The Future of Wellness: Innovative Diagnostics and Treatments Unveiled

Our first guest of 2024 is Dr. Darshan Shah, a surgeon, longevity expert, and founder of Next Health. In their conversion, David and Dr. Shah take a snapshot of today’s ever-changing health optimization and longevity landscape. The two discuss new diagnostic tools like executive physicals and AI-enabled heart scans, highlighting the power of early detection in combating conditions like Alzheimer’s, heart disease, and cancer. David also takes the opportunity to learn about up-and-coming treatments like gene therapy from an expert. Dr. Shah also shares his personal journey from surgery to functional medicine, emphasizing the importance of looking beyond traditional Western healthcare to prevent chronic diseases. 

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Key Moments
“I think there’s a lot going on in the world of longevity that unfortunately the FDA is trying to block. But you know, the research continues to go on in other countries and it will continue to flourish and we will be able to do a lot of these things here at some point, whether it be in the United States or outside.”

“I always tell people that we have a few different goals in mind. Our first goal is to optimize along the most common things — we need to make sure your nutrition, your exercise and your sleep is perfect, right? And so, as close to perfect as we can get it.”

“If Steve Jobs were alive today, and he had an executive physical, he would have been saved from pancreatic cancer.

“I always tell my patients, you need to know what your hemoglobin A1C level is. I should ask you, and you should be able to tell me what it is.”

Connect with Dr. Shah
Website
Next Health
Making the Cut: 10 Things You Should Consider Before Having Plastic Surgery
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Transcript

David

Hey, Darshan, how are you doing today?

Dr. Darshan Shah

I’m doing great, David. Thanks so much for having me.

David

Wonderful to have you on. Tell us a little bit about your background.

Dr. Darshan Shah

Yeah. So, David, I am a physician. I’ve been a physician now for almost 30 years. I can’t believe it when I say that myself, but I went to medical school in University of Missouri, Kansas City, graduated when I was 21 years old and decided to become a surgeon at that point in time. I was a surgeon for 20 years or so before I started having my own personal kind of health issues.

Dr. Darshan Shah

And I decided at that point to do a lot of research, try to figure out how to get myself healthy. So at that moment when I found the miracle of the longevity science world of the functional medicine world, I realized that that’s where medicine should be headed. And I changed my career completely into longevity and functional medicine.

Dr. Darshan Shah

And so now I’m a longevity doctor, a functional medicine practitioner, and we have a set of clinics throughout the United States called Next Health. What we do in next health is we help people who aren’t necessarily sick. They go to their doctor, their doctor tells them you’re fine, or they put them on a couple of pills for high cholesterol and blood pressure, and they’re just kind of left to their own devices to just get sicker.

Dr. Darshan Shah

Right? Western medicine is so focused on treating treating us with pills and surgery and try to do instead is to really dive deep, look under the hood of what’s going on in someone’s biology and give them a plan to optimize their health so they never need to use medicines or surgery in the future and they stay away from all forms of chronic disease.

Dr. Darshan Shah

So that’s how we do it. Next Health, we call ourselves health optimization and longevity centers, and we have a pretty good process around that now.

David

I think it’s I think this is so interesting because I find so many physicians are in such terrible health, Right? It’s appalling to me, like you guys know all about areas. No, no, it doesn’t happen.

Dr. Darshan Shah

Well, here’s a thing, David. We don’t know all about health. We know all about these. That’s why we spend years and years learning about is disease. In fact, our knowledge starts when you have the diagnosis of disease. That’s when your typical Western medicine doctor’s knowledge starts, right? Everything before that, nutrition, exercise, physiology, sleep, all of that is kind of like forgotten about because that is the domain of your dietitian and your nutritionists, your trainers, etc..

Dr. Darshan Shah

So I ask you what I learned to get myself healthy. I actually became a certified trainer. I actually got my nutrition license so I could learn about these things for the first time in my life because we literally got three or 4 hours of nutrition in medical school, a zero in exercise.

David

No, I will say in defense of Western medicine, when bad stuff happens, I’m really happy for that. Really highly skilled people, you know, who can take care of it.

Dr. Darshan Shah

Western medicine is fantastic. For once you have a disease and you’re diagnosed or you have a trauma or you’re sick with an infection. Western medicine. Thank God for the advances of Western medicine. But you know, I always say next health is for the 95% of us that aren’t sick, that don’t need the right hospital. They don’t need to be in emergency room.

Dr. Darshan Shah

Where do we go? Where do where do we go to get optimal health? And what’s incredible, David, is, as you know, there’s so much of that science that’s coming out of Western medicine that we’re applying to health now, and it’s just supercharging people’s health. And so that’s what we do next month as well as we bring some of that technology to people that aren’t sick.

David

One of the things I wanted to add I was really interested in having you on Darshan, was to talk about this thing. It gets bandied around a lot called an executive physical like, So what is this?

Dr. Darshan Shah

So the executive physical is basically the physical that everyone should have, but they can’t because insurance doesn’t pay for it. Okay? So unfortunately, because people have to pay for it out of their own pocket, a lot of the people that are getting this physical are executives, CEOs, people that own their own companies that have the disposable income to do this kind of a thing.

Dr. Darshan Shah

However, I will say that the prices of some of these testing modalities is getting lower exponentially year by year. And my hope is that insurance will cover it one of these days and or it’ll become extremely affordable for people. So right now, for somewhere between 10 to $15000, we’ve collected a group of tests that is super comprehensive and that we can use to literally detect all forms of chronic disease of cancer, Alzheimer’s disease, any kind of dementia, heart disease, heart attacks, strokes, all forms of chronic disease.

Dr. Darshan Shah

We can detect a 20 to 30 years before it even starts. And what we empower people to do, David, it’s become I call it I call it become the CEO of your own health. Understand what these biomarkers are, where you stand currently and how you keep them optimized. So, you know, all disease, David, develops over a course of time, right?

Dr. Darshan Shah

It doesn’t happen like immediately. And what you see in his blood biomarkers and scanning biomarkers is things slowly start heading in the wrong direction. Unfortunately, most people don’t know it’s been heading in the wrong direction for a couple of decades when they start getting symptoms. Our bodies are so resilient to symptoms that we don’t feel symptoms until it’s too late.

Dr. Darshan Shah

A lot of times a first indication that you have that if humans have for having heart disease is their first heart attack. 50% of all heart disease diagnosed the first heart attack and 50% of those are fatal. So the first symptoms we have of Alzheimer’s disease is severe dementia. We let it get severe before we diagnose it. Same thing with metabolic syndrome that now we have continuous glucose monitors and a few people are using them.

Dr. Darshan Shah

And people understand biomarkers like hemoglobin, A-1 C and insulin levels. But for years no one knew that they were headed down the path of diabetes until they started having vision abnormalities, until their toes started becoming purple from advanced advanced diabetes. And so we have the technology now, David, to head off all forms of chronic disease. If you look at the CDC, top ten causes of death, like, you know, heart disease is number one, right?

Dr. Darshan Shah

Number two is going to be Alzheimer’s and dementia. Number three, it’s going to be cancer. And sometimes two and three are reversed. And then you have other forms of all forms of chronic disease. And all of these things can become orphan disease. If people had more access to these testing modalities earlier in life. So we start people to get an executive physical when they’re somewhere between mid 30 to 40.

Dr. Darshan Shah

Some people want to do it earlier, which is fine, as you can never be too early with this kind of stuff. But that’s where we start. And if you want to give you kind of a quick rundown of the tests that are included, the executive position.

David

That was going to be my next question. So cardiovascular disease number one killer. Talk me through that. What are the tests you’re looking at?

Dr. Darshan Shah

So we’re looking at blood biomarkers, right? Your typical ones of cholesterol. We use APO B as the as the kind of the best marker of cardiovascular disease as far as cholesterol is concerned. But cardiovascular disease is not just cholesterol levels. I think there’s so much controversy around cholesterol because people just tend to hone in on one thing. Cardiovascular disease has three factors associated with it.

Dr. Darshan Shah

One is your cholesterol levels. But that’s only after you look at inflammation levels and you look at damage to your vessel wall, which is due to high blood pressure. So those are three things that combine going to cause cardiovascular disease. So we’re looking at people’s inflammatory markers as well. Inflammation is root cause of almost all diseases and definitely cardiovascular disease is high up there in the west.

Dr. Darshan Shah

Now, the test that we use to assess someone is we look directly at the blood vessels of the heart using an advanced CAT scan of the heart called the clearly scan. Have you heard of the clearly, I can’t even.

David

I know I’ve heard calcium CT scan and I’ve heard what’s the one I had done like a sonogram on my arteries. Yeah, but I don’t know about this. Tell me, what is this?

Dr. Darshan Shah

Okay, so the clearly scan is an AI enabled CAT scan of your heart that goes way beyond the calcium score. The calcium score is just adding up the amount of calcium that it detects around your heart and saying that you might have some calcified plaque. Here’s the chance of you having it. What a clearly scan does is it shows you every blood vessel in exquisite detail and how much plaque is along that blood vessel, both soft and non calcified.

Dr. Darshan Shah

So this is a scan that takes about 20 to 30 minutes. There is some radiation involved. So we don’t do it very often. We do it as our initial testing modality for people with risk factors, but we can tell in exquisite detail exactly how much plaque you have and exactly where it is. And so I was just looking at a few clearly scans a few minutes ago at some of our patients.

Dr. Darshan Shah

And, you know, we have a couple of patients that had no idea that had heart disease and they have massive lesions in critical arteries. Some of these artists are called Widowmaker because these are arteries first, first time, you know, that you have a blockage, you’re having a heart attack. And so, you know, it’s a life changing technology and it gives you better and more information than even a coronary angiogram.

Dr. Darshan Shah

So that’s where, you know, you go into someone’s groin, you shoot dye in their blood vessels, like that’s too much. You don’t need to do that anymore. You can now do that with AI enabled scans of your heart. So it’s super state of the art. There are about a thousand bucks right now to do this test. But you know, I think I think if you can afford it, it’s great to have a baseline of a clearly test.

David

And what are the biomarkers you’re looking at for inflammation?

Dr. Darshan Shah

So we’ll get a bunch of different biomarkers. I mean, the basics are, of course, hs-crp, highly sensitive CERP, but we also look at down homocysteine levels. We’re also looking at amyloid protein levels, fibrinogen, and we have cytokines or interleukin levels. These are all levels that we’re measuring to assess someone’s true state of inflammation. You know, CERP and homocysteine tend to rise later in the game when you have more moderate to severe inflammation.

Dr. Darshan Shah

But those are both markers that every person you know, we empower our patients to know. Like this is what CRP means is what homocysteine means. You need to know what your your levels are. You need to be comfortable that you’re less than one, you know. And so we rewatch those levels pretty carefully.

David

You brought something up with a clearly scan. You’re able to see hard plaque, so calcified plaque and soft plaque and is there is it possible to remove plaque at this point? I don’t think you can remove hard plaque once that’s there. But can you remove the source like.

Dr. Darshan Shah

Yes. So now with the new PCSK9 inhibitors, there’s studies showing that you are actually able to reverse plaque with with using intensive therapy, especially soft plaque, of course. And then believe it or not, there’s some studies showing even reversal of heart plaque, which is incredible with intensive therapy. So I never promised the patient. The goal is to stabilize the plaque you want as the least amount of soft plaque as possible.

Dr. Darshan Shah

So whether that’s hard placards, plaque and reversal, that’s what you want. And what’s great about the clearly scan too, is it tells you how much of that soft plaque is highly unstable. So unstable plaque is the one that gets a blood clot in it and blocks your blood vessel and gives you a heart attack. That’s what you really want to know.

Dr. Darshan Shah

And that’s kind of like more of an emergency. That’s when maybe you do need a stent put into one of those arteries. So, you know, these are all concerns that people have when you’re over 40 years old, but definitely over 50 or 60. But the sooner you know, the better, because the sooner you can change your lifestyle and get an intervention, the the sooner you can stabilize that plaque so it doesn’t go in the wrong direction.

David

Let’s go to cancer. You’re doing blood biopsy and also scans.

Dr. Darshan Shah

Yes. Okay. So the state of the art for cancer for years, for like 50 years, ever since I went to medical school 30 years ago, all we had was colonoscopy, mammograms, and, you know, like woman would get an overdue an exam. Men would have a rectal exam to feel their prostate for a hard lump. And then we have PSA, which is a marker of prostate cancer.

Dr. Darshan Shah

That’s all we could detect, really, Right. Most other cancer you didn’t even know until it became symptomatic brain cancer always diagnosed through your stage four, Steve John’s pancreatic cancer, stage four when you started having symptoms. If Steve Jobs were alive today and he had executive physical, he would have been saved from pancreatic cancer. And so what people need to know is that even though you have to keep your colonoscopy up to date, you have to keep your PSA levels and your obituary and exams up to date, mammograms up to date, you’re only picking two cancers.

Dr. Darshan Shah

There are two or three cancers. All of the other cancers, about 50 of them that are very relevant, that are not detected until you have symptoms. And so now the state of the art is combining a full body MRI scan with what’s called a liquid biopsy. So we do both of those as well. So a full body MRI is going to detect earlier stages of brain cancer, pancreatic cancer, liver cancer, etc. that you would have never known about until they became symptomatic.

Dr. Darshan Shah

And then the liquid biopsy detects cell free DNA. So this is DNA being shed from active cancer cells that has migrated into your blood. And now we can detect those with advanced DNA sequencing. So now we know at stage one or two, a lot of these cancers, if they’re developing in, you, are not. So that’s kind of what we make part of our executive physical.

Dr. Darshan Shah

And look, I mean, there’s four people who know about this kind of stuff. There’s always a controversy of, well, what if you get a false positive? What if something shows up and you don’t know what it is? And so I always have a conversation with my patients beforehand. It’s like, look, we have to be able to be in a mindset that we can tolerate the potential negatives of a false positive, which is mainly just stress and additional diagnostic testing versus the potential positive at detecting a potentially fatal tumor or anatomical abnormality at stage one.

Dr. Darshan Shah

Right. And so that’s kind of what we what we talk about with our patients to make sure they understand what the value and some of the psychological risks that occur with advanced testing.

David

Are you able to remove some of the false negatives or false positives because you’re the synergistic interaction of the the blood based biopsy with the with the scan?

Dr. Darshan Shah

Absolutely. And we also use our blood tests. You know, we have a lot of testing modalities that we do do a thousand different blood biomarkers as well, a genetic testing as well. And so we can you know, we paint an overall picture both with symptoms testing, traditional testing and advanced testing, paints an overall picture for us.

David

I’m just curious what size of mass is able to be detected with the scans?

Dr. Darshan Shah

I mean, as small as less than a centimeter in diameter, you can go, you know, even five millimeters in diameter. You can find cancer masses as well. A lot of it has to do with how the MRI uses a special technique called diffusion weighting. So it can actually provide a visual a visual representation of how tissue feels, believe it or not.

Dr. Darshan Shah

And so something feels hard to light up on these scans, even if it’s a tiny tumor. So that’s it’s really interesting how how this technology works. But yeah, we can detect pretty small tumors.

David

Well, let’s talk about the other biggie, Alzheimer’s, functional testing that what sort of test you’re looking at there.

Dr. Darshan Shah

Right. So we do some functional testing. We do a cognitive brain test online for our patients that are experiencing potential symptoms of cognitive impairment. Right. So it all starts with Malcolm of impairment and we take them through a questionnaire. If they’re unsure, then we’ll put them on a computer that does some testing for them. But in reality, you know, there’s not great testing for Alzheimer’s until just now.

Dr. Darshan Shah

So just in the last one year, we now have blood tests that can detect tau protein and amyloid protein in your blood. If you know, these are that proteins that are involved with Alzheimer’s disease, we can not detect these in the blood. And the initial studies are showing a high correlation with the PET scans, which are a specific kind of high radiation scan that we use to actually diagnose Alzheimer’s.

Dr. Darshan Shah

So there’s a great correlation between a positive blood test and these PET scans. So even though, you know, they don’t say the testing companies don’t say and there’s needs to be a lot more research done on preventative testing of blood biomarkers for Alzheimer’s, we’re still doing them to give us an indication and then we’ll go down a diagnostic pathway if something is comes up positive.

David

So let’s move on from the scary stuff, is that we really don’t want to find optimization. Before we started, you were telling me that you’re doing therapeutic plasma exchange, which you’re actually the first clinician I’ve spoken to who does that.

Dr. Darshan Shah

Yeah, So just take a step back, David, if you don’t mind. When we talk to our patients, I always tell people that we have a few different goals in mind. Our first goal is to optimize along the most common things we need to make sure your nutrition, your exercise and your sleep is perfect, right? And so as close to perfect as we can get it, most people have not even had a great education around those type of around nutrition, sleep and exercise.

Dr. Darshan Shah

Most of your audience is pretty advanced, but we empower people by using things like continuous glucose monitors, sleep monitoring technology, whether it be an or a ring or pad. And we and we put into place via to testing grip testing, etc. to really understand where they are on those basic aspects of health. Then the second part is the scary stuff that we talked about is ruling out anything that could potentially kill you.

Dr. Darshan Shah

And the third part is where I love to be with patients. Is the functional medicine treating disease at its root cause. This is functional medicines. That means it’s improving gut health, improving your hormonal health, improving your emotional and brain health as well, and detoxifying your life so around those four different aspects of functional medicine is where we do a deep dive with blood testing and we see where their markers are and we put into place habits and therapies to really optimize along those core aspects.

Dr. Darshan Shah

And then once we have all that right, we can talk about some of this advanced longevity technology that we use on site. If you want to get all that right first, right. Like you don’t want to start doing plasma exchange and and stem cells if you’ve not you know, if you’re going to McDonald’s every day and you’re sleeping 4 hours a night, it doesn’t make sense.

Dr. Darshan Shah

Right. So so we want to make sure we’re really getting you the maximal results and you’re not basically wasting your time or your money on this. Therapeutic plasma exchange is a new procedure that we just started doing as well about eight months ago for longevity and health optimization purposes. But to be clear, this has been FDA approved for two decades and we’ve been using in the Hospital for Disease state, such as an autoimmune crisis, for example, is one disease state that we never use it for.

Dr. Darshan Shah

And what therapeutic plasma exchange does is we put an I.V. in one arm, we remove your blood in your plasma, we put in a giant machine that looks like a dialysis machine, and it separates the plasma from the blood. So then in another I.V., the blood goes back into your arm, and then that plasma is totally removed. And I always say the bad stuff lives in the plasma, Right?

Dr. Darshan Shah

So you have your immune complex, says you have inflammatory mediators, you have your cytokine and inflammatory cytokines. All this stuff lives in the plasma and your body’s working so hard, your liver, the kidneys is working so hard to eliminate these toxins. What this machine does is just physically separates it completely and we remove it and we throw it away and we replace that plasma with fresh albumin and IV fluids so your body can regenerate the positive things that need to be in plasma, like clotting factors, hormones, etc..

Dr. Darshan Shah

All that regenerates within 24 to 48 hours. But all the bad stuff takes months or potentially years to eliminate. We’re removing it with therapy, plasma exchange.

David

With something like therapeutic plasma exchange. I’m guessing there markers that you’re comparing to judge success. So before and after, what would you be looking at?

Dr. Darshan Shah

Yeah, same that we’re looking at using Depends on what we’re doing it for. So if we’re doing it for longevity, we’re actually testing a methylation age, you know, before the test, before the treatment protocol begins. Are we test one at the end of the treatment protocol? We’re measuring inflammatory cytokines as well. So a lot of people are suffering with inflammation and we’re measuring those as well.

Dr. Darshan Shah

Some people are suffering from like heavy metal toxicity. So we’re measuring heavy metal levels as well. Just depends on what we see in the blood that’s abnormal, that we want to affect a positive change in. Now some people, you know, like you, David, they’re like this model of perfect health and they come in.

Dr. Darshan Shah

And they still want to have it done. You know, they’re like, I want the latest technology that’s not going to cause any harm. Why not? And so really, the only thing we can monitor in someone like that is their methylation age. And we’ve seen tremendous changes in people’s biological age, even just with one treatment. So it’s it’s really it’s really I’m really excited about some studies coming out this year on massive biomarker changes and especially biological age changes with therapy, plasma exchange.

Dr. Darshan Shah

We’re going to be seeing a lot of research being published this year on that.

David

All the people that I’ve spoken to about it, I find it absolutely fascinating that you just like strip out not even all the plasma, but a section of the plasma, and then you have this amazing results and it sort of brought me like, oh, maybe the poor man’s version of this is just donate a lot of blood off, know?

Dr. Darshan Shah

Yeah, well, unfortunately, you can’t donate this much blood really anemic But you know, a lot of people do have positive health effects from blood donation. As you know, it raises other people eating levels as well. So I think, you know, plasma exchange right now, it is slightly expensive, but it’s not going to be forever. And I think the more research we see coming out for it, the more mainstream it will get.

Dr. Darshan Shah

The more mainstream things get, the lower the price gets. So I’m I’m excited to see where this kind of leads us. And it’s so funny to think that maybe, you know, the solution to aging, one of the solutions to aging and inflammation has been under our noses for decades in the hospital, and we just weren’t using it, you know.

David

With me the first time. Yeah.

Dr. Darshan Shah

Exactly. Exactly.

David

So you mentioned hormone optimization, which I’m not a doctor and I’m not a scientist, but I find the whole hormone thing incredibly complicated, you know, therapeutic plasma exchange. Okay, that’s pretty straight ahead. But this stuff is like, wow. So if I came in to you, I’m 65. You say I’m feeling light and I want you to be my doctor here, but I’m just going to make this up.

David

So I think, well, you know, maybe I’m not I don’t have as much mental acuity or my recovery in the gym takes a little longer. What’s interesting to me is there’s sort of like various ways people do this. They’re just like, give somebody like, okay, here, try this gel. We’ll see how you feel. And there are other places where there’s like a lot of testing going on with a male.

David

What are you looking at in terms of hormone markers?

Dr. Darshan Shah

Yeah. So first of all, if you go to someone that gives you a gel and says, take this and see how you feel, definitely that’s a red flag. That means it’s you know, it’s another one of those like, you know, I hate to brag on Western medicine and most Western medicine doctors are much more advanced now. And there’s but it used to be when you had 10 minutes to see a patient and they told you this and the testosterone level was low, you just give them a bottle of gel and see you later, you know, and and absolutely, that’s not the way to do it.

Dr. Darshan Shah

We do an in-depth hormone panel on men and women. It includes things like testosterone free testosterone, sex hormone binding globulin. And also, you know, you have to measure everyone’s PSA level when you’re doing hormone therapy, you’re measuring estradiol levels, you’re measuring thyroid levels, everything. So we get a complete hormonal picture. Now, David, for someone like yourself, since you gave me the example, I will tell you that if your testosterone level was low and I said low in quotes, you know, because a lot of it has to do with your symptoms.

Dr. Darshan Shah

And then we would talk about testosterone replacement therapy. Now, there’s ways to increase or boost your testosterone naturally, as we all know, of lifting heavy weights, ashwagandha, DHEA, there’s other things you can do to do that, but it probably wouldn’t get your testosterone level up too much. And we like to see men have a testosterone level that mimics kind of like where you were in your twenties or your early thirties.

Dr. Darshan Shah

Okay. So for most men, that’s somewhere above 400 for sure, but somewhere around 5 to 900, somewhere in there. So we go very much based by symptoms. David And we’re following your hormone levels on almost a quarterly basis for a couple of years until we get things exactly right Now we have different modalities of treating testosterone, low testosterone.

Dr. Darshan Shah

One is by taking a pill that encourages your normal natural production of testosterone that’s called Clomid. That can probably get you up about 100 to 300 points. Another method is by using testosterone injection therapy. And with that, it’s very important to do at least twice a week. We prefer three times a week dosing. So you don’t have these massive ebbs and flows of testosterone.

Dr. Darshan Shah

And the last way that I like that, I use personally and, you know, I like for a lot of patients is testosterone pellet therapy. That’s where you put a small pellet of dissolvable testosterone under the skin of the buttock. And it takes a little procedure once every 4 to 6 months, but basically lets me forget about, you know, having to inject myself with testosterone.

Dr. Darshan Shah

This is letting me have small doses, testosterone every day without having that inject myself. So those are three modalities. We never almost never used testosterone creams on anybody. I can’t remember the last time I prescribed that just because the absorption is so variable and it’s, you know, can get on your loved ones, it can get on your pets.

Dr. Darshan Shah

And people forget all the time to put it on all of that good stuff.

David

I’m curious, what the hell do you get a surge in the beginning or is it even?

Dr. Darshan Shah

Yeah. So the first time that you do a pellet therapy and maybe even the second time you’ll have an immense feeling of a surge. And that’s because your testosterone has been low for so long that now it’s finally normalized. Your body feels it. But after the first or second time you put the pellet in? No, it’s very controlled release and it keeps getting really, you know, increases over six weeks and then it’s pretty steady over the next three or four months.

Dr. Darshan Shah

Yeah, I don’t feel a surge and I think most people feel pretty good. I’m after doing the pilots. I had had a couple of rounds of it.

David

I’ve been hearing, you know, much lower doses of testosterone replacement therapy for women.

Dr. Darshan Shah

Yeah, Yeah. A lot of women used to starting replacement therapy. And in fact, you know, for for a lot of women, that’s all we use is testosterone replacement therapy if they’re, you know, pre-menopausal. So we’re where, you know, women are a little bit more complex just because it depends on what stage their end of their of their cycle when you evaluate them and also what stage of life they’re and as far as pre during or post-menopausal.

Dr. Darshan Shah

So we really try to tailor the hormone replacement therapy towards where they are.

David

Tell me, what do you excited about bringing in to your clinical practice that you can’t right now?

Dr. Darshan Shah

I’m excited about so many things. And unfortunately our FDA makes it really, really hard to do things that they they they should be approving just so that the United States can stay ahead of the game on patient care and medical technology. However, they are not approving and they’re putting roadblocks in place because of the intervention by pharmaceutical companies that they can make money off of these things.

Dr. Darshan Shah

You know what I mean? So things such as stem cell therapy, exosome therapy, peptides, that peptides, it’s such an exciting field. There’s so much we can do in peptide therapy. You know, we see that right now with the peptides of Cmpc and marijuana, like what’s game changers for the world, right? There are risks of course, but I’ve been using peptides for years now, things like PPC, 157, CJC, etc. and now the FDA is putting more restrictions in place on these peptides.

Dr. Darshan Shah

So I think there’s a lot going on in the world of longevity that unfortunately the FDA is trying to block. But you know, there’s the research continues to go on in other countries and it will continue to flourish and we will be able to do a lot of these things here at some point, whether it be in the United States or outside.

Dr. Darshan Shah

Now, there is a lot of talk right now about gene therapy. And you might have heard of all the statin gene therapy. And I think that’s definitely an incredible new frontier. A statin is just one gene. Of course, we can do thousands of different genes. If you theorize along gene therapy, what can potentially be done. But I think Pakistan’s a good place to start because it’s a reversible type of a thing.

Dr. Darshan Shah

And also you can the effects are simply just muscle growth. And, you know, we have the biohackers trying this out right now. This still needs to be a lot of research done, but I feel like it’s going to go in the right direction where we’ll see more gene therapies coming out and also it becoming more standardized and more available to people.

David

I’m a really big on testing and monitoring. You know, I do some of the things that you’ve mentioned. I’m hearing your what you just told me I’ll probably do more. Basically, I don’t want to die. Right.

David

But it’s sort of a shame that people go and they’ll get a physical like once a year and, you know, they’re not even even checking people’s vitamin D levels. They’re not. It’s just like it’s puzzling to me. I wish that more of this was covered by insurance. And, you know, there was more oversight on people’s health because, you know, as you said, especially with like the two biggies, you know, cancer and heart disease, it’s really about what are you seeing early on?

David

You know, once a cancer mass gets to a certain level like you becomes it just you’re looking at, you know, 10000 to 20000 different forms of this. And that becomes really difficult. And the same thing with Cardiovasc disease.

Dr. Darshan Shah

I mean, it’s just mind blowing to me that like, you know, treating cancer cost upwards of 250000 to $400000 a patient, whereas giving everyone in the country a genetic test that you can get, you know, if you if you really do this a scale, you can do it for 50 bucks, 100 bucks, you know, on a yearly basis, you’d avoid so much health care costs and also so much pain and suffering right.

Dr. Darshan Shah

And the same is true for heart disease. And, you know, calcium scores are not approved by insurance. Like to me, that’s like the most utilized testing in all of medicine that you could find so much advanced heart disease with calcium scores. And they’re only like $100. Like, why not improve that? Right. And and, you know, these blood tests for Alzheimer’s, same thing.

Dr. Darshan Shah

Like, you know, they’re going to come out and they’re going to probably be a few hundred dollars to start. But I’m sure, you know, doing those at scale in detecting Alzheimer’s at an early stage is so valuable. And then, you know, I do think, though, that we do have some good testing now for metabolic disease and metabolic diseases, the base of these other diseases.

Dr. Darshan Shah

So if you can keep your insulin levels under control, then you will be way ahead of the game. You have much less risk of Alzheimer’s, cancer and heart disease. And the best way to do that is know what your hemoglobin N1 sea level is. So that’s a blood test that every doctor should be able to do for you.

Dr. Darshan Shah

And it cost basically a dollar or two. And if you’re hemoglobin A1, see every I always tell my patients, every patient you need to know what your hemoglobin and then sea level is. I should be able to ask you, you should be able to tell me what it is.

David

4.7.

00:33:19:19 – 00:33:43:01

Dr. Darshan Shah

Right? 4.7 is an incredible goal to have. So I want to be 5.2 or less. But if you start edging up 5.4 or 5.5, 5.6, you’re going in the wrong direction. We got to do something about your diet, your exercise, your sleep to get you back into inactivity. So that’s just an easy, cheap test that almost everyone has access to.

Dr. Darshan Shah

And if your doctor’s not doing it, I would insist on it. Same with Hs-crp. Inflammation is another, you know, root cause of all disease. Everyone should know whether just the AP is.

David

I don’t actually know what the number is.

Dr. Darshan Shah

Zero.

David

So it’s pretty low. Yeah. Yeah. One of the things you said early on was sort of the basics, but what I tell people, like, you got to get the big rocks, right? So that’s sleep. If you’re not sleeping, you’re sabotaging anything else. You do it, you go to sleep, figure it out, go see somebody, get that figured out.

David

And you know, what are you eating? What are you bringing into your body? And then how you moving? Like if you sort of get that more or less figured out. Okay, now we can talk about the exotic stuff, but like, you got to get that done. Dinner, the rest of it not going to work so well.

Dr. Darshan Shah

Yeah. David You know what I always find and I talk to have that talk with my patients and just even my friends and family is that people get so hung up on the little details. Like, you know, they read tomatoes are bad for you or they read, you know, and they get so hung up and then they get like paralysis by over analysis, you know, And I say let’s let’s look at the let’s look at the 20% of the information and the routines and habits is going to make 80% of the difference.

Dr. Darshan Shah

That’s the principle, right? And it’s so simple with sleep, exercise and and diet. What that 20% is like, just get that right, you know? Yeah. It’s a bonus on top of that. Right. So avoid ultra processed food Right. And like that’s to me is like step one two and three of getting your diet right You can pretty much eat anything else.

Dr. Darshan Shah

And ultra processed food is step one step two and diet is maintaining a flat glucose curve. And the way to do that is reduce your carbs, your refined carbohydrates, your refined grain intake, get your carbohydrates in your meal, don’t snack done. You do that automatically going to be healthier than most of your friends, I hate to say. And yeah, I mean, we could say the same things about exercise and sleep.

Dr. Darshan Shah

Keep living you know, don’t be sedentary. That’s and that’s that’s a massive problem that we have in our society now. It is.

David

Yeah. I could go on and on about that, but.

Dr. Darshan Shah

When you walk in this right now, David, I turned it off.

David

Oh, good for you.

Dr. Darshan Shah

I get to 20,000 steps in a day. It’s amazing.

David

Walking is just the best dance. This has been wonderful. Thank you. I’m. I’ve always sort of wondered for myself. I mean, personally, this podcast is really just about informing me about something and other people listen to it. You know, I was really curious about, you know, what exactly happens in something like if somebody goes to see you next health, like with an executive physical, what are we looking for?

David

And what are the solutions? They’re like, if we find something. Okay, that’s good.

Dr. Darshan Shah

Yeah. Yeah. So that’s what we do. I mean, you know, you come in, the executive physical takes about 3 hours to do and then we take some takes a couple of weeks for us to get the results. But then we sit down with you over two or three sessions and really make sure you understand what we’re looking at.

Dr. Darshan Shah

You know? And like I told you, we have this kind of paradigm that we use of the wellness field, which goes over the 12 aspects of health, and then we develop a plan for you and a lot of the technology that you need to keep yourself healthy. We have it on site and people come in on a regular basis, weekly basis to use it, and then we just rinse and repeat on a yearly basis.

David

Wonderful. Thank you so much for your time today. I know you’re a really busy guy, and we were trying to book this for a long time and it’s been really nice to see you and have you on.

Dr. Darshan Shah

Well, thank you so much for everything that you’re doing, David. Informing the public and doing the podcast and asking the best questions. And sure, people learn so much from your conversations. So thank you for what you do.

David

Thank you so much. Great to see you today.