania School of Medicine, he trained at Mass General/McLean.2 With over 25 years of experience, he is a leading voice in moving psychiatry beyond symptom management toward full functional recovery through metabolic interventions.3+2

In this episode of Medicine Redefined, Dr. Altamash Raja and Dr. Darsh Shah sit down with psychiatrist Matt Bernstein, MD to question why mental health outcomes continue to worsen despite more medications and access to care. Matt introduces metabolic psychiatry, a framework that looks beyond symptoms and diagnoses to the underlying biology of the brain — including metabolism, insulin resistance, and energy function. He explains why treating neurotransmitters alone often falls short, and how lifestyle-based interventions can lead to deeper, more lasting recovery. They explore a new, human-centered approach to mental health that integrates nutrition, movement, circadian rhythm, and mind-body practices — challenging the way psychiatry is practiced today. 00:00 Introduction and Current State of Mental Health 01:20 The State of Psychiatry and Mental Health Outcomes 04:22 Understanding the DSM and Diagnostic Challenges 05:42 Introduction to Metabolic Psychiatry 06:31 Chemical Imbalance Theory vs. Metabolic Theory 17:27 The Role of Insulin Resistance in Mental Health 20:48 Assessing Metabolic Health in Psychiatry 25:37 Understanding Brain Energy and Mental Health 26:00 Insulin Resistance and Bipolar Depression 28:04 The Role of Fasting Insulin in Metabolic Health 28:43 Adverse Effects of Psychotropic Medications 30:20 Metabolic Health vs. Traditional Psychiatric Treatments 31:54 Innovative Approaches in Psychiatric Care 32:43 The Accord Program: A Comprehensive Metabolic Treatment 35:55 Challenges and Successes in Metabolic Interventions 46:10 Metabolic Dysfunction in Young Adults 50:04 Concluding Thoughts and Future Discussions Resources & Studies Mentioned Pillinger Study (Antidepressants): The effects of antidepressants on cardiometabolic and other physiological parameters (Pillinger et al., The Lancet 2025) Perry Study (Insulin & Psychosis): Longitudinal Trends in Childhood Insulin Levels and Risks of Psychosis (Perry et al., JAMA Psychiatry 2021) Book Mentioned: Brain Energy by Dr. Chris Palmer Testing Tool: Keto-Mojo (Glucose & Ketone Meter) Connect with Dr. Bernstein Residential Program: Accord MH (accord.health) Professional Bio: LinkedIn Profile Clinical Group: Ellenhorn Connect with Medicine Redefined Website: medicineredefined.com Instagram: @medredefined Twitter/X: @medredefined Newsletter: The Progress Note Work with Dr. Raja Refining Health & Performance: refininghealthrx.com Dr. Raja’s musculoskeletal and longevity practice (Telemedicine available in NJ, NY, PA, FL).

Darsh and Altamash break down why health outcomes are shaped by small, repeated choices (not occasional slip-ups). Using weight gain around the holidays as an example, they discuss how consistency and habit adherence matter more than intensity or “reset” culture. They explore how simplifying habits makes them easier to stick with, and why prioritizing maintenance during high-risk periods can prevent long-term health decline. A practical conversation on building health that actually lasts. On this episode… 04:30 – Holiday Survival and why maintenance matters 08:15 – Managing workouts at Disney World & South Korea. 13:00 – Nutrition Tips with protein treats and fasting 20:15 – James Clear’s Rule: "Reduce the scope, stick to the schedule." 28:00 – The Protein Debate 36:00 – The cost of going all in 39:30 – Why you need to decide in advance what you will fail at. 48:00 – Future guests, the newsletter returns, and what’s next! Resources mentioned… Protein Targets & Muscle Physiology The Helms Paper (Bodybuilders/Lean Mass): A systematic review of dietary protein during caloric restriction in resistance trained lean athletes (Helms et al., 2014) Protein for Adults: Optimizing Protein Intake in Adults (Wolfe, 2017) Supplements & Training: Meta-analysis of protein supplementation on resistance training gains (Morton et al., 2018) Anabolic Resistance: Skeletal muscle protein metabolism in the elderly (Breen & Phillips, 2011) Position Stand: ISSN Position Stand: Protein and Exercise (2017) Sleep & Circadian Protocols Morning Light: Phase advancing human circadian rhythms with morning bright light (Crowley & Eastman, 2015) Exercise Timing: Circadian rhythm phase shifts caused by timed exercise (Thomas et al., 2020) Jet Lag: Physical exercise accelerates reentrainment of human sleep-wake cycles (Yamanaka et al., 2010) Sleep Tools: Eight Sleep System | 15% off Remade Sleep Supplement: https://getremade.com/?ref=doctor.darsh Habits, Identity & Mindset James Clear: Atomic Habits ("Reduce the scope, stick to the schedule") Jonathan Haidt: Conversations with Tyler (Transcript regarding "The Anxious Generation") Oliver Burkeman: Four Thousand Weeks Intermittent Fasting: Intermittent fasting strategies and effects on cardiometabolic risk factors (BMJ, 2024) Connect with Us! Website: medicineredefined.com Follow: @doctor.darsh | @dr.altraja Altamash’s New Practice: Refining Health & Performance (Now accepting patients in NJ, NY, PA, FL)

Join Dr. Altamash Raja and Dr. Darsh Shah on Medicine Redefined as they introduce Dr. Darren Candow, a leading researcher on creatine supplementation. The episode dives into the benefits of creatine, not just for muscle performance, but also for brain health, bone density, and cardiovascular health. Addressing myths and misconceptions, the conversation highlights creatine's potential role in cognitive function, aging, cancer prevention, and post-concussion recovery. Brain Health, TBI & Sleep Deprivation The "Germany Study" on Sleep Deprivation (30g Dose): Reference: Gordji-Nejad, A., et al. (2024). Single dose creatine improves cognitive performance and induces changes in cerebral high energy phosphates during sleep deprivation. Scientific Reports. Brain Creatine in Vegans vs. Omnivores (The "Brazil Study"): Reference: Solis, M. Y., et al. (2013). Brain creatine depletion in vegetarians? A cross-sectional 1H-magnetic resonance spectroscopy (1H-MRS) study. British Journal of Nutrition. Creatine for TBI in Children: Reference: Sakellaris, G., et al. (2006). Prevention of traumatic headache, dizziness and fatigue with creatine administration. A pilot study. Acta Paediatrica. Creatine for Depression (The "Utah Studies"): Reference: Kondo, D. G., et al. (2011). Open-label adjunctive creatine for female adolescents with SSRI-resistant major depressive disorder. Journal of Clinical Psychiatry. Reference: Roitman, S., et al. (2007). Creatine monohydrate in resistant depression: a preliminary study. Bipolar Disorders. Bone Health, Aging & Long COVID Creatine for Long COVID: Reference: Slankamenac, J., Ostojic, S. M., et al. (2023). Creatine supplementation combined with breathing exercises reduces respiratory discomfort and improves creatine status in patients with long-COVID. Journal of Postgraduate Medicine. Creatine & Bone Health (Post-Menopausal Females): Reference: Chilibeck, P. D., Candow, D. G., et al. (2015). Effects of creatine and resistance training on bone health in postmenopausal women. Medicine & Science in Sports & Exercise. Alzheimer’s Disease (The 2024 Study): Reference: Fairman, C. M., et al. (2024). Eight weeks of creatine monohydrate supplementation is associated with increased muscle strength and size in Alzheimer's disease. Frontiers in Aging Neuroscience. (Note: This is likely the "groundbreaker" he mentioned from this year). Bioavailability & Dosing The Original "Big Paper" (1992): Reference: Harris, R. C., et al. (1992). Elevation of creatine in resting and exercised muscle of normal subjects by creatine supplementation. Clinical Science. Meat vs. Solution vs. Candy (Gummies): Reference: Harris, R. C., et al. (2002). Absorption of creatine supplied as a drink, in meat or in solid form. Journal of Sports Sciences. Note: This is the study confirming that creatine in solid forms (like gummies/candy) is bioavailable. Caffeine Interference (The "350mg" Threshold): Reference: Vandenberghe, K., et al. (1996). Caffeine counteracts the ergogenic action of muscle creatine loading. Journal of Applied Physiology. Reference: Trexler, E. T., & Smith-Ryan, A. E. (2015). Creatine and Caffeine: A Brief Review of Concurrent Use. ACSM's Health & Fitness Journal. People Mentioned Dr. Sergej Ostojic: Leading researcher on creatine for Long COVID and clinical applications (University of Novi Sad). Dr. Scott Forbes: Frequent collaborator with Dr. Candow on brain and bone health. Dr. Chad Kerksick & Dr. Andrew Jagim: Cited for their reviews on creatine safety in children.

Join Dr. Altamash Raja and Dr. Darsh Shah in a comprehensive discussion with Dr. Allison Grimaldi on femoral acetabular impingement (FAI) and hip health. This episode of Medicine Redefined dives into part two of the hip-focused conversation. Dr. Grimaldi provides a deep dive into FAI, discussing types of impingement, symptoms, and the importance of accurate diagnosis and individualized treatment. The conversation also touches on advances in hip arthroscopy, metabolic health, and the role of systemic inflammation in joint conditions. Tune in for valuable insights into hip pathology, patient care, and the future of hip health. 00:00 Introduction and Exciting Update 00:40 Recap of Part One and Introduction to FAI 01:04 Understanding Femoral Acetabular Impingement (FAI) 03:49 Imaging and Diagnosis of FAI 07:53 Development and Risk Factors of FAI 12:05 Weightlifting and FAI in Adolescents 16:07 Surgical Interventions and Outcomes 24:53 Non-Surgical Management and Rehabilitation 29:48 Post-Surgery Expectations and Long-Term Management 41:15 Micro Instability and Dysplasia 45:02 Understanding Hip Dysplasia and Instability 46:44 Clinical Tests and Imaging for Hip Dysplasia 49:29 Rehabilitation Approaches for Hip Instability 53:47 Exercises for Deep Muscle Recruitment 01:02:23 Metabolic Health and Tendon Pathology 01:09:41 Considerations for Aging Athletes 01:14:18 Future of Hip and Pelvic Pain Care 01:19:51 Shifts in Understanding Hip Impingement 01:22:28 Final Thoughts and Advice for Practitioners Resources & citations 2016 Warwick Agreement on FAIS (consensus statement).  UK FASHIoN RCT: arthroscopy vs physio for FAIS (BMJ 2019).  Australian FASHIoN trial: cartilage imaging & outcomes (BMC 2021).  Hip microinstability: international consensus diagnostic criteria.  Post-arthroscopy effusion/synovitis and outcomes: overview blog + PubMed.  Modern Hip Arthroscopy for FAIS May Delay the Natural History of Osteoarthritis in 25% of Patients: A 12-Year Follow-up Analysis. - PubMed Connect with Dr. Grimaldi Website: dralisongrimaldi.com.  Hip Academy: Program & membership.  Instagram: @dralisongrimaldi.  X (Twitter): @alisongrimaldi.

Join hosts Darsh and Altamash as they sit down with Dr. Allison Grimaldi to dive deep into the complexities of hip pain and the latest research in the field. In this episode, Dr. Grimaldi sheds light on the challenges of diagnosing and treating hip issues, the anatomy of the hip joint, and the critical role of gluteal tendinopathy.  Learn how significant lifestyle changes and thorough education can alleviate symptoms more effectively than traditional corticosteroid treatments. Don't miss this enlightening discussion aimed at both clinicians and patients who are eager to better understand their bodies. TIME STAMPS 00:00 Introduction to Postpartum Health Challenges 00:27 Welcome to Medicine Redefined 01:05 Exciting Update: New Practice Launch 01:34 Introducing Dr. Allison Grimaldi 01:46 Why Focus on the Hip? 06:18 Understanding Hip Anatomy 08:44 Lateral Hip Pain and Its Complexities 22:55 Diagnosing Gluteal Tendinopathy 27:16 Identifying Hip Pain: Key Questions and Symptoms 27:52 Differentiating Gluteal Tendinopathy from Other Conditions 29:19 Common Presentations and Misdiagnoses 31:14 Effective Sleep Positions for Hip Pain Relief 36:07 Diagnostic Tests for Gluteal Tendinopathy 39:31 Insights from the LEAP Study 44:16 Balancing Short-term Relief and Long-term Solutions 46:11 The Role of PRP in Treatment 50:13 Concluding Thoughts and Next Steps SOURCES LEAP Trial: https://www.bmj.com/content/361/bmj.k1662 Gluteal Masterclass: https://pubmed.ncbi.nlm.nih.gov/39854929/

Ever felt like your insurance company is gaslighting you? Dr. Altamash Raja shares a real story that turned a routine billing error into a masterclass on how to actually navigate health insurance. From copays and deductibles to hidden tiers and the fine print that drains your wallet - this Progress Note breaks it all down. Join hosts Dr. Darsh Shah and Dr. Altamash Raja as they cut through the noise, explain the system in plain English, and arm you with the knowledge to advocate for yourself next time your claim gets “lost”. TIMESTAMPS 00:36 Insurance Negotiations Frustrations 06:33 Understanding Health Insurance Terms 17:26 Navigating Insurance Plans and Benefits 23:56 Navigating Insurance Verification 25:52 The Business Side of Healthcare 26:37 Challenges in Inpatient Rehab 28:41 Understanding Healthcare Metrics 31:59 Emergency Visits and Insurance 34:10 Planning for Medical Emergencies 37:14 Insurance Tiers Explained 40:01 Practical Tips for Managing Insurance 46:20 Final Thoughts and Recap 48:10 Outro and Disclaimer SOURCES [00:06:00] — Premiums, Deductibles, Coinsurance & Copays Explained – Aetna [00:17:00] — HMO vs. PPO: Which Is Right for You? – Humana [00:34:00] — What Is a “Surprise Medical Bill” and What Should I Know About the No Surprises Act? – Consumer Financial Protection Bureau [00:34:00] — No Surprises Act: Balance Billing Rules for Emergency and Air Ambulance Services – Centers for Medicare & Medicaid Services [00:40:00] — Navigating the Insurance Appeals Process –Patient Advocate Foundation

Dr. Darsh Shah and Dr. Altamash Raja sit down with Dr. Nisha Chellam to explore her journey from traditional internal medicine to functional medicine. Together, they discuss the “revolving door” of chronic disease, why she stopped attending supplement-driven conferences, and how she blends evidence-based care with lifestyle change. Dr. Chellam shares how she helps patients uncover the true root causes of illness and reclaim ownership of their health. SOURCES: 00:10:00 — Discovering Functional Medicine Institute for Functional Medicine: What Is Functional Medicine? 00:18:00 — Root Cause Medicine Explained Cleveland Clinic: Functional Medicine Approach 00:34:00 — Functional vs. Lifestyle Medicine American College of Lifestyle Medicine: What Is Lifestyle Medicine? 00:58:00 — Functional Labs and Data-Driven Care PubMed: The Value of Advanced Biomarkers in Functional Medicine 01:06:00 — Metabolic Health and Insulin Resistance American Heart Association: Understanding Insulin Resistance 01:15:00 — Redefining What “Good Medicine” Means BMJ: Rethinking Medicine — The Movement to Redefine Care Contact Dr. Chellam: Linkedin | Nisha Chellam Instagram, YouTube, X | @holisticicon Find Us Here: Instagram, Threads, X, TikTok | @medredefined Thank you for listening! Let us know what you think!

Darsh and Altamash talk to Dr. Leah Houston, an emergency medicine physician turned healthcare entrepreneur, for insights on the broken physician credentialing system and how technology could restore autonomy to doctors.TIMESTAMPS:00:01:00 – Evercred (decentralized physician credentialing platform) evercred.com00:04:00 – Centers for Medicare & Medicaid Services (CMS) oig.hhs.gov00:05:00 – Relative Value Unit (RVU) definition en.wikipediaorg00:12:00 – The Joint Commission (healthcare accreditation body) 00:14:00 – National Provider Identifier (NPI) en.wikipedia.org00:19:00 – Interstate Medical Licensure Compact (IMLC) imlcc.com00:28:00 – Decentralized Identity (DID) in healthcare healthdatamanagement.com00:29:00 – Direct Primary Care (DPC) payment model https://www.healthinsurance.org/glossary/direct-primary-care/00:39:00 – Blockchain (distributed ledger technology) explained techtarget.comThank you for listening!

Darsh and Altamash are back, trading thoughts on what’s been capturing their attention lately - from the tech tools boosting daily efficiency to the appeal of living more “pro-analog.” They dive into the hype and science behind ketones, unpack how GLP-1s are reshaping the way we think about food and cravings, and share insights on what it really means to find preventive, proactive healthcare today. It’s a thoughtful but approachable conversation, blending current events, health trends, and practical takeaways. TIMESTAMPS 00:00 Introduction to Medicine Redefined 00:33 Current Events and Political Landscape 02:10 Random Show Concept and Personal Updates 02:44 Writing and Creative Outlets 06:48 Tech Tools and Apps for Efficiency 10:32 Medical Innovations: Vagus Nerve and Hydrodissection 19:48 Breathwork and Meditation Techniques 23:49 Exploring Exogenous Ketones 28:31 Understanding Brain Health and Mood Disorders 29:31 Exploring Ketone Supplements 30:52 Nootropics and Cognitive Enhancers 32:48 The Future of Social Connection 40:44 The Concept of Misogi and Mental Fortitude 42:34 GLP-1 and Obesity Treatment 49:36 Navigating Healthcare and Finding the Right Provider SOURCES 05:12 | How and Why To Try Alternate Nostril Breathing (Cleveland Clinic) 08:47 | Buteyko vs Soma Breathing: Origins, Benefits and Differences (Buteyko Clinic International) 14:33 | OU Researchers Explore Vagus Nerve Stimulation for Multiple Conditions (University of Oklahoma) 19:55 | Exogenous Ketones: Do They Work, and Are They Safe? (Medical News Today) 24:18 | Ozempic Quiets Food Noise in the Brain — But How? (Scientific American) 27:42 | “Food Noise”: Do Weight Loss Drugs Stop It? (Health.com) 33:11 | How to Find a Medicine 3.0 Doctor like Dr. Peter Attia (Vitality / AWI Longevity Clinic) 37:40 | Embracing an Analog Lifestyle: Opt Out of Overwhelm (The Tiny Life) 41:05 | “The ‘Boring Phone’ – Gen Z Ditch Smartphones for Dumbphones” (The Guardian) 45:22 | Alfred – Productivity App for macOS (Official Site) 47:36 | OpenAI Whisper (Speech Recognition AI)

Darsh and Altamash dive into Netflix’s Fit for TV and the wild story behind The Biggest Loser. From shocking weight loss tactics to the billion-dollar business of reality TV, tune in as they break down the science of obesity, GLP-1s, and the dark side of weight-loss entertainment. Sources:  00:01 | Fit for TV (Netflix doc) 01:30 | The Biggest Loser (NBC show) 02:50 | Jillian Michaels (trainer) 03:45 | Bob Harper (trainer) 04:15 | GLP-1 drugs (Ozempic/Wegovy) 05:20 | Calories In/Out model 14:20 | Dr. Robert Huizenga 15:20 | Motivational interviewing 15:30 | Metabolic ward studies 25:20 | NYT: After The Biggest Loser 25:25 | Kevin Hall (NIH) 26:00 | Hall et al. 2016 (Obesity) 27:10 | Yo-yo dieting 27:30 | Leptin hormone 30:50 | Alan Aragon (nutritionist) 32:00 | Set point theory 32:45 | Stephan Guyenet (author) 33:20 | Sarcopenia 35:00 | Temptation challenges 35:10 | Big Brother (reality show) 35:15 | Survivor (reality show) 38:50 | Dr. Mike Varshavski 39:05 | Dr. Mike Israetel 39:10 | Aesthetic Revolution (concept/book) Thanks for listening!

Dr. Darsh Shah and Dr. Altamash Raja continue their conversation with Dr. Shawn Arent on hormone physiology and performance. They dive into female physiology and menstrual cycle myths, the overlooked role of thyroid and reverse T3, catecholamines and autonomic balance, and the future of performance enhancement with GLP-1s and muscle-preserving drugs. A practical, evidence-based look at optimizing health and performance!TIMESTAMPS00:00 Introduction to Medicine Redefined00:37 Deep Dive into Hormone Physiology00:54 Female Physiology and Menstrual Cycle01:03 Thyroid Hormone Optimization01:12 Catecholamines and Autonomic Balance01:23 GLP-1 Agonists and Muscle Preservation01:58 Guest Introduction: Dr. Shawn Arent02:21 Discussion on Female Physiology02:29 Menstrual Cycle and Training07:28 Hormonal Influence on Injury07:50 Autoregulation in Training19:03 Thyroid Hormone and Metabolism33:55 Catecholamines and Training Response40:55 Sympathetic vs. Parasympathetic Dominance45:30 Tracking Trends for Better Interventions45:53 Wearables and Recovery in Rugby46:55 Debunking Post-Workout Downregulation50:52 Contextualizing Fitness Advice57:06 Balancing Training Methods01:04:30 The Role of IGF-1 in Recovery01:07:02 GLP-1 Agonists and Muscle Preservation01:15:22 Myostatin Inhibitors: The Future of Muscle Growth?01:21:25 Final Thoughts on Health and PerformanceThe Impact of Menstrual Cycle Phase on Athletes’ Performance: A Narrative Review MDPICurrent evidence shows no influence of women’s menstrual cycle phase on acute strength performance or adaptations to resistance exercise training FrontiersThe Effects of Menstrual Cycle Phase on Exercise Performance in Eumenorrheic Women: A Systematic Review and Meta-Analysis SpringerInfluence of Menstrual Cycle Phases on Maximal Strength, Power and High-Intensity Interval Performance – A Systematic Review with Meta-Analysis MDPIEvidence-Based Training Guidelines for Elite Women Football and Team Sports Human KineticsHormones, Hypertrophy, and Hype: An Evidence-Guided Primer on Endogenous Endocrine Influences on Exercise-Induced Muscle Hypertrophy ESSRMenstrual Cycle Effects on Sports Performance and Adaptations to Training: A Historical Perspective PubMedEffect of Estrogen on Musculoskeletal Performance and Injury Risk FrontiersAnterior Cruciate Ligament Injuries in Female Athletes: A Narrative Review of Prevention, Risk Factors, and Management Bone Jt OpenThe Influence of Age on the Effectiveness of Neuromuscular Training to Reduce ACL Injury in Female Athletes: A Meta-Analysis PMCCatecholamine and Cardiovascular Responses to Exercise: An Update SpringerEffects of Different Training Interventions on Heart Rate Variability in People with Overweight and Obesity: A Systematic Review FrontiersBlood-Based Biomarkers for Monitoring Workload and Recovery in Athletes Sports Med OpenChanges in Lean Body Mass with the Use of Glucagon-Like Peptide-1 Receptor Agonists for Weight Loss and Strategies to Mitigate LBM Loss WileyADA Newsroom: GLP-1 Agonists and Lean Body Mass ADA NewsEffects of Subjective and Objective Autoregulation Methods in Resistance Training: A Systematic Review PeerJBiomarkers in Sports and Exercise: Tracking Health, Performance, and Recovery in Athletes SpringerExercise, Training, and the HPT/HPA/HPG Axes in Athletes CSMRCirculating Testosterone as the Hormonal Basis of Sex Differences in Athletic Performance PMCOptimizing Health and Athletic Performance for Women SpringerThank you for listening!

We are back with a powerhouse guest, Dr. Shawn Arent, for part 1 of a series on hormone optimization. From cortisol misconceptions to insulin fearmongering, they cut through the noise with science-backed insight into performance, recovery, and stress physiology. You’ll rethink everything you’ve seen on social media about hormones.TIMESTAMPS00:00 Introduction to Medicine Redefined00:36 Welcoming Dr. Sean Arent02:11 The Importance of Cortisol02:49 Understanding Cortisol's Role in Performance04:59 Chronic Cortisol and Overtraining13:51 Monitoring Stress and Performance22:30 The Role of Nutrition in Cortisol Management33:31 Insulin: The Anabolic Hormone39:27 Exercise and Insulin Sensitivity40:43 Impact of Stress and Sleep on Glucose Levels43:02 Continuous Glucose Monitors: Pros and Cons47:42 Athlete Nutrition and Performance55:52 Hormonal Responses to Training01:07:18 Sex Hormones and Athletic Performance01:17:37 Conclusion and Future TopicsSOURCES00:00:22 | Cortisol deficiency (Addison’s disease) is life-threatening00:04:42 | Cortisol peaks in early morning (chronobiology) 00:05:25 | Acute sleep deprivation significantly increases cortisol 00:05:42 | One week of 5h/night sleep restriction lowers testosterone by \~10–15% 00:22:11 | Cortisol stimulates gluconeogenesis (maintains blood glucose upon waking) 00:27:38 | No single reliable biomarker for overtraining syndrome 00:27:38 | Overtrained athletes show blunted HR, blood lactate and cortisol responses 00:29:00 | Prolactin rises in response to stress/exercise 00:30:00 | Dietary fat guidelines: 20–35% of calories from fat 00:33:30 | Insulin is an anabolic hormone promoting nutrient storage 00:33:30 | Low-fat (∼20% fat) diets reduce testosterone 10–15% vs high-fat diets 00:39:26 | Regular exercise improves insulin sensitivity 00:39:26 | ~38% (~98M) of U.S. adults have prediabetes 00:40:29 | Shorter sleep duration impairs insulin sensitivity 00:01:02:57 | Exercise above the lactate threshold elicits maximal GH release01:04:42 | Resting lactate \~1–2 mmol/L; intense exercise >20 mmol/L 01:08:53 | Higher testosterone levels correlate with greater lean mass in men 01:11:51 | Winners in competition show post-event testosterone spikes 01:12:29 | Female athlete amenorrhea leads to low bone density and stress fractures01:12:29 | Amenorrheic female athletes have lower IGF-1 (growth factor) 01:08:53 | Testosterone even within normal range affects strength/mass

In this episode of Medicine Redefined, Darsh and Altamash dive deep into the question on every future and current physician’s mind: is medicine still worth it? What starts as a reflection on the financial and emotional toll of the profession quickly evolves into a powerful conversation about agency, reinvention, and longevity in medicine. With honesty and humor, they unpack their own journeys from burnout to building lives and careers on their own terms, sharing hard-earned insights and tactical frameworks for thriving in a changing healthcare landscape.If you’ve ever felt disillusioned about your path in medicine or wondered how to break free from the constraints of the job, this episode will challenge and inspire you to rethink what’s possible.TIMESTAMPS00:00 Introduction to Medicine Redefined00:54 Is Medicine Still Worth It?02:24 Challenges in Modern Medicine05:20 Financial Realities of Medical Education10:46 Diversifying Medical Careers17:40 The Importance of Diverse Experiences22:20 Generational Shifts in Medical Practice22:55 The Importance of Professional Diversification23:21 Shared Decision Making with Patients23:48 Challenging the Culture of Self-Destruction24:15 Advice for Aspiring Neurosurgeons24:32 Balancing Interests and Professional Growth25:54 The Business of Medicine27:59 Frameworks for Medical Students29:33 Reframing Medical Careers33:49 Setting Prices in Direct Pay Practice41:18 Final Thoughts and Parting WordsSOURCES| [00:06:45] | One Big Beautiful Bill Act (H.R.1, 119th Congress) – A 2025 budget reconciliation bill passed by the House and signed into law, containing sweeping tax and spending changes (health, taxes, etc.) | [00:06:51] | Medicaid coverage cuts – CBO estimated the reconciliation bill would reduce Medicaid enrollment by on the order of 10–12 million people | [00:06:53] | Fiscal impact of the bill – Analyses (e.g. by the CRFB) show the bill adds roughly $3.4 trillion to the deficit (≈$4.1 trillion including interest) | [00:07:30] | Student loan policy changes – H.R.1 eliminates Grad PLUS loans (effective July 1, 2026) and caps borrowing for medical/law students at $50,000/year ($200,000 total) | [00:07:45] | AAMC medical school cost data – The AAMC reports median 4‑year cost of attendance for public med schools ~$286K (2025 cohort, i.e. ~$71–73K/year including living) | [00:08:04] | AAMC medical school debt – AAMC data show the median debt at graduation for MD grads is about $205,000 | [00:09:39] | Primary care physician trend – Reports indicate many U.S. med students are “turning away from primary care in favor of more lucrative specialties”, leading to projected shortages. | [00:09:39] | Primary care shortage (projected) | [00:09:39] | Overall physician shortage – AAMC projects an all‑specialty physician shortage up to ~86,000 doctors by 2036 | [00:09:49] | Healthcare spending share (physicians) – U.S. health expenditure data: hospitals ~31% and physicians/clinics ~20% of total spending in 2023 (so physician pay is a fraction of total cost) | [00:10:00] | Private equity in healthcare – Deal activity surged in 2024 | [00:10:05] | PE healthcare deals (2024) – A recent analysis counted ~1,069 private‑equity healthcare deals in the U.S. in 2024. | [00:17:15] | Peter Attia – Physician who left surgical residency[00:21:09] | Emphasizing diversity of thought and experience in healthcare teams can broaden insight and drive innovation[00:21:34] | The notion of a physician “martyr complex” [00:32:20] | Nearly 39% of U.S. doctors now have side “gigs” [00:33:23] | A 2023 randomized trial (knee bursitis) found local corticosteroid injections relieved pain significantly more than extracorporeal shockwave therapy (ESWT)[00:34:16] | Concierge medicine and Direct Primary Care (DPC) are growing trends[00:39:58] | Patients paying concierge/DPC fees gain perks (shorter wait times, direct doctor access)

In this episode of Medicine Redefined, Dr. Darsh and Dr. Altamash sit down with Dr. Vince Marchese, sports medicine physician and founder of Apex Medicine, to explore how transparency and direct pay models are transforming healthcare. We break down why traditional insurance creates confusion and barriers, how clear pricing empowers patients, and what happens when physicians reclaim time to focus on care - not paperwork.TIMESTAMPS00:00 Introduction to Medicine Redefined00:35 Meet Dr. Vince Marchese01:13 Journey to Sports Medicine01:37 Breaking Away from Insurance02:06 Life as a Direct Pay Practitioner09:33 Understanding Insurance Complexities10:27 The History of Insurance11:56 Navigating the Insurance Maze15:37 The Case for Direct Pay17:31 Empowering Patients with Knowledge41:39 The Insurance Dilemma42:00 State Mandates and Penalties42:58 Self-Insurance and Cost-Saving Strategies44:40 Catastrophic Insurance and HSAs52:04 The Benefits of Direct Pay Models55:02 Building a Patient-Centric Practice01:04:31 Scaling and Future of Direct Pay Medicine01:11:44 Support Systems and Taking the Leap01:16:03 Closing Thoughts and ResourcesSOURCESHealthcare Spending & Insurance Costs[00:16:01] “51 cents of every healthcare dollar goes to insurance” – In fact, CMS and KFF data show [1, 2] private insurers cover ~30% of U.S. health spending, and federal/state programs ~51%. Administrative overhead is only about 7.4% of spending [1]. [00:10:00] Average premium costs – Kaiser Family Foundation reports that in 2024 the average annual employer health insurance premium is ~$8,951 for single coverage and ~$25,572 for family coverage [4], illustrating why monthly premiums can seem “crazy high.”Policy & Regulations[00:31:54] Balance billing protections (No Surprises Act) – Effective Jan 1, 2022, federal law bans surprise/“balance” bills for most emergency and certain other out-of-network services [5, 6]. For example, CFPB explains that patients generally will no longer face balance bills for emergency care [5, 6] under the No Surprises Act.Health Savings Accounts (HSAs)[00:43:30] Triple tax advantage of HSAs – HSAs are truly tax-advantaged. According to IRS rules and financial guides, HSA contributions are tax-deductible, earnings grow tax-free, and qualified withdrawals are tax-free [7, 8]. Bank of America and IRS publications both highlight this “triple-tax” benefit.[00:44:17] HSA contribution limits – For 2024, IRS rules allow $4,150 annual HSA contributions for self-only HDHP coverage and $8,300 for family coverage [7] (The podcast guest’s “~$4,000” estimate for solo coverage aligns with the $4,150 limit for 2024 [7]).Price Transparency & Cash Payments[00:21:30] MRI cash prices – Pricing guides show that uninsured (cash) MRI costs vary widely. For example, a 2025 SingleCare review finds a national average MRI cost of ~$1,325 (range ~$400–$12,000) without insurance [9]. A cash-pay platform (MDsave) reports a $1,335 average for an MRI, with their cash price as low as ~$805 [10]. These sources confirm that self-pay MRI prices can be far below billed/insurance prices.[00:21:30] Cash vs. negotiated prices – Studies show many hospitals set their cash (self-pay) rates lower than insurer-negotiated rates. For example, one analysis found 60% of insurer-negotiated hospital rates exceed the hospital’s cash price for the same service [11], and a JAMA-published study reports that cash prices are often below the commercial prices insurers pay [12]. In short, paying cash (or high-deductible plans) can sometimes cost less than the “discounted” insurance rate.Referenced Book[00:21:24] The Price We Pay – Dr. Marty Makary

In this episode of Medicine Redefined, Darsh and Altamash sit down with Dr. Patrick “Rocky” Sullivan, an emergency physician turned ketamine therapy pioneer, to explore how this powerful molecule is quietly transforming mental health care. Drawing from years of ER experience and clinical innovation, Dr. Sullivan breaks down the science, stigma, and promise behind ketamine treatment for depression, PTSD, addiction, and chronic pain.We unpack the nuances of off-label prescribing, why most depression treatments miss the mark, and how ketamine-assisted psychotherapy (KAP) is helping patients rewire trauma in real time.If you’ve ever wondered how ketamine really works, who it's for (and who it’s not), or what a responsible treatment plan should look like, this conversation will change your perspective. It's an eye-opening look into the future of mental health care.TIMESTAMPS00:00 Introduction to Medicine Redefined00:36 Meet Dr. Patrick Sullivan01:46 The Evolution of Ketamine Therapy03:18 Rocky's Journey into Psychiatry07:57 Understanding Ketamine's Mechanism08:49 Off-Label Uses and Research11:12 Ketamine in Emergency and Pain Management14:14 The Importance of Set and Setting15:29 From Anesthetic to Antidepressant17:15 Mainstream Depression Treatments23:02 Navigating Treatment Options26:45 Screening and Safety Protocols37:29 Ketamine Assisted Psychotherapy41:42 Telehealth and Ketamine Delivery42:16 The Importance of Provider Interaction43:11 Case Studies: Depression and OCD43:55 Case Studies: Pain and Trauma44:24 Case Studies: Alcohol Use Disorder46:12 The Role of Therapy in Ketamine Treatment47:54 Ketamine's Mechanism and Benefits52:09 Maintenance and Dosage Variability01:05:13 Challenges in Ketamine Research and Regulation01:16:14 Conclusion and Contact InformationSOURCES04:13: Ketamine suicidal ideation meta-analysis; Ketamine depression meta-analysis05:09: What is ketamine?06:01: History of ketamine07:36: Off-label prescriptions07:44: Research referenced on alcoholism and ketamine:1997 study1998 study2001 study2018 study07:44: 2000 study done on depression and ketamine07:44: 2006 study repeated09:30: Ketamine dose-dependent responses10:13: Ketamine on respiratory drive10:58: Ketamine for asthma13:47: Psychedelic therapy15:21: Treatment-resistant depression16:18: SSRIs and other antidepressant drugs17:36: ECT and Ketamine therapy studies:Study 1Study 2Study 3 (70% statistic)18:48: TMS18:48: Spravato study18:48: IV Infusion ketamine study22:19: Treatment resistance depression prevalance25:20: Mathew Perry story28:05: Studies on how Ketamine works in the brain:Study 1Study 229:30: Adjustment disorders32:21: Studies on BDNF and ketamine:Study 1Study 2Study 3Study 432:37: Exercise and BDNF 32:39: HIIT and BDNF35:08: Ketamine assisted psychotherapy research38:08: Ketamine for PTSD44:27: EMDR44:46: How to change your mind:DocumentaryBook01:04:25: Ketamine is top-studied drug in depression01:05:40: Low-dose naltrexone01:06:00: FDA approval for naltrexone01:07:23: American Society of Ketamine Physicians, Psychotherapists & Practitioners01:14:02: Rocky’s website!

In this episode of Medicine Redefined, Darsh and Altamash take a deep dive into the complex world of medications with Dr. Vinay Patel, pharmacist and founder of MakoRx. Dr. Patel exposes the hidden realities behind Big Pharma, explaining why generic drugs can be so confusing and revealing the true factors driving skyrocketing pharmacy prices. We also explore how cutting-edge AI technology is revolutionizing drug discovery and development. This conversation will fundamentally change how you understand the medications you rely on every day. Whether you’re a healthcare professional or simply curious, this episode delivers powerful knowledge and a fresh perspective. Tune in!TIMESTAMPS00:00 Introduction to Medicine Redefined00:36 Meet Vinay Patel: Healthcare Innovator01:04 Understanding PBMs: The Hidden Middlemen02:47 The Evolution of PBMs05:29 Vertical Integration and Its Impact15:52 The Complexities of Drug Pricing26:30 Compounding Pharmacies and GLP-1 Medications34:15 Mark Cuban's Cost Plus Solution37:39 The Dominance of Employer-Based Health Insurance39:46 The Generic vs. Brand Medication Debate40:52 Challenges in Generic Drug Manufacturing45:05 The Role of Pharmacists in Medication Management50:50 Solutions for a Broken Healthcare System53:54 Introduction to Make O Rx58:29 Overcoming Barriers in the Healthcare Market01:01:31 The Future of Pharmaceuticals and AI01:05:54 Key Takeaways for Healthcare Providers01:08:04 Final Thoughts and Contact InformationSOURCES00:19: Price We Pay Book01:35: Pharmacy Benefit Management History03:24: Medical Modernization Act03:53: Affordable Care Act04:13: Vertical Integration04:33: Big Three Control 80% of Prescriptions04:56: 20% of Smaller Companies05:40: Tyson Foods RightWay06:01: Smaller PBMs Gaining Traction07:42: Antitrust enforcement in healthcare08:22: Affordable Care Act and High Deductible Plans09:24: Gag clauses09:58: Trump’s Law to Eliminate Gag Clauses10:39: Elizabeth Warren and Josh Hawley's Bill on PBMs13:25: Clawbacks14:32: Clawback disclosure law14:52: Losing money on drugs15:00: GLP-1 drugs16:27: Info on drug pricing17:05: Insurance companies set drug prices22:01: Article on rebates22:30: Net prices have gone down22:39: List prices have gone up24:21: Deep dive into drug prices in US24:45: US VS Europe drug pricing26:49: US subsidizes the world’s drug prices27:32: History of Ozempic28:31: Current status of Ozempic shortage29:11: Compounding drugs law32:21: Compounding pharmacy creditation34:42: Alliance for pharmacy compounding35:35: Cost plus36:16: NADAC39:27: Number of people on employer health insurance41:35: Bottle of lies56:55: Mako RXDr. Vinay Patel’s contacts:Email:  [email protected]: https://www.linkedin.com/in/vinaypharmd/

In this episode, Darsh and Altamash talk about why so many people feel let down by the healthcare system. They break down where trust has gone wrong, how rising costs and confusing policies leave both patients and doctors frustrated, and why it feels like "no one is coming to save you". They also get into AI’s growing role in medicine, the recent Surgeon General pick, and what it means to get on board with AI.00:00 Introduction (Dr. Darsh hates on LeBron)00:49 Setting the Stage: Healthcare System Frustrations01:58 Theme 1: Erosion of Trust in Healthcare15:12 Theme 2: Financial Burden and Affordability Crisis23:32 Theme 3: Systemic Pressures and Burnout31:28 The Future of Medical Education31:48 AI in Medical Decision Making33:15 The Rapid Advancement of AI33:46 AI's Impact on Jobs and Society37:24 Healthcare System Challenges and Layoffs39:43 Controversial Surgeon General Nomination47:22 Functional Health and Longevity Market55:49 Accountability in Health and SocietyResources mentioned in the show:03:30 Public Trust fell after COVID04:09 UHC Medicare Fraud case04:38 21st Century Cures Act14:24 The Price We Pay book29:30 Simon Sinek ranting about soft skills30:14 People referenced:Vanessa Van EdwardsVin GiangJefferson Fisher33:03 Chat GPT study34:41 Sergey Brin interview35:02 AI Singularity36:16 Morgan Housel podcast39:30 Nobel Prize study47:32 Healthcare huddle47:41 Function health acquiring Ezra47: 57 Function health50:53 Dr. Mike Episode with Prenuvo50:50 Dr. Mike Episode with Eric Topol56:28 David Wiss Episode57:27: Young people can’t pass military test57:47: I, Robot movie59:38: Indistractable bookDEEP DIVE:04:17 Distrust in pharmaceutical companies15:45 Medical debt bankruptcies15:57 Exponential growth of healthcare costs16:12 35% of Americans cannot afford quality healthcare17:10 Law that stops emergency rooms from refusing care:18:04: Healthcare premiums have been increasing over time18:27 Laws and regulations for price transparency: Link 1Link 2Link 3Issues with compliance18:49 Drug pricing transparency23:46 Healthcare burnout at all time high COVID and the impact on burnout24:12 Average medical school debt accrued24: 17 Average doctor salary26:10 Generational divide between new and old doctors37:23 Tech Layoffs37: 43 Stand up for science37:52 Schools losing funding41:49 Red 3 ban42:21 Surgeon general completed med school but not residency 46:47 RFK don’t listen to me on vaccinesThank you for listening, let us know your thoughts!

We welcome back Dr. Jeremy Boyd for a deep dive into one of the most debated injuries in sports medicine: the ACL tear. Building on our previous conversation around philosophy and mindset in rehab, this one gets tactical—real tactics, real strategies, and real challenges. Topics Covered in the Episode:• The 4 main pathways for ACL injury management: reconstruction, repair, non-operative rehab, and cross-bracing for regeneration/recovery• What makes someone a coper—and how to identify them safely• ACL rehab with a unique blend of manual therapy, neurocognitive testing, and performance training• Why rehab isn’t just physical—it’s psychological and personal• Risks and benefits of surgery vs. non-op management (and shared decision-making)• ACL self-healing and of course, the use of orthobiologics in ACL healing• What every patient recovering from an ACL tear should know. Resources Mentioned in the show:⁠Cross Bracing Protocol⁠⁠ACL Self-healing study⁠⁠KANON trial for non-op ACL healing⁠⁠PRP for ACL injuries

Dr. Jeremy Boyd, founder of Trifecta Therapeutics, a sports rehabilitation and performance practice with three locations in Southern NJ/Greater Philadelphia, is residency and fellowship trained and board-certified in Orthopaedic and Sports Physical Therapy. As a Fellow of the American Academy of Orthopaedic Manual Physical Therapists (FAAOMPT), he demonstrates advanced skills in diagnosing and treating complex neuromusculoskeletal conditions, utilizing a comprehensive approach that integrates advanced manual therapy and psychological considerations. Dr. Boyd's expertise is trusted by elite athletes from the NFL, NBA, MLB, and the Olympics, and he has a particular interest and focus on ACL injuries and rehabilitation within his practice.Topics covered in this episode:Why manual therapy remains so polarizing — and what the research actually saysHow to tease out whether patient “failed” rehab or the rehab actually failed the patient The critical role of therapeutic alliance in patient outcomesThe downsides of social media misinformation in rehab and healthcareHow to properly dose both exercise and rest for high performersPractical advice for physicians and clinicians to evaluate the quality of a rehab programResources mentioned in the show:Adam Meakins — The Sports PhysioAdriaan Louw — Pain Neuroscience EducationChange Maker by John BerardiRange by David EpsteinMastery by Robert GreeneConnect with Jeremy BoydTrifecta TherapeuticsJeremy Boyd — @thedecentdoctor

Dr. David Wiss, a registered dietitian with a PhD in Public Health from UCLA and a minor in Health Psychology. David is the founder of Nutrition in Recovery and the creator of the Wise Mind Nutrition app, which blends nutritional psychology, behavioral change, and trauma-informed care. His work sits at the cutting edge of nutritional psychiatry, functional medicine, and public health—and today’s conversation will leave you thinking deeply about how food shapes not just our bodies, but our minds, behaviors, and even our societal structures.In this episode, we cover:The spectrum between disordered eating and full-blown eating disorders like ARFIDHow ultra-processed foods hijack our brain’s reward system and mimic addictionThe emerging connection between gut health, inflammation, and mental healthWhy early life trauma shapes long-term food behaviors and emotional regulationHow Dr. Wiss’s personal recovery journey inspired the Wise Mind Nutrition app and his unique clinical approachMentioned in show:David's WebsiteWise Mind Nutrition AppNutrition in RecoveryARFIDNova Institute Think TankFood Politics - Dr. Mike PodcastRecommended Article -Nutritional CriminologySocial MediaInstagram

In this unscripted deep dive, Altamash and Darsh tackle the overlooked but increasingly relevant topic of microplastics—what they are, how they affect our bodies, and what practical steps we can take to reduce exposure. From water filtration and air quality to household hacks and consumer habits, they explore the intersection of environmental toxins, chronic disease, and health optimization. Plus, the conversation veers into everything from sauna myths and visceral fat to book abandonment and the art of communication. A curious, wide-ranging discussion grounded in evidence and everyday life.Podcasts mentioned in the showToxins on Medicine RedefinedRhonda Patrick on Modern WisdomPeter Attia on MicroplasticsStudiesAbdominal fat causing pain?

Dr. Sarah “Sassy” Weinstein—triple board-certified in family medicine, sports medicine, and lifestyle medicine. After finishing her family medicine residency, Dr. Weinstein headed to Colorado for a sports medicine fellowship, then expanded her expertise by becoming board-certified in lifestyle medicine. Now practicing in Princeton, New Jersey, she blends advanced sports medicine techniques with holistic, lifestyle-focused care—all within a direct specialty care model that cuts out needless insurance barriers.In this episode, you’ll discover:How she built a fulfilling practice by leaving draining environments behind and embracing direct specialty care.Smart strategies for marketing and community outreach, helping her connect authentically with patients who need her most.A blueprint for handling logistics in a cash-based model, from price transparency to collaboration with imaging centers.Practical lifestyle medicine tips to address inflammation, enhance recovery, and boost overall wellness.Advice for medical trainees and early-career physicians on finding autonomy and renewed passion in the evolving healthcare landscape.Core Sports Medicine

Dr. Robyn Tiger is a board-certified physician and founder of StressFreeMD, a platform dedicated to helping healthcare professionals navigate burnout and reclaim a sense of calm in their daily lives. After overcoming her own high-pressure struggles as an interventional radiologist, Dr. Tiger dove deeply into lifestyle medicine, mind-body techniques, and cognitive behavioral tools—eventually developing a holistic approach to sustainable stress management. She is the author of Feeling Stressed Is Optional and a sought-after speaker who educates medical trainees, institutions, and practitioners on evidence-based strategies for improving mental well-being. Through her coaching and online programs, Dr. Tiger empowers others to prioritize self-care, rediscover their “why,” and cultivate resilience in the face of modern healthcare’s most pressing challenges.In this episode:- Revisiting Dr. Tiger’s JourneyHow her initial struggles with burnout shaped her holistic, mind-body approach to stress relief.- Labels & IdentitiesWhy identifying solely as a “doctor,” “mom,” or “Type A” may keep you stuck—and how to break free.-Stress: Good vs. BadUnderstanding healthy stress (eustress) and how to prevent chronic distress from impacting your health.- Practical Self-Care ToolsBusy-physician strategies to eat well, move mindfully, sleep better, and support mental health.- Aligning with Your PurposeReconnecting with your deeper “why,” so you can show up better for your patients, colleagues, and loved ones.Social media:WebsiteInstagramLinkedin

Today, we are honored to welcome Dr. Leonaura Rhodes, a physician, public health expert, neurotherapist, and certified brain health coach. With over three decades of experience, she has dedicated her career to helping individuals optimize brain function, manage stress, and design fulfilling lives. Dr. Rhodes combines her expertise in medicine, coaching, and neuroscience to empower people with actionable strategies for peak health and longevity.In this episode, we explore neurodegenerative diseases, the lifestyle factors that influence brain health, and practical steps to protect cognitive function as we age. Topics include:• Understanding neurodegenerative diseases: causes, progression, and common types like Alzheimer’s, Parkinson’s, and vascular dementia.• The role of genetics vs. lifestyle—can we prevent cognitive decline?• The 11 key factors that influence brain aging and cognitive function.• The power of exercise, sleep, and diet in maintaining long-term brain health.• How stress, inflammation, and gut health contribute to neurodegeneration.• The latest insights on supplements like creatine and their impact on brain performance.• How to build a resilient mind and optimize mental well-being through mindfulness and stress management.

In this episode, we revisit our 2024 health predictions to see what we got right—and what we completely missed. Then, we dive into the biggest winners and losers of 2025, the most overhyped health trends, and the breakthrough technologies that will actually make an impact. Plus, Altamash shares his personal experience with surgery and recovery, revealing the critical lessons he learned about muscle loss, nutrition, and what most people (and even doctors) overlook when it comes to post-surgical healing. Resources mentioned in the show: ⁠ESPEN practical guideline: Clinical nutrition in surgery⁠⁠: https://pubmed.ncbi.nlm.nih.gov/34242915/ Study on Sleep Regularity & All-Cause Mortality⁠⁠: https://pubmed.ncbi.nlm.nih.gov/37738616/ Study on Muscle Atrophy Post-Surgery & Nutritional Strategies⁠: https://pmc.ncbi.nlm.nih.gov/articles/PMC8156786/ ⁠JAMA Open Access Paper on Nutrition Competencies for Medical Trainees⁠: https://www.google.com/search?q=%E2%81%A0JAMA+Open+Access+Paper+on+Nutrition+Competencies+for+Medical+Trainees%E2%81%A0&rlz=1C1VDKB_enUS1124US1124&sourceid=chrome&ie=UTF-8

In this episode, we revisit our 2024 health predictions to see what we got right—and what we completely missed. Then, we dive into the biggest winners and losers of 2025, the most overhyped health trends, and the breakthrough technologies that will actually make an impact. Plus, Altamash shares his personal experience with surgery and recovery, revealing the critical lessons he learned about muscle loss, nutrition, and what most people (and even doctors) overlook when it comes to post-surgical healing. Tune in to hear: The 2025 health trends that are here to stay—and the ones that need to go. AI’s growing role in healthcare and how it’s changing the game. The truth about wearables, biohacking, and ultra-optimized living. Why traditional insurance models are on the decline. A deep dive into surgical recovery: what helps, what hurts, and how to bounce back faster Resources mentioned in the show: ESPEN practical guideline: Clinical nutrition in surgery Study on Sleep Regularity & All-Cause Mortality Study on Muscle Atrophy Post-Surgery & Nutritional Strategies JAMA Open Access Paper on Nutrition Competencies for Medical Trainees

Denzel Hill is an architectural designer with a unique perspective, aiming to connect the built world with nature to create healthier communities. He is the founder of Under One Sun Creative Consulting, an architectural design and visualization company. His company focuses on providing architectural drawings for custom residential builders and affordable home developers, emphasizing sustainability and communication. Denzel's vision focuses on designing healthy spaces with an emphasis on food security and a high quality of life. He is passionate about incorporating agriculture into the residential landscape, envisioning homes and communities that integrate elements for food production. Denzel is also committed to teaching and mentorship, believing it is key for progress. His journey is also informed by his background as a student-athlete at Columbia University, where he developed resilience, discipline, and perseverance Mentioned in the show: Tower Garden The Biggest Little Farm What The Health Social media: Substack Instagram Linkedin

Dr. Heather Hammerstedt is an emergency medicine physician, lifestyle medicine coach, and founder of Wholist Health. With over 20 years of experience in acute and chronic care, she has dedicated her career to addressing the root causes of illness through integrative approaches. Dr. Hammerstedt’s unique perspective combines her frontline emergency medicine work with her passion for coaching patients on nutrition, mindfulness, and movement. In this episode, we discuss: Lessons learned from the COVID-19 pandemic and its ongoing impact on healthcare inefficiencies. The growing distrust between patients and providers and its implications for care. Alarmism in health messaging and the role of social media health experts. Who should lead public health conversations: clinicians, influencers, or multidisciplinary teams? Strategies for clinicians to navigate systemic barriers and moral injury. Simple lifestyle changes—nutrition, sleep, and movement—that can transform health. Resources mentioned in the show: JAMA Network Open: Proposed Nutrition Competencies for Medical Students and Physician Trainees Wholist Health Dr. Matt Ramsey’s Podcast: 43cc

Altamash and Darsh are back to discuss current events. Topics covered in the episode include: Current insurance industry issues - Brian Thompson, BCBS Therapy Culture "Health Experts" Resources mentioned in the show: Mark Manson episode Tangle News on CEO Shooting - Must Read

Dr. Lida Fatemi, DO, MPH is a board-certified internal medicine physician, educator, speaker, certified physician coach, and founder of the Conscious Physician Method. A best-selling author and leader in the integration of psychedelics into medicine, Dr. Fatemi has gained national recognition for her innovative approach to healing trauma, burnout, and mental health challenges. Her work combines evidence-based medicine with holistic practices, focusing on helping healthcare professionals and patients rediscover vitality, joy, and balance. Dr. Fatemi’s personal experiences, including growing up under a terrorist regime in Iran and surviving war, deeply inform her passion for alternative healing methods and her commitment to changing the healthcare landscape. As a trailblazer in the use of psilocybin and other integrative therapies, she has spent over a decade educating others on the potential of these treatments to transform lives and redefine care. In this episode, we explore Dr. Fatemi’s journey into medicine and psychedelics, the science and culture of psilocybin, and its applications in addressing mental health, addiction, and burnout. We’ll also discuss how these therapies can be integrated into mainstream healthcare, overcoming stigma, and the future of psychedelics in medicine. Mentioned in the show: Psilocybin MAPS Social Media: Instagram Conscious Physician Podcast

Dr. Melissa Sundermann (aka Doctor Outdoors) is a plant-based physician, double board certified in both Internal Medicine and Lifestyle Medicine and has been practicing medicine for over 20 years. She also has training in Integrative Medicine through the University of Michigan and has completed a Professional Training Program in Mind Body Medicine through the Center for Mind Body Medicine based in Washington, DC. She has been featured in several Lifestyle Medicine articles and podcasts as well as an invited speaker for health/medical events. Dr. Sundermann currently practices concierge medicine at LifeSpan Medicine. She does her best to practice what she preaches and enjoys running, biking, hiking, skiing and spending time outdoors and creating adventures with her husband, 2 college-age children and 2 dogs. She is a 10x Boston Marathon finisher, and 3x Full Ironman Triathlon finisher. Social Media: Instagram LinkedInMentioned in the show:Lifestyle Medicine PillarsNature as the 7th PillarForest BathingSun ExposureWater Exposure

Meagan McGuire is back on the show to break down the current landscape of student loans. Meagan Landress is a student loan consultant for Student Loan Planner. She obtained her finance degree at The Coles College of Business at Kennesaw State University. In March 2017, Meagan started her practice, Financial Coach Meagan, to help people begin their financial planning journey with student loan debt in the mix. In this episode, we discuss: Recent court rulings and injunctions against the SAVE plan What the election results may mean for student loans and borrowers The state of PSLF longterm PSLF buyback program Contingency planning

We're baaaccckkk!! In this episode, we provide some life updates over the last 4 months. We'll also dive into the topics of work, success, and personal development through the lens of a couple podcasts we listed to with Alex Hormozi on Chris Williamson's Modern Wisdom podcast. 24 Controversial Truth About Success & Failue 21 Brutally Honest Lessons to Improve Your Life

Lawrence B. Keller is a CERTIFIED FINANCIAL PLANNER™ professional and the founder of Physician Financial Services, a company dealing exclusively with the financial needs and concerns of members of the medical profession.

Mr. Keller has spent the last 33 years providing insurance and investment products and services to residents, fellows, and attending physicians. These include, but are not limited to, disability income insurance, life insurance, and investments. Mr. Keller represents many well-respected companies in the financial services industry, which allows him the flexibility to provide unbiased advice and help recommend products that best suit each individual's needs and concerns. Recognizing that a physician's time is limited, and in an effort to remain knowledgeable to provide the most value to his clients, Mr. Keller has obtained his CFP® certification as well as earned the Chartered Life Underwriter (CLU), Chartered Financial Consultant (ChFC), Registered Health Underwriter (RHU) and Life Underwriter Training Council Fellow (LUTCF) designations. Mr. Keller continues to keep abreast of the marketplace by attending professional conferences, and is an active member of the National Association of Insurance and Financial Advisors (NAIFA), the Financial Planning Association (FPA) and the Society of Financial Service Professionals (SFSP). In addition, Mr. Keller has qualified for the National Association of Insurance and Financial Advisors National Quality Award and is also a Qualifying & Life Member of the Million Dollar Round Table (MDRT), an independent, international association of the life insurance industry's most successful underwriters. He is also a qualifying member of the 2023 Top of the Table®. In this show, we discuss: Term life insurance Whole life insurance Umbrella insurance Larry's Website Financial Waterfall by WCI

Lawrence B. Keller is a CERTIFIED FINANCIAL PLANNER™ professional and the founder of Physician Financial Services, a company dealing exclusively with the financial needs and concerns of members of the medical profession.

Mr. Keller has spent the last 33 years providing insurance and investment products and services to resident, fellow, and attending physicians. These include, but are not limited to, disability income insurance, life insurance, and investments. Mr. Keller represents many well-respected companies in the financial services industry, which allows him the flexibility to provide unbiased advice and help recommend products that best suit each individuals needs and concerns. Recognizing that a physician's time is limited, and in an effort to remain knowledgeable to provide the most value to his clients, Mr. Keller has obtained his CFP® certification as well as earned the Chartered Life Underwriter (CLU), Chartered Financial Consultant (ChFC), Registered Health Underwriter (RHU) and Life Underwriter Training Council Fellow (LUTCF) designations. Mr. Keller continues to keep abreast of the marketplace by attending professional conferences, and is an active member of the National Association of Insurance and Financial Advisors (NAIFA), the Financial Planning Association (FPA) and the Society of Financial Service Professionals (SFSP). In addition, Mr. Keller has qualified for the National Association of Insurance and Financial Advisors National Quality Award and is also a Qualifying & Life Member of the Million Dollar Round Table (MDRT), an independent, international association of the life insurance industry's most successful underwriters. He is also a qualifying member of the 2023 Top of the Table®. In this show, we discuss: The importance of having a disability insurance policy The important variables built into the policy Pearl and pitfalls of acquiring a policy Shopping and comparing insurance policies Finding the right agent who is working on your behalf Resources mentioned in the show: WCI on disability insurance Jimmy Turner on Medicine Redefined

RJ Kedziora is the co-founder of Estenda Solutions, a leading company specializing in custom software and data analysis for healthcare and medical companies. With a remarkable journey spanning over 30 years, he possesses a deep understanding of designing, developing, and deploying successful software projects. His extensive experience enables him to provide valuable guidance and innovative insights, resulting in cost-effective solutions that improve patient outcomes. Mr. Kedziora received his M.B.A. from West Chester University and a Bachelor of Science in Computer Science from Duquesne University where he received the Excellence in Computer Science Award. He has spoken at numerous technical and healthcare conferences on a variety of topics and written or co-authored multiple articles focused on healthcare information technology, several published in peer-reviewed scientific journals. Social Media: RJ LinkedIn Estenda Estenda LinkedIn Driving Quality in Digital Health: The Role of Generative AI in Testing (Webinar – Friday, June 14th at 12pm) Mentioned in the show: The Price We Pay Instagram - Dannah_Eve (Safety Tips)

Matt Martin is the CEO of Precision Health Reports, a company focused on longitudinal analysis of cardiometabolic markers. Matt served as a U.S. Army Infantry Officer, gaining leadership skills in the fast-paced environment. His health journey took him down a path of precision medicine, in which he now works with healthcare practitioners, first responders, and individuals to ensure we can all do our part to improve cardiometabolic health.

Matt Martin is the CEO of Precision Health Reports, a company focused on longitudinal analysis of cardiometabolic markers. Matt served as a U.S. Army Infantry Officer, gaining leadership skills in the fast-paced environment. His health journey took him down a path of precision medicine, in which he now works with healthcare practitioners, first responders, and individuals to ensure we can all do our part to improve cardiometabolic health.

In this episode, Dr. Darsh and Dr. Altamash share research on the positive benefits of earthing/grounding (putting our barefoot on Earth). They will discuss what it is, how we think it works, what the research shows, and how you can implement the practice in your routine. Mentioned in the show: Review Article of Earthing Health Implications of Reconnecting the Human Body to Earth's Surface Effect of Earthing on Inflammation Earthing Influence on Physiologic Processes Episode 135 - Acupuncture with Alex King, DO

Joseph Carchedi, MD, is a Board Certified Practitioner of the world renown Institute of Functional Medicine and founder of the Lower Gwynedd Functional Medicine Institute. Dr. Carchedi earned his medical degree at Università degli Studi di Roma la Sapienza-Facoltà di Medicina in Rome and completed his residency at Finch University of Health Sciences/Chicago Medical School in Chicago, IL. He is board certified and has 25 + years of experience in Internal and Emergency Medicine. Additionally, Dr. Carchedi is a medical marijuana certifying physician. Dr. Carchedi provides an integrative, functional approach to identifying the underlying causes of disease, rather than the traditional method of diagnosing and prescribing. He addresses and treats issues with immunity, disease prevention, and energy problems such as chronic fatigue, fibromyalgia, hormonal imbalance, women’s health, cancer issues, and weight management. Dr. Carchedi also addresses and treats issues with anxiety, chronic pain, and depression with non-drug based treatments. His focus is patient-centered utilizing holistic healing by treating the mind, body, and spirit. This approach includes gene analysis (Genomics), sophisticated nutritional strategies, herbal remedies and supplements, IV therapies and the recent state of the art Platelet Rich Plasma injections, and if required, traditional pharmaceuticals. Dr. Carchedi is an avid athlete and cyclist who was also the team medical physician for various professional cycling teams from 1990’s to the present.

Amy Morin is a psychotherapist, mental strength trainer and an international bestselling author. Her books in the 13 Things Mentally Strong People Don't Do series have sold more than 1 million copies and been translated into more than 40 languages. She's the award-winning host of the Mentally Stronger podcast and she gave one of the most popular TEDx talks of all time. The Guardian dubbed her the "self-help guru of the moment" and Forbes refers to her as "a thought leadership star. Follow Amy: Website Instagram TED Talk Books Mentioned in the show: Gottman's 4 Horseman of Conflict Indian Matchmaking - Netflix