JJ: [00:00:00] [00:00:03] I’m JJ Virgin, [00:00:06] PhD dropout, sorry mom, turned four [00:00:09] time New York Times best selling author. Yes, I’m a [00:00:12] certified nutrition specialist, fitness hall of famer, and [00:00:15] I speak at health conferences and trainings around the globe, [00:00:18] but I’m driven by my insatiable curiosity and [00:00:21] love of science to keep asking questions.

Just digging for [00:00:24] answers and sharing the information I uncover with as [00:00:27] many people as I can. And that’s why I created the [00:00:30] Well Beyond 40 podcast, to [00:00:33] synthesize and simplify the science of health into [00:00:36] actionable strategies to help you thrive. In each [00:00:39] episode, we’ll talk about what’s working in the world of wellness, [00:00:42] from personalized nutrition and healing your metabolism, to [00:00:45] healthy aging and prescriptive fitness.

Join [00:00:48] me on the journey to better health. So you can love how you [00:00:51] look and feel right now and have the energy to play [00:00:54] full out at 100.[00:00:57]

So you’re eating [00:01:00] well, you’re exercising, you’re managing your stress. [00:01:03] If you’re sleeping well, [00:01:06] yay, check, check, check, check. Or maybe you’re looking at [00:01:09] improving those a little bit, but you want to know what the next [00:01:12] level is. And you’ve heard about some of the different tests out there, [00:01:15] like a full body MRI, or maybe a [00:01:18] liquid biopsy, that can help you with early [00:01:21] detection.

Because one of the things we know with, Whether it’s [00:01:24] cardiovascular disease, which is our number one killer, or [00:01:27] cancers, that early detection really is the single most [00:01:30] important thing. I have been so curious about these [00:01:33] tests, which ones make sense to do, which ones [00:01:36] don’t. There’s been so much information flying around the internet.[00:01:39]

And I’m super excited today to have Dr. [00:01:42] Darshan Shah with me because we are going to [00:01:45] unpack all of those tests. The things you’ve been hearing about, [00:01:48] um, like doing a coronary calcium [00:01:51] scan, doing a liquid biopsy, doing a [00:01:54] clearly test. What are all these different tests? Are they worth [00:01:57] it? What should you do?

If so, when should you do them or [00:02:00] how often? What are they going to tell you? We’re going to unpack [00:02:03] all of that and we’re also going to talk about [00:02:06] what are the most important pillars really for [00:02:09] longevity. What are the things that really are the [00:02:12] 80 20, that 20 percent that will make the biggest 80 percent [00:02:15] difference.

I have got an [00:02:18] incredible new friend here today. I must say new [00:02:21] friend because it was absolutely one of those people that you first meet them and go, [00:02:24] this is someone I’ve been looking for for a long time. [00:02:27] Super smart, super fun. He’s a well known health [00:02:30] specialist, surgeon, author, entrepreneur, and he’s the founder of [00:02:33] Next Health.

This is the [00:02:36] clinic that is sweeping the nation. [00:02:39] are now six and 44 on the [00:02:42] way all over the country and actually all over the world. [00:02:45] And this is the world’s largest health [00:02:48] optimization and longevity clinic. [00:02:51] And not only is it doing all of the [00:02:54] fundamentals and then the advanced testing, [00:02:57] but it also has some of the advanced fun stuff [00:03:00] to the biohacking lab.

So we’re going to be talking about [00:03:03] that and what things you are going to [00:03:06] be looking at, wanting to look at. To [00:03:09] optimize your wellbeing and extend your lifespan because [00:03:12] literally Dr. Shaw has helped thousands of [00:03:15] patients do this. So this is [00:03:18] the, uh, this is a, another Doogie Howser [00:03:21] here. He completed his medical training, uh, [00:03:24] and finished all of that at 21.[00:03:27]

He also has alumni status at Harvard Business [00:03:30] School and Singularity University. Quite an [00:03:33] overachiever and super smart and has really put all of this [00:03:36] together in a way that makes it very understandable, [00:03:39] um, so that you can figure out what you do next. [00:03:42] Put all of this information so you [00:03:45] can look at next health and also, um, [00:03:48] you know, look at these different tests and what you might want to [00:03:51] be thinking about doing.

I put them all at jjvirgin. [00:03:54] com forward slash next health and I will be [00:03:57] right back. Dr. Darshan Shah. Stay with [00:04:00] me.[00:04:03]

Dr. [00:04:06] Darshan Shah, I don’t know where you’ve been all my life, but um, [00:04:09] you’re a keeper. Oh, thank you. That’s so sweet of you. Yes. [00:04:12] I mean, just even when I met you last night for the first time at our [00:04:15] party, it was like, where have you been? Like a long lost [00:04:18] friend. I’ve been following you for a

Dr. Darshan Shah: long time [00:04:21] and I’m so glad to finally get to meet you.

What are you following [00:04:24] me for? You know, um, I got into this [00:04:27] world of health, wellness, [00:04:30] nutrition, quite a long time ago, actually. [00:04:33] And back when there weren’t many podcasts out [00:04:36] there and you were one of the first podcasts I was listening to. For [00:04:39] quite a while, yeah, so I’ve been following you for a [00:04:42] while and, you know, we can talk more about kind of like my trials and [00:04:45] tribulations and business and things like that, but all throughout that, [00:04:48] like, I’ve, I’ve had your podcast on the auto [00:04:51] download

JJ: list.

That makes [00:04:54] my heart sing. You never put these things out there. He goes, anybody [00:04:57] listening, anybody, anybody out there. So. [00:05:00] I’d love to go back because you’ve had quite a journey. In fact, [00:05:03] when you were coming in here, I was looking over some stuff. I was kind of [00:05:06] stalking you and I go, you’re like Doogie Hauser.

Oh, You [00:05:09] graduated medical school at 21. [00:05:12] Yes, I did. And then you ended up with like, [00:05:15] tell us through your journey, cause you hit a big leap, [00:05:18] which I’m super

Dr. Darshan Shah: excited about. Yeah. So, you [00:05:21] know, I, Came from a family of physicians. [00:05:24] And for me being a physician was my goal. [00:05:27] And for, for many reasons, one is, um, you know, I had a [00:05:30] lot of familial pressure to become a physician, but also [00:05:33] I saw a lot of like the respect they got.

I saw [00:05:36] a lot of good that they were doing and I wanted to just go [00:05:39] into medicine. So I rushed through school. I was very [00:05:42] lucky to be able to graduate early. [00:05:45] And the nice thing about that for me was it afforded me [00:05:48] the opportunity looking back in retrospect. [00:05:51] To really get kind of multiple careers in [00:05:54] medicine.

So my first career, as soon as I graduated [00:05:57] from, um, surgery from, um, medical school [00:06:00] was to learn surgery. And I did, uh, trauma [00:06:03] surgery. I did general surgery. I [00:06:06] did, um, a lot of. [00:06:09] Emergency surgeries. And so doing that, you [00:06:12] really gain an appreciation for this, the [00:06:15] human body. I mean, you, you, when you’re operating and you [00:06:18] see this incredible machine work, you gain an [00:06:21] incredible amount of appreciation for that.

So I did that for about 10 years. And [00:06:24] then I decided. I wanted to learn more and I went to the Mayo [00:06:27] Clinic and I trained in reconstructive surgery. [00:06:30] And um, after I got done with that, I started a business opening [00:06:33] surgery centers and hiring other surgeons to work at [00:06:36] those surgery centers. And I was also operating

JJ: it.

I was going to [00:06:39] say, wait, wait, you jumped ship. So you were, you were both [00:06:42] being a reconstructive surgeon and opening [00:06:45] surgery centers. Exactly. So I was an entrepreneur.

Dr. Darshan Shah: And

JJ: [00:06:48] And

Dr. Darshan Shah: operating 12, 14 hours a day, five, six, how [00:06:51] was your sleep? This is what led to [00:06:54] all of my issues. I [00:06:57] forgot to sleep. Oops. I forgot to [00:07:00] sleep.

I forgot to buy my own food and cook it. [00:07:03] Oh boy. You were eating hospital food, hospital food. [00:07:06] My God. Yeah. And the hospital food, even now you go to the hospital. [00:07:09] It’s. How many of the worst stuff for you, you [00:07:12] know, and so, yeah, I was eating whatever I could find. I was [00:07:15] stressed out. I was working in the business and working on the business [00:07:18] and I became very sick.

I was [00:07:21] 45, 50 pounds heavier than what you see right now. [00:07:24] Um, worse than that though, I had an autoimmune [00:07:27] condition developing. Um, so I couldn’t really move well. [00:07:30] My joints were all really aching. And you were how old? [00:07:33] I was 40 years old. Oh, well, I mean, all this started in my [00:07:36] thirties.

JJ: Right, right, right. For 10 years.

Just Right. You don’t just wake up with [00:07:39] autoimmune disease one day, . No. As we know, we’re 45 extra [00:07:42] pounds. Exactly. So, but, but wow. Yeah. It [00:07:45] wasn’t like you were like 70 with achy joints. [00:07:48] I felt like a 70-year-old.

Dr. Darshan Shah: Yeah. I felt like I have it on three [00:07:51] blood pressure medications. Oh my gosh. Yeah, and they couldn’t get my blood [00:07:54] pressure under control.

I could not sleep. And [00:07:57] so I did what any person who wants to [00:08:00] get well does. So my wife became pregnant with our [00:08:03] first child when I was about 40 [00:08:06] and I decided that I need to make a major change [00:08:09] because I remember this day like it was yesterday. I came home one [00:08:12] day from work. It was like literally 10 o’clock at night and I [00:08:15] opened up a medical journal and there was like this chart in one of [00:08:18] the articles about if you have metabolic [00:08:21] syndrome.

Combined with, um, combined with [00:08:24] an autoimmune disease, your, your 20 [00:08:27] year survival rate is basically cut in half. And so I was [00:08:30] like doing the math on my own. I was like, [00:08:33] that’s me. I had like a [00:08:36] 50 percent chance or higher of dying before my son [00:08:39] graduated from college. That’s what I, you know, the math showed [00:08:42] that it was like, I have to make a change here.

And so 10 [00:08:45] years ago that’s what led to kind of this new journey and this [00:08:48] new career I have now.

JJ: Wow. Yeah. There’s nothing like [00:08:51] kids where all of a sudden you stop doing some of the dumb stuff you’ve been [00:08:54] doing. She’s like, I need to be around. Yeah, exactly. Yes. [00:08:57] So, so you’ve had the wake up the [00:09:00] epiphany.

How did you learn [00:09:03] all of the different things? Because as we know, [00:09:06] These are not things taught in medical school, right? So

Dr. Darshan Shah: [00:09:09] what’d you do? I did not have the knowledge. So I thought, you know [00:09:12] what? I am going to go to Beverly Hills and hire the best concierge medical [00:09:15] doctor I can find. He or she must know [00:09:18] how to fix me.

So I go down to Beverly Hills [00:09:21] 10 years ago, 10 years ago. Yeah. Yeah, 10 [00:09:24] years ago, 25, 000 later, he [00:09:27] prescribes me a brand new autoimmune medication [00:09:30] to, you know,

JJ: dampen my [00:09:33] immune system. Because concierge back then, and even now, [00:09:36] doesn’t mean integrative. No, not at all. It just sounds like, [00:09:39] you know, Neiman Marcus

Dr. Darshan Shah: local service.

Yeah. You just get their cell phone [00:09:42] number and call them whatever you want. If you have a call for a call, you call them, but they [00:09:45] still like no advice on nutrition. No [00:09:48] advice on exercise, no advice on

JJ: stress. Too bad [00:09:51] I didn’t meet you 10 years ago when I was working with one of [00:09:54] these. [00:09:57] Yeah,

Dr. Darshan Shah: I should have wiped out the phone book a few times.

[00:10:00] So then, you know, he, he also noticed that I was, um, [00:10:03] kind of depressed about my situation. So he put me on [00:10:06] Prozac. So now instead of 10 [00:10:09] pills, I’m on 14 pills. [00:10:12] And so I was like, this is not going to work for me. [00:10:15] So I decided, you know, I talked to a group of my friends and I [00:10:18] decided to take some time off and [00:10:21] focus on my health.

And so that meant to me what it [00:10:24] means to like you as well. I know you, for listening to [00:10:27] your podcast, like go get educated about this stuff, go [00:10:30] learn. And so I went to [00:10:33] I went to conferences, [00:10:36] I got my personal trainer certification about [00:10:39] exercise. Where was all of this in [00:10:42] medical school? Like, this

JJ: should have been an entire semester, half a [00:10:45] year.

Well, come on. You know, I actually was talking to Dr. Andy [00:10:48] Galpin about this, and I was like, who I’m obsessed with. But I was [00:10:51] like, why is it? Because I had this epiphany. I go, doctors [00:10:54] get an hour of nutrition, but they get no hours of exercise. [00:10:57] Zero. Like, zero. Zero. Zero. And he goes. Come on, [00:11:00] let’s be real. I, I, I was all the way up in a PhD program in [00:11:03] exercise science, and I still feel like there’s so much to [00:11:06] learn.

How could a doctor expect to, to, you know, be expected to know [00:11:09] nutrition and exercise and mental, it’s too [00:11:12] much. Absolutely. It’s just

Dr. Darshan Shah: overload. Well, and [00:11:15] here’s the thing. I think people really need to recognize [00:11:18] The bucket of Western medicine is [00:11:21] meant to diagnose disease and treat that disease, [00:11:24] right? And so, so if you have an emergency, say you have an [00:11:27] autoimmune crisis, you end up at the ICU, you need a [00:11:30] Western medicine trained doctor.

You don’t need, you know, a [00:11:33] personal trainer but that [00:11:36] entire bucket is completely different than the bucket [00:11:39] of lifestyle and health, right? And so, [00:11:42] I think once I, in my mind, separated [00:11:45] those two, I had that, aha, [00:11:48] I’m using the Western medical [00:11:51] system to achieve something that it was never meant to achieve in the [00:11:54] first place, right?

And so that’s why [00:11:57] going out and educating myself really [00:12:00] started to move the needle for me. And this is where I [00:12:03] discovered, I fell into, like 10 years ago, functional [00:12:06] medicine wasn’t really a big thing, right? It was just starting. [00:12:09] IFM and and IHS. And so [00:12:12] I fell into an IFM conference. I’m like, oh my [00:12:15] gosh,

JJ: this is what, and you went to, and you heard Jeff Bland.

[00:12:18] Yes, exactly. I remember the first time I heard Dr. Jeff Bland, I think it [00:12:21] was like maybe 15, 20 years ago. And I’m like, [00:12:24] he’s making up words. Yeah, exactly. What [00:12:27] is he talking about? [00:12:30] Metabolomics? What is he [00:12:33] talking

Dr. Darshan Shah: about? That’s exactly how I felt. But then I [00:12:36] realized that there was something definitely here.

[00:12:39] And it was incredible. Like within eight months, I lost like [00:12:42] 35, 40 pounds. I got off almost [00:12:45] all my medications. And I was like, [00:12:48] this is, and I was talking to my surgical patients too, [00:12:51] at this point in time. And a lot of them avoided surgery just [00:12:54] by doing some of the same things I did. Because they would ask me like, you’re looking [00:12:57] so good, Dr.

Shah. Like, what are you doing? I’m like, oh, let me tell you. I [00:13:00] like learned to sleep better. I started, you know, [00:13:03] my meals with, with fiber instead of eating pancakes [00:13:06] every morning. And so just these little changes [00:13:09] made such a massive difference that I, number one, got [00:13:12] myself healthy. But number two, I realized like, This [00:13:15] is the medicine I want to practice.

And so, [00:13:18] um, yeah, but I changed my entire career into [00:13:21] combining kind of the best of what Western medicine has to [00:13:24] offer with this entire field of functional medicine, [00:13:27] nutrition, exercise, physiology.

JJ: So important [00:13:30] too, because I’ve always felt like in the years that I’ve been [00:13:33] studying all this, there was this divide, you know, there was [00:13:36] like functional, integrated, natural, holistic [00:13:39] versus, and you know, I had a son who nearly [00:13:42] died.

Um, was hit by Carla for dead in the street. [00:13:45] Traumatic brain. Like he had a 20 order. [00:13:48] Well, he had a massive brain [00:13:51] injury and he had 13 fractures, which was the least [00:13:54] of the issues at the time, you know, crushed healed full bit. [00:13:57] And, um, the trauma [00:14:00] center, he went to Farber UCLA, [00:14:03] um, amazing, amazing doctors there.

And this one, [00:14:06] Dr. Carlos Donaire, who’s like, you know, the [00:14:09] angel forever. Um, and they got him to [00:14:12] like, I wouldn’t have, again, I wouldn’t have wanted, you [00:14:15] know, someone treating with [00:14:18] supplements, he would die on the table, right? I needed the [00:14:21] surgeon, but once we got him through all of [00:14:24] that, they wanted to keep him in the hospital.

I go, I’m taking him home. [00:14:27] And now we’re going to start hyperbaric and red light [00:14:30] and exercise and neurofeedback [00:14:33] and everything else. And we’re going to bring him back through. And [00:14:36] so you’ve got to use like, why wouldn’t you use all [00:14:39] the

Dr. Darshan Shah: available? All the tools. That’s so key. That’s a [00:14:42] realization I had like.

There’s some great stuff in Western medicine, [00:14:45] like one of my things I did at Mayo Clinic was I did a lot of research in [00:14:48] the, with the hyperbaric oxygen chambers and you know, we were [00:14:51] treating people with like massive injuries that [00:14:54] had like, you know, like large amounts of tissue loss and the [00:14:57] hyperbaric oxygen would heal these massive [00:15:00] injuries.

from the inside out. I’m like, why can’t we [00:15:03] use that for people that are not in the hospital? That’s one [00:15:06] of the first things I did when I started this new career was [00:15:09] get a hyperbaric chamber so people can use it for their [00:15:12] wellness. And it makes a big difference. So that’s just one [00:15:15] example of using all the tools that you have [00:15:18] available to you.

JJ: So you’ve now put together these [00:15:21] centers and you have, I think you said six of [00:15:24] them, but you have like 44 more getting ready to go. [00:15:27] So someone’s going to come into a center. What walk us [00:15:30] through the process? Like who’s, who’s a candidate? What can [00:15:33] happen for them? And what do you see? [00:15:36] Well, I’ll let you do that.

And then I have another key question so that [00:15:39] anyone listening, whether they come in or not, we’ll have some key [00:15:42] takeaways they can do. Yes. I’d love to, I’d love to

Dr. Darshan Shah: talk about that. So, [00:15:45] um, basically the people that come [00:15:48] into our center are people that are either a, [00:15:51] They realize that they’re, they’re exercises on [00:15:54] point.

They’re doing good nutrition as best as they can. You [00:15:57] know, they’ve heard about sleep. They’ve read about it. They’re helping their sleep, but they [00:16:00] know there’s more, you know? And so what’s [00:16:03] beyond the basics, the basic pillars, how [00:16:06] can I, Access functional medicine. How could I [00:16:09] access the Western medicine and bring that into my life?

[00:16:12] So that’s one group of people. Another group of people [00:16:15] are people like in the situation I was. People are frustrated with the [00:16:18] Western medical system that’s getting put on more and more [00:16:21] medications and don’t really have the [00:16:24] tools available to them to turn back the [00:16:27] Their health span to turn back the clock of their health and, [00:16:30] and, and get healthier.

So that’s another group of people. [00:16:33] And then the third group of people we have are like the advanced people [00:16:36] that are already doing all of this stuff. They’ve [00:16:39] had biomarker panels on and they want real [00:16:42] longevity medicine. So we call ourselves a health optimization [00:16:45] and longevity center. And um, what [00:16:48] we do is we combine and ’cause this is what I did in my [00:16:51] career and that whole structure around this combine the best [00:16:54] of sleep nutrition.

And exercise [00:16:57] education with functional medicine and [00:17:00] then Western medicine, keeping you alive, making sure you don’t [00:17:03] die. So the diagnostics of Western medicine. And [00:17:06] then lastly, when we got all that, right, we talk about longevity [00:17:09] medicine. And I’m making this like real thing because I just think, well, the [00:17:12] wellness wheel that we did come through this journey.

[00:17:15] Well,

JJ: what I love the most, we were talking offline about this [00:17:18] is you got to fix the big rocks [00:17:21] first. You know, I’m always amazed. I’m like [00:17:24] sleep, nutrition, Exercise. [00:17:27] Like these have to be in one. For me, sleep [00:17:30] also has stress, sleeping stress. [00:17:33] Right. And I put recovery in there too. That’s all, that’s [00:17:36] really all the recovery to pillar.

Like if you’re stressed out, you’re not going to be able to [00:17:39] recover, you know? And then I think exercise, we actually need to [00:17:42] move it more even into movement [00:17:45] because you can’t exercise 20 minutes a day, sit on your butt [00:17:48] for the rest of the time. Right. So [00:17:51] I’m like, you know, I became obsessed this year. I’m like, now [00:17:54] I’m going to really be a good step tracker too.[00:17:57]

So, and then, of course, nutrition is [00:18:00] just such a huge pillar that creates [00:18:03] so much animosity online. I’m like, it’s like [00:18:06] religious wars, and I said, these are just tools, people. [00:18:09] Diets are tools. You have to pick the one that’s right for you. [00:18:12] And so those, like, [00:18:15] I said, do those because then you’ll see where you’re [00:18:18] at.

And what really is going to need to get tweaked and [00:18:21] fixed. So someone coming in, like, what are some of the key [00:18:24] diagnostic tests and tools you think people should be [00:18:27] going through? Yeah,

Dr. Darshan Shah: that’s, that’s all very [00:18:30] well said. And so, you know, I think in those [00:18:33] pillars, people get paralysis by over [00:18:36] analysis, just too much information.

Right. And so [00:18:39] we really try to distill it down. I use a. [00:18:42] What’s up guys, [00:18:45] it’s Dr. J. [00:18:48] I’m Dr. J. [00:18:51] I’m Dr. J. [00:18:54] I’m Dr. J. [00:18:57] I’m Dr. J. [00:19:00] I’m Dr. J. [00:19:03] I’m Who runs their business by looking at their KPIs [00:19:06] once a year with a consultant that only has [00:19:09] 15 minutes to spend time with them, right? And you’re not going to run your [00:19:12] business that way.

So why would you run your health that way? So we [00:19:15] educate people on the KPIs of their health. What are the [00:19:18] key biomarkers they need to know? So what are [00:19:21] those? Okay. So in the blood testing world, we [00:19:24] do We do about 10 biomarkers we want people to [00:19:27] follow. Hemoglobin A1c is one of them. [00:19:30] HSCRP, which is an inflammatory [00:19:33] marker.

ApoB is another one. Homocysteine [00:19:36] levels, uric acid levels. So there’s like a little list we [00:19:39] give people. We actually give them a spreadsheet so they can put these things in there. It’s nice

JJ: too. [00:19:42] And then do you

Dr. Darshan Shah: put optimal

JJ: ranges? Optimal ranges. That’s your [00:19:45] math out there. Right. Which, what’s nice about that, because I [00:19:48] talk about the fact that 6.

8 percent of us [00:19:51] pre pandemic were metabolically healthy. But then when you look at what the [00:19:54] metabolic health marker ranges were, those are not [00:19:57] metabolically healthy. I’m like, what are we now? Like maybe [00:20:00] 3 percent of the population is really metabolically healthy. [00:20:03] Yeah. Um, but already I’m hearing the [00:20:06] tests in there that you go to the doctor.

And [00:20:09] they’re not looking at apophenicol, and they’re not looking [00:20:12] at homocysteine, and they’re not looking at uric acid. I’m [00:20:15] sure fasting insulin’s in there too. And I look at this and go, [00:20:18] why are we missing the ones [00:20:21] that have the biggest determinant when you really look at them? Just like, [00:20:24] are you doing DO2max testing by any chance?

Yes. Yes. We

Dr. Darshan Shah: [00:20:27] utilize DO2max, skeletal muscle mass, [00:20:30] DEXA scans. We, we were utilizing, [00:20:33] and the reason we’re not looking at those. And I’ll tell you, I’ll tell you [00:20:36] exactly the reason is that none of those [00:20:39] have a number that’s diagnostic of a disease. [00:20:42] So, you know, if you go to a [00:20:45] Western trained medical doctor, they look at homocysteine level.

If [00:20:48] they even look at it, most of them won’t order it. Like, what are they going to do with [00:20:51] the homocysteine level that’s high? The tools are [00:20:54] there to fix that in that world. You know what I think? It’s so [00:20:57] funny. It’s one of the easier ones to. And it is one of the easier ones to [00:21:00] fix, right? But there’s not a prescription medication that’s, that’s attached to

JJ: [00:21:03] homocysteine.

So, um, [00:21:06] It’s amazing to me, and I’m so thrilled you’re doing [00:21:09] VO2s. And also when you look at like DEXA, there’s not even norms [00:21:12] for how much skeletal muscle mass you should have, like how, [00:21:15] or, or body fat percentage. And the body fat [00:21:18] percentage norms I was taught in doctoral school [00:21:21] are totally different than what are listed now.

And I’m like, I’m [00:21:24] sure we didn’t change in the [00:21:27] last, 30 years. Why is it all of a sudden? [00:21:30] Okay. Now to be 30 percent body fat when back then, [00:21:33] why did this become? Okay. You know, how could that [00:21:36] possibly be? Um, so for [00:21:39] the VO two max, like how much are you getting into [00:21:42] exercise and, and, and specific [00:21:45] exercise prescription stuff?[00:21:48]

Dr. Darshan Shah: On the exercise pillar, you’re absolutely [00:21:51] right. You have to have, there’s multiple mini pillars within [00:21:54] that, right? Right. And so the Pareto [00:21:57] principle is exactly what you said. Don’t be [00:22:00] sanitary. Okay. That’s the first thing we got to fix. Okay. [00:22:03]

JJ: So the average American, I was just looking up when I was doing my talk here at [00:22:06] IHS, average American right now is getting three to [00:22:09] 4, 000 steps a day.

Yeah. I

Dr. Darshan Shah: believe it. [00:22:12] It’s wild. Gosh. And, and I would [00:22:15] say that I would even think it’s even lower than that [00:22:18] from what I could see in my patients. And [00:22:21] so, you know, we, we tell people just cause you exercise [00:22:24] 20, 30, even an hour a day doesn’t mean that counteracts negative [00:22:27] effects of you sitting there for four hours plus.

So the [00:22:30] studies on sedentary behavior show after four hours is when it [00:22:33] really starts affecting your health. And for every 10 percent [00:22:36] increase you have after four hours of sedentary behavior, [00:22:39] you increase your all cause mortality rate by [00:22:42] 10%. So it’s just like a massive, like, [00:22:45] exponential curve on the deleterious effects of being sedentary.

So [00:22:48] first you just need a shock, a shocker in C. [00:22:51] Well, there’s something similar to that. I have an app [00:22:54] on my laptop and then every 45 minutes, [00:22:57] it shuts the screen off. If you can’t do that, just get an egg

JJ: [00:23:00] timer and it goes off every 45 minutes. We can all do this on [00:23:03] our, cause I mean, these apps are set up now to just ping you.

I had [00:23:06] a friend. Manesh Sethi, and he made [00:23:09] this, what’s it’s called, Pavlok, and it was to create [00:23:12] new habits, and it was a little shocker walk. Shocker, yeah, I remember [00:23:15] that. I remember reading about it. Some

Dr. Darshan Shah: [00:23:18] people need that.[00:23:21]

So yeah, and then on the VO2max, yeah, so [00:23:24] we, we put into place, and the other pillars are, of course, [00:23:27] um, VO2max training. So two exercise [00:23:30] training and strength trainings. We put all those into place and then [00:23:33] a lot of education around recovery. Cause you know, [00:23:36] if you, if you are, I see so much over [00:23:39] exercising down one pillar, not mixing it enough, [00:23:42] especially after the age of 40, 45, you really need to [00:23:45] have a balanced exercise regime versus us going [00:23:48] down one

JJ: pillar a lot.

Yeah. And most of the time, what I [00:23:51] see is people going, and I think this is the issue with [00:23:54] exercise, Exercise could be chi [00:23:57] gong, you know, or power lifting. [00:24:00] It’s like anything in between. But you see a lot of people [00:24:03] just erring on the cardio side. You do. And when I was [00:24:06] in school, they were like, do not have people lift weights till they’ve lost the weight.

I’m [00:24:09] like, I was rogue and I violated that. I was like, well, that’s [00:24:12] the dumbest thing I’ve ever heard. That’s exact opposite. [00:24:15] Um, but you know, especially as you age and you are [00:24:18] cardio centric. You are going to make yourself worse. [00:24:21] You’re going to make yourself worse. You’re going to create

Dr. Darshan Shah: more inflammation.

You’re going to damage your [00:24:24] joints. You’re going to lose those fast twitchers. Exactly. Lose the fast [00:24:27] twitch muscle fibers, all of that. And so we really, [00:24:30] we spent a lot of time for women, mostly [00:24:33] getting them to add strength training and cut back [00:24:36] on the cardio. And for men, a lot of men are just [00:24:39] gym brats, right?

Like they just want to spend. Bison chest. [00:24:42] Leg day, chest [00:24:45] day, arm day. Yes, I know. Where’s your, where’s your walking [00:24:48] day? There’s none of that. So yeah, so we do a lot of [00:24:51] balancing of exercise routine. And then, you know, [00:24:54] like everyone asks, like, what is the right amount? So I [00:24:57] always start slow and then we look at their VO2max [00:25:00] and if they’re improving, if we’re improving VO2max, we know we’re [00:25:03] adding in enough.

If we’re not improving it, we know that we need to [00:25:06] add more. And the same goes for like, [00:25:09] Zoju, like measuring lactate thresholds and those kind of things.

JJ: You do all of [00:25:12] that?

Dr. Darshan Shah: Yeah.

JJ: Wow. Your patients must love [00:25:15] doing those VO2max tests. At least explain what a [00:25:18] VO2max test is for everybody. Yeah. So VO2max Without scaring [00:25:21] them.

Dr. Darshan Shah: Yeah. Yeah. So a virtual max test is when [00:25:24] you. Get on a treadmill, or you can actually do it on a bike [00:25:27] too, and you, you have [00:25:30] your exercise to, to understand [00:25:33] what is the maximum uptake of oxygen that your mitochondria [00:25:36] are able to do, basically. That’s a very basic level. [00:25:39] And so we have numbers on, um, [00:25:42] and research that show that [00:25:45] after you, um, reach the age of 40, your VO2 [00:25:48] max will decline if you’re not exercising.[00:25:51]

And so you have different levels of where you should be, that [00:25:54] number should be, um, for your age [00:25:57] group and your sex. And so you really want to aim [00:26:00] for, for, for, for that number. So I always use [00:26:03] 50 at 50, you know, if you can be 50 at 50, you’re, you’re [00:26:06] doing okay. And if you can go beyond that, that’s even better because then you [00:26:09] build up a reserve.

For when you become 70 and [00:26:12] 80.

JJ: And this is of any of the [00:26:15] tests, I think the biggest correlation was all [00:26:18] cause

Dr. Darshan Shah: mortality, right? Exactly. Yeah. There’s a massively correlated with [00:26:21] all cause mortality. Um, there’s a lot of research around this [00:26:24] test, um, on the strength front with grip, gripping

JJ: [00:26:27] strength. Yeah. I brought a little prop to my talk yesterday.

You would have [00:26:30] thought they were like, what is that? [00:26:33] You brought a grip dynamometer. I brought a hand grip dynamometer. They were [00:26:36] like, what? I don’t know. People are ordering it on Amazon. [00:26:39] and [00:26:42] please [00:26:45] subscribe [00:26:48] to [00:26:51] my channel. [00:26:54] And I actually have the same or more muscle [00:26:57] mass than I did even in my 20s and 30s, but my strength was [00:27:00] declining because I was having trouble opening jars.

And I go, [00:27:03] what is this? You know,

Dr. Darshan Shah: pull

JJ: ups to [00:27:06] the rescue does not mean go squeeze tennis balls. [00:27:09] Right. That means like, go do a farmer’s carrier. That [00:27:12] is

Dr. Darshan Shah: such a good point. Cause I have this conversation with people all the time. Like, why don’t [00:27:15] I just buy one of those grip You know, those exercises [00:27:18] for your overall strength.

It’s not about your grip strength. [00:27:21] And the same is true of VO2max. It’s a proxy for your overall [00:27:24] cardiovascular fitness and your mitochondrial health. It’s [00:27:27] not just, you know, go do head training once a week and you’re [00:27:30] improving. It’s a proxy for all the work you’re putting in.

JJ: [00:27:33] Now when you’re doing a DEXA, how are you unpacking that?

[00:27:36] What are you looking at? Yeah, so with

Dr. Darshan Shah: the DEXA scan, we’re looking [00:27:39] at bone density, we’re looking at visceral fat, we’re [00:27:42] looking at skeletal muscle mass as well, um, [00:27:45] mostly appendicular, so arm and leg skeletal muscle [00:27:48] mass, and comparing that to charts as well as to [00:27:51] where we think you should be. Um, but really it’s not, [00:27:54] You know, I think a lot of people, um, get so [00:27:57] hung up on like, they have a long way to go from where they are to where it [00:28:00] should be.

It’s just, it’s, I really try to explain to [00:28:03] people that it’s not about where you should be so much as [00:28:06] are you improving or are you declining? And [00:28:09] so I try not to focus so much on where they should [00:28:12] be. I just like to focus on, okay, we’re here now. [00:28:15] Here’s how we’re going to improve you. Let’s check again in [00:28:18] six months and let’s see where you’re at in six months.

Make sure that [00:28:21] The actions we put in place are making [00:28:24] a difference in the right direction. What I

JJ: love about all [00:28:27] of that is the in between when [00:28:30] you’re focusing on resistance training. This is why early on it was like, [00:28:33] okay, I was one of the first personal trainers. I went, I [00:28:36] could run with people, but if I take them to the gym, they’re [00:28:39] seeing All these changes, because all of a sudden they’re stronger.

[00:28:42] Like it is very quantifiable. Yes. You know, versus you [00:28:45] went for a run.

Dr. Darshan Shah: Exactly. [00:28:48] Yeah. Yeah. Yeah. That’s very, uh, [00:28:51] like a lot of people, most people like [00:28:54] to see numbers, you know, the frequency of those [00:28:57] numbers. Some people like to see them like every day. Some people like to see them once [00:29:00] every six months, but there’s very few people I find [00:29:03] that don’t like the numbers, you know, or, and those [00:29:06] people that I just let.

Me manage numbers [00:29:09] for them and tell them they’re going in the right direction. So I think it was [00:29:12] really important is for everyone to realize there’s not one way of doing [00:29:15] this and work for everybody. And for me, I see hundreds [00:29:18] of patients and so, you know, I try to divide people up into [00:29:21] groups of like, what is their tolerance to looking at the numbers.

[00:29:24] And I try to fit the program and my communication [00:29:27] style to what the patient is gonna react the best to, to [00:29:30] create compliance.

JJ: Yeah. So on the [00:29:33] sleep front, yes. [00:29:36] Yeah. Um, any, like, what is your, [00:29:39] this is such, I think this is one of the most complicated [00:29:42] topics of all, the whole [00:29:45] sleep unpacking. And there’s also all this crazy [00:29:48] information out there online about sleep.

[00:29:51] Um, you know, what are some of your fundamentals

Dr. Darshan Shah: for sleep? [00:29:54] My principal of sleep is sleep. [00:29:57] Number one, if you have sleep apnea, you have to have it [00:30:00] treated. And so I can’t tell you the number of patients that I [00:30:03] see come in with sleep apnea and people that don’t even [00:30:06] look like they should have sleep apnea.

I see. Like runners that [00:30:09] have sleep apnea, that have a body messiness of like [00:30:12] 20 and Oh wow. And how are you finding out about sleep apnea? [00:30:15] Um, I, we ask ’em questions, so there’s a stop. [00:30:18] Bang questionnaire that we go put them through [00:30:21] and and then we measure their sleep [00:30:24] at night. So we have the home sleep monitor that measures their pulse [00:30:27] oximeter and their heart rate at night and we find multiple [00:30:30] episodes of their sleep.

Oxygen levels dropping at night, [00:30:33] and so we have to fix that one way [00:30:36] or the other. Yeah. And a lot of people is as simple as like raising the [00:30:39] head of their bed, you know? But some people do need CPAP, [00:30:42] some people do even need surgery to get it fixed. So, you [00:30:45] know, I think. If you have sleep apnea, the [00:30:48] solution is not like, you know, wearing blue blocker glasses.

You [00:30:51] have to be aggressive. [00:30:54] So, okay. So once we make sure [00:30:57] that we have that addressed or we’ve ruled it out, [00:31:00] then we move on to, I always say, you know, one of the [00:31:03] best ways for us to know how you’re sleeping is to track it in some [00:31:06] way or form. We need a tracker. We’re not going to use it forever. [00:31:09] Let’s use it for 60 weeks to see where you’re at [00:31:12] and what actions we can put into place to improve [00:31:15] your sleep.

Those actions are divided into two [00:31:18] categories, your sleep routine and your sleep environment, and then [00:31:21] we just start making little changes to both of those to get [00:31:24] them to the point of, um, improving their sleep quality. [00:31:27] And by sleep quality, I don’t mean just like the seven, eight [00:31:30] hours of sleep, I also mean making sure they’re getting enough deep sleep and REM sleep [00:31:33] as well.

Which do you have a sleep tracker you’d prefer? [00:31:36] I don’t. And the [00:31:39] reason is different things work better for different people. No, I just [00:31:42] use two and take the better score. That’s another way of doing it. [00:31:45] Some people [00:31:48] are, you know, they can wear a ring on their finger at night. Some [00:31:51] people can’t, you know, some people [00:31:54] like that little pad under their mattress at night to wear.

Some [00:31:57] people do it on their watch. So I try to work with what they have and what [00:32:00] they’re already used to. Yeah, but I will say [00:32:03] my favorite for me personally is, um, I’ve been using [00:32:06] the sleep, the eight sleep bed lately. So I’ve been, what is it? [00:32:09] The eight sleep bed. Have you seen that? I haven’t seen it. I’ve heard of [00:32:12] it.

Okay. Yeah. So what’s great about it is it’s a [00:32:15] mattress cover or you don’t buy a mattress, but it’s a cover [00:32:18] that actually times the temperature of [00:32:21] your sleeping environment. So it changes the temperature [00:32:24] of your bed. Well, yeah. With your sleep cycles. [00:32:27] Yeah, I really do need to check it out. Yeah. What does it do about the [00:32:30] dogs in the bed?

And too much about the [00:32:33] dogs in the bed of the fortune teller. I think that it might make the dogs uncomfortable [00:32:36] enough that they leave because they don’t see our, our [00:32:39] genetics are wired to look at [00:32:42] signals, to decide when it’s time to sleep and when it’s time to wake up. [00:32:45] One of those signals is temperature.

So as they got [00:32:48] cool at night, you know, when we were cavemen, And we didn’t have [00:32:51] temperature controlled environments all the time. It was a massive [00:32:54] signal to our biology that it’s time to sleep. And as it got [00:32:57] warm again during the day, it was a signal to wake up. And so, [00:33:00] I found that just that has [00:33:03] Improve my personal sleep quality by like 50 [00:33:06] percent just by doing.

Yeah, we are

JJ: adamant with [00:33:09] the dropping of the temperature at night. And we’re trying [00:33:12] to, this is more challenging, I say we have the coolest stuff at [00:33:15] home, like we have sunlight and sauna and we have [00:33:18] a relaxed sauna and we have a cold plunge, we have [00:33:21] juve red lights, but we’re not home. So it’s [00:33:24] not helping.

[00:33:27] But when we are home, but I do it on the road, I just take hot baths. [00:33:30] And then we just drop that temperature down.

Dr. Darshan Shah: [00:33:33] The [00:33:36] other thing that’s really important about sleep that a lot of people don’t realize [00:33:39] is your sleep routine starts the moment you [00:33:42] wake up. And so the first thing you want to do when you wake up [00:33:45] is try to go outside, like physically put [00:33:48] your body outside and look at the, [00:33:51] and expose your eyeballs to sunlight.[00:33:54]

Don’t look at the sun, just be outside and look at the sunlight. [00:33:57] Even if it’s a cloudy day. The signal [00:34:00] still works for your [00:34:03] brain to set your circadian rhythm at that point. The best [00:34:06] morning for your brain,

JJ: right? Now, on [00:34:09] the nutrition front, before we get to some of the other fun stuff, [00:34:12] um, you know, just cause I’m a nutritionist, it’s a whole other, [00:34:15] it’s been like 10 hours on this piece.

But are there [00:34:18] some like clear cut things that you can [00:34:21] focus

Dr. Darshan Shah: on? Yes. So, um, I always go back to the Parano [00:34:24] principle. You know, the most important thing you can do with [00:34:27] your nutrition that will probably make the most difference is just cut out [00:34:30] ultra processed food. Then you can pretty much eat almost anything [00:34:33] you want.

Um, but cutting out ultra processed [00:34:36] food is a massive first step. Right? I mean, who picks out on [00:34:39] broccoli? Right. Exactly. Exactly. But it goes beyond that. I [00:34:42] think, you know, cutting out ultra processed food [00:34:45] is not just like having, like [00:34:48] packaged food at home. It’s also a lot of us eat more than [00:34:51] 50 percent of our meals out, right?

And a lot [00:34:54] of the restaurants we go to, they’re using ultra [00:34:57] processed foods, you know, vegetable, you know, seed oils, [00:35:00] and they’re putting together this concoction of ultra processed foods [00:35:03] for you to eat and they’re serving it to you. And that’s where [00:35:06] most of us are getting a big dose of ultra processed [00:35:09] food, that and of course fast food.

JJ: I know when I went, well, we had sweet [00:35:12] greens delivered today because I heard Drew’s podcast about the [00:35:15] sweet greens kind of like. Okay, because that’s [00:35:18] always in my oil hunt. And it’s not that, like, I think, [00:35:21] you know, we don’t have to be like, I’ll never have that. That’s not the [00:35:24] issue. You actually need six as they’re essential, but you [00:35:27] know, you’re six to three gets so out of whack because [00:35:30] of traveling.

So that is the one that we really watch. I [00:35:33] keep keep. So, uh, I’m thinking I need to just start to travel [00:35:36] with my olive oil at some point. Like, I’m like, how many suitcases [00:35:39] am I going to take? I mean, it’s, you know, come on, you know, [00:35:42] now you’re at the restaurant with all of your sea salt and [00:35:45] they’re like, leave, you know, [00:35:48] it gets a little bit, um, [00:35:51] it gets to be a lot sometimes.

It is. It is a wild with the ultra [00:35:54] processed foods and the effect on your metabolism. And I heard this [00:35:57] one from our buddy, Sean Stevens, the cheese sandwich. Yeah. [00:36:00] Study. Did you hear this cheese? So [00:36:03] they did a, and this, I mean, I was like, [00:36:06] like, well, I wouldn’t tell him to eat the cheese sandwich. So like, this was a [00:36:09] cheese sandwich.

They did a processed cheese [00:36:12] spread. God knows what that is with, you know, a, [00:36:15] um, yeah, just some, basically it was [00:36:18] like my mom used to send me to school with, was the [00:36:21] processed cheese from the white bread, the lunch bread that used to be lunch. [00:36:24] Maybe if I was lucky, I got bologna. And [00:36:27] then versus a whole grain and real cheddar [00:36:30] cheese sandwich.

And it, there was a [00:36:33] 500 calorie metabolic difference in the thermic [00:36:36] effect, like just this dump. in your [00:36:39] metabolism. So, I mean, [00:36:42] it’s the Walter Process food thing. [00:36:45] Makes you want more and lowers your metabolic rate from that. [00:36:48] That’s like that one, two [00:36:51] big punch

Dr. Darshan Shah: big or exactly. And [00:36:54] you know, I feel like some people think that.

It’s [00:36:57] um, they, they’re never going to eliminate ultra processed food [00:37:00] from their diet. They’re never going to stop going to restaurants. They just give up. [00:37:03] I try to encourage people that even if you have a 50 percent [00:37:06] reduction, it’s going to make a massive difference. Exactly that fact that [00:37:09] you talked about, the thermic effect of that food versus [00:37:12]

JJ: You don’t get an A plus since it’s like boring.

[00:37:15] Get a B plus, A minus. And [00:37:18] I had a great nutrition mentor who said, the sicker you are, the [00:37:21] farther back in your ancestry you need to go. I think it’s like you have very little [00:37:24] margin for error. If you’re in that situation, be really [00:37:27] clean. Right? But once you get [00:37:30] yourself back to it, you know, then you can have a little [00:37:33] wiggle room.

Plus exercise gives you more wiggle room. Absolutely [00:37:36] know. Right? And eating some energy [00:37:39] deficit, like it really becomes problematic if you’re eating too [00:37:42] much. Right? Absolutely. And snacking [00:37:45] multiple times a day, snacking should not be a thing. Right? Just, I know. [00:37:48] No snacking, like I, I still [00:37:51] remember when snacking became a.

And it was [00:37:54] when Susan Powder screamed, stop the insanity. We [00:37:57] started taking all the fat out of things. I was working at [00:38:00] Pritikin at the time and everything was like eat as low [00:38:03] fat as humanly possible. And we were starving to death. [00:38:06] So we had the snack. And so they created a whole snacking thing. [00:38:09] And back then I was like, we have to not do this.

We’re keeping our blood sugar [00:38:12] all the time, like, and we’re dripping food all the [00:38:15] time. Is this a terrible idea? All right. So we’ve got [00:38:18] the, we’ve talked. Over these three colors. [00:38:21] Okay, so now that we’ve gotten those two. [00:38:24] The 80 20 there, what would be the next step? So the [00:38:27] next

Dr. Darshan Shah: step now is we, I always tell people the next step is, now I’m [00:38:30] going to make sure you’re not going to die.

What do most [00:38:33] people end up passing away from? If you look at the [00:38:36] CDC top 10 causes of death, heart disease is number one. We all [00:38:39] know about, you know, heart attacks. 50 percent of [00:38:42] all heart disease gets diagnosed with your first heart attack and 50 percent of those [00:38:45] are fatal. Right. So a quarter of the population [00:38:48] doesn’t know they have heart disease until they’re Dead [00:38:51] from it.

Um, so this, what is that? [00:38:54] It’s because it is massively [00:38:57] ignored and underdiagnosed in medicine, [00:39:00] just like metabolic diseases, which is the [00:39:03] foundation for heart disease. And [00:39:06] Alzheimer’s is another major cause of death and [00:39:09] cancers as well. Metabolic disease leads to all of [00:39:12] those, right? Mm-Hmm. And so there’s a massive amount [00:39:15] of under-diagnosis happening in the [00:39:18] general population.

And, you know. The typical [00:39:21] western medicine doctors are going to kill me for saying this, but [00:39:24] it’s like, we just need to get much more [00:39:27] proactive about diagnosing diseases early, [00:39:30] rather than diagnosing them when people finally get [00:39:33] symptomatic. Symptomatic means you’ve had a heart attack, you have chest [00:39:36] pain, you have mild cognitive impairment, you have a [00:39:39] tumor that’s causing you to, you know, throw up now.

It’s just [00:39:42] way too late. All of these things start 20 to [00:39:45] 30 years before you get symptoms, and [00:39:48] we’re so used to diagnosing things. [00:39:51] So, this is where bringing the best of Western [00:39:54] medicine comes into play. So, we have incredible [00:39:57] diagnostics in Western medicine, we’re just not using them early enough. [00:40:00] So, I have all my patients do [00:40:03] tests like full body MRIs.

We have the [00:40:06] grill liquid biopsy tests for, [00:40:09] um, for cancer as well. In addition to their [00:40:12] normal screening on the cancer front, on the metabolic [00:40:15] disease front, we’re doing continuous glucose monitors, [00:40:18] insulin levels, homocysteine, uric acid, we talked about those things too. [00:40:21] Continuous glucose monitors have been a game changer.[00:40:24]

With the cardiac diagnostics, we [00:40:27] are doing a coronary calcium score on [00:40:30] everybody, and then a clearly test if they need it, [00:40:33] and that’s giving us a lot of information. And [00:40:36] also we’re doing, um, we’re doing MRI, I think I [00:40:39] talked to you about. Yes. In addition to a full functional medicine [00:40:42] blood panel as well.

So, you know, these [00:40:45] are diagnostics that are getting cheaper and cheaper now as time goes on, they’re still, [00:40:48] you know, expensive for most, but [00:40:51] if the patient does do this diagnostic kind of [00:40:54] test, we call an executive physical, this group of tests, [00:40:57] we get incredible information of pre diagnosed disease [00:41:00] 20 or 30 years before it occurs.

JJ: And the [00:41:03] reality is it is [00:41:06] really expensive to treat a disease when it’s [00:41:09] already entrenched, right? So [00:41:12] let’s unpack this a little bit because the first thing you said was full body [00:41:15] MRI and a liquid biopsy, but just [00:41:18] all like liquid biopsy. Now, do you need both? Do you need [00:41:21] the liquid biopsy as well or just the [00:41:24] MRI?

Dr. Darshan Shah: So 21st century cancer [00:41:27] diagnostics should be your normal screening tests or your [00:41:30] colonoscopies. Mammograms and GYN exams for women. [00:41:33] Prostate, uh, specific antigen. [00:41:36] And there’s two deeper prostate blood tests we can get for men. [00:41:39] Skin cancer checks. Okay. So everyone should be checked for [00:41:42] skin cancer once a year.

Um, and [00:41:45] those are like the only recommended [00:41:48] diagnostics in the Western world right now for cancer. [00:41:51] On top of that, the full body MRI [00:41:54] is extremely powerful for diagnosing [00:41:57] tumors that those tests can’t

JJ: diagnose. So [00:42:00] then Why would you need to do, and especially with [00:42:03] mammograms, with Switzerland just outlawing mammograms.[00:42:06]

Yeah, and I’ve got, yeah, I’ve got some [00:42:09] amazing doctors in Mindshare who have done, [00:42:12] gone through all the statistics that show, There’s no [00:42:15] difference between someone getting a mammogram or not getting a mammogram and [00:42:18] their death from breast cancer. Um, [00:42:21] and in fact, we have this one doctor, Dr. Jen Simmons, [00:42:24] who’s actually got a new technology that she’s pushing [00:42:27] out.

So it’s very, it’s a very cool time in the mammogram. [00:42:30] Um, but couldn’t you just skip all those and just [00:42:33] do the full body MRI?

Dr. Darshan Shah: No, because MRI is [00:42:36] not very good at looking at your colon for colon cancer, [00:42:39] unless you’re focused on the breast. It’s [00:42:42] not gonna pick up all breast cancers either. [00:42:45] Could you do that in an ultrasound

JJ: for your Yes.

That in [00:42:48] that in an ultrasound for your breast, you could do a virtual colonoscopy and [00:42:51] only go in and get polyps. Yes. You can do that as well. Yep. [00:42:54] That’s what I did the first time. ’cause I was like, I was like, oh no, I don’t wanna do that. [00:42:57] One of my friends had just launched virtual [00:43:00] colonoscopy. Yes. I center.

I go, that sounds better. Yes. [00:43:03] That that’s a lot better. Granted insurance

Dr. Darshan Shah: didn’t cover it, but [00:43:06] Right, right. This is why like a lot of these things [00:43:09] that are like. Cutting edge insurance is not going to cover it. So [00:43:12] how do you get the most from your insurance and then [00:43:15] add only what you need to add? You know what I mean?

And so [00:43:18] look, there’s definitely going to be a world where mammograms go away, [00:43:21] colonoscopies go away. We’re not there yet, but it’s [00:43:24] important to be more complete. I think [00:43:27] a lot of people just stop at what insurance covers and they don’t [00:43:30] go an additional step. And it’s time for people to start going that [00:43:33] additional.

So especially with early detection being cancer, [00:43:36] everything. I always say like if Steve Jobs. [00:43:39] Had full body MRI I’ve eaten so weird. Yeah. And [00:43:42] that, right? I mean I think that’s what caused the, yeah. I mean [00:43:45] that period issue was just

JJ: fructose [00:43:48] overload. Crazy diet. Yeah. It would be a fruitarian. Right. [00:43:51] So we could ask Dr.

Rick Johnson. Yes. We would have something to [00:43:54] say on that. Um. So, and then [00:43:57] the liquid biopsy, talk about that.

Dr. Darshan Shah: So the liquid [00:44:00] biopsy detects cell free DNA of [00:44:03] active tumors that are growing inside of [00:44:06] you. And what’s really powerful about that is I would say [00:44:09] cancer’s biggest enemy is being diagnosed at stage one, right?

And [00:44:12] so if you can diagnose tumors [00:44:15] early, Then you have a much better fighting chance of being [00:44:18] cured and versus like, you know, stage three or four, we’re talking [00:44:21] five year survival rates now. So liquid biopsy is picking [00:44:24] up cell free DNA. That’s DNA. There’s not a genetic risk [00:44:27] of cancer. It is actual tumor DNA that’s [00:44:30] being shed into your bloodstream.

And you can pull that out of a [00:44:33] blood sample now. And so for about 50 different types of [00:44:36] tumors, it will find the cell free DNA. And then we can [00:44:39] go looking for the actual tumor. So [00:44:42] that in itself wouldn’t be diagnostic enough. [00:44:45] It wouldn’t, no, you have to follow it up [00:44:48] with a traditional diagnostic study like an [00:44:51] MRI that’s looking, so say it picks up a pancreatic [00:44:54] tumor on your cell for DNA, then we’d have to do a MRI [00:44:57] of your pancreas with thin cuts to actually look for [00:45:00] the tumor itself, because it’s likely picking up something if it’s [00:45:03] not symptomatic.

It’s not a large enough [00:45:06] tumor to become symptomatic. So you have to really go searching for it, [00:45:09] but it is very specific. So it will tell you, you have a [00:45:12] liver tumor, you have a pancreatic tumor. [00:45:15] It’ll, it’ll tell you where to look.

JJ: So [00:45:18] in the order of how you would do it, because do you do all [00:45:21] of them or do you do this one?

And then because of the results of this one, do the [00:45:24] next

Dr. Darshan Shah: one. Um, we do everything at the [00:45:27] same time. And the reason is most people are [00:45:30] not going to pick up anything, right? Exactly. And the [00:45:33] other important thing about the full body MRI to know as well, is that we [00:45:36] can also pick up anatomical issues. So things like abdominal [00:45:39] aortic aneurysms.

[00:45:42] That would be good to find. Exactly. Almost all of those are [00:45:45] fatal, right?

JJ: Because they’re ruptured. [00:45:48] Yep. That’s what my grandmother died of the bombs. Um, Oh, [00:45:51] she was like, my mom just passed at 93 and everyone’s [00:45:54] like, Oh, I’m sorry. I go, my mom, like won this round of [00:45:57] life. She like slid into home. She was fully functional and [00:46:00] then zoomed out like lights.

Same with grandma. [00:46:03] Fully functional and then boop, it’s like, that’s, that’s what you want in [00:46:06] your nineties. Although I want it in my a hundred twenties. Yes. I’m, and [00:46:09] then, uh, right. And then, ’cause here’s what, here’s what’s [00:46:12] super cool because we’re living to 120. [00:46:15] Well, that means that we are, ’cause I started to go, [00:46:18] am I not middle aged anymore?

But you are middle [00:46:21] aged if. We’re living to 120. So that’s it. [00:46:24] I love that. There you go. Just fix it. [00:46:27] Exactly. Um, okay. What about the CLEARLY test?

Dr. Darshan Shah: [00:46:30] Okay. The CLEARLY is also another [00:46:33] revolution in diagnostics for cardiac disease. So the reality is, you know, there’s [00:46:36] so much controversy about cholesterol.

[00:46:39] Cholesterol levels are not diagnostic for cardiac disease. [00:46:42] It just means you have a high cholesterol. You, you need [00:46:45] multiple factors for that high cholesterol to cause damage [00:46:48] to your blood vessels. So one of the most underutilized [00:46:51] tests in that we’ve had available [00:46:54] forever is a coronary calcium score.

That’s a quick cut [00:46:57] scan of your heart that tells you if you have calcium deposit into [00:47:00] your blood vessels. Is that hard [00:47:03] or soft plaque? That is shard of black. Okay. [00:47:06] Now that clearly is diagnostic for soft [00:47:09] black. So now explain the difference. Everybody knows. [00:47:12] Absolutely. Yeah. So when a blood vessel gets, [00:47:15] starts getting clogged for lack of a better term there, [00:47:18] there’s, it goes through kind of a stepwise fashion [00:47:21] of that clogging occurring.

First thing that happens [00:47:24] is cholesterol gets under the arterial wall and [00:47:27] that’s called soft black. Then your body tries to [00:47:30] heal it with inflammation and it calcifies it. That’s [00:47:33] called. So first you’re going to have soft plaque and [00:47:36] then you’re going to have hard plaque. Hard plaque is your body’s [00:47:39] attempt to make sure, you know, this soft plaque [00:47:42] doesn’t turn into a heart attack.

And so it’s actually trying to heal this [00:47:45] plaque. And so what the clearly does is a cat scan [00:47:48] of your heart and utilizing Artificial intelligence is [00:47:51] now able to show us every [00:47:54] artery of your heart and how much soft plaque is there, how [00:47:57] much hard plaque is there, and it can even go one step [00:48:00] further and tell you if that soft plaque is unstable.

[00:48:03] Wow. So you wouldn’t

JJ: have to do the coronary calcium score. [00:48:06] Exactly. Be redundant. Wow. That’s [00:48:09] amazing. Well, what happens It’s an incredible test. If you’ve [00:48:12] got unstable soft plaques, I know that’s

Dr. Darshan Shah: the dangerous, [00:48:15] super dangerous, unstable, soft plaque usually means you need to [00:48:18] go see a cardiologist and probably get some sort of intervention done.[00:48:21]

Maybe a scan and put it in. Yeah, exactly. Because [00:48:24] you’re living with a ticking time bomb pretty much.

JJ: Wow. What [00:48:27] an amazing test. And how often would you [00:48:30] Get those and at what age would you start?

Dr. Darshan Shah: Yeah, it really [00:48:33] depends. So there is more radiation to the clearly test [00:48:36] because you now you’re really getting a really clear cat skin of your [00:48:39] heart.

So we try not to use it unless it’s [00:48:42] indicated or we feel strongly. So we’re looking at [00:48:45] really like looking at the overall patient, like what is their family [00:48:48] history? What is their cholesterol level? Do they have high blood pressure? [00:48:51] Do they have inflammation? What are their homocyst levels? And if [00:48:54] they have a constellation of.[00:48:57]

Risk factors that we’ll get the clearly and then some [00:49:00] people are getting the clearly on a yearly basis because they have a lot of risk [00:49:03] factors. Other people’s once every five years or so, [00:49:06] because we, we have a really good picture. We know what we’re going to [00:49:09] do, and it’s not dangerous right

JJ: now. And if they have a lot of risk [00:49:12] factors and, you know, okay, there’s a [00:49:15] little of the genetics, but it’s more just lifestyle risk [00:49:18] factors.

Um, and they repair all [00:49:21] those and their ApoB comes down and their homocysteine gets into [00:49:24] range. Hscrp is good. [00:49:27] Do they still need to do it? Because [00:49:30] There’s the long term damage that they’ve done or are [00:49:33] they have they gotten themselves kind of in the clear [00:49:36] because of all the lifestyle

Dr. Darshan Shah: steps? Everyone’s different.

So there are [00:49:39] some people that have completely fixed their [00:49:42] lifestyle, but they still have coronary disease that we need to [00:49:45] monitor very closely. And so I can think of, [00:49:48] you know, dozens of patients that we were able to actually [00:49:51] reversed some of their plaque. I was just going to ask you, [00:49:54] so you

JJ: can

Dr. Darshan Shah: revert how, how do you do [00:49:57] that?

Getting all the lifestyle things right, first of all, [00:50:00] um, using some of the more aggressive cholesterol [00:50:03] managing medications helps as well. Lopurtafa, which is the [00:50:06] injectable medication. But, you know, some people are [00:50:09] reversing coronary disease just with lifestyle. You’ve seen [00:50:12] that. Really? Where does it go?

Like what happens to [00:50:15] this, this plaque? How does the hard plaque go away? Yeah. [00:50:18] So the hard plaque is harder to reverse, but the soft [00:50:21] plaque, if you It’s all that risky. It’s not breaking free [00:50:24] and Soft plaque. Yeah. What’s, no, no. So what happens [00:50:27] is your body has a mechanism to fix this. Absorbing your [00:50:30] HDLs.

Your HDLs, go in there, remove okay. [00:50:33] Cholesterol from your, from the arterial wall. So if [00:50:36] you can just give them a chance, your body can [00:50:39] reverse this damage. Wow. Yeah. . Wow. Wow,

JJ: [00:50:42] wow. Rather vote for exercise too. I know. Exercise [00:50:45] and fiber are good with that. Absolutely. That is super cool.

Dr. Darshan Shah: [00:50:48] Yeah.

JJ: Which then leaves me, when I think of heart [00:50:51] disease, and especially women, I know there’s.

It’s one of the things that’s [00:50:54] irked me for the last decade. [00:50:57] is all the negativity around hormones [00:51:00] and all the concern around breast cancer when women [00:51:03] die mostly of heart disease. And [00:51:06] if they’re monitoring it, even if they do get [00:51:09] breast cancer, their, their survival rate’s so good if they [00:51:12] catch it early.

And when estrogen goes [00:51:15] down, like, and I didn’t know this at first, I was working in [00:51:18] a cosmetic surgery, a plastic surgery [00:51:21] institute, seeing clients and [00:51:24] branch and marsh. And I could [00:51:27] tell who was on hormones and who wasn’t. So [00:51:30] they could do all their labs. The doctors would send them in. They’d had their labs [00:51:33] done.

I’m looking at them and it was like, I didn’t even have to ask. [00:51:36] It was so clear, so clear what [00:51:39] would happen with their, their inflammatory markers, [00:51:42] their cholesterol, everything was like off the charts. [00:51:45]

Dr. Darshan Shah: It’s I see that all the [00:51:48] time. Yeah. And so, you know, you mentioned [00:51:51] this misconception around hormones as creatives [00:51:54] basically, you know, I think it’s killed a decade of women.

[00:51:57] Yeah. I mean, it’s, it’s, it’s really sad to see what the woman’s health [00:52:00] initiative did and specifically the media that misreported [00:52:03] a lot of it. That was stupid.

JJ: 25 percent of all [00:52:06] of the breast cancer increase, which was one [00:52:09] person. Oh, there’s, there’s

Dr. Darshan Shah: so many, so many [00:52:12] flaws and a lot of the reporting behind the.

Study [00:52:15] itself, obviously. And so after we [00:52:18] talk about, you know, in my kind of paradigm that I take our [00:52:21] patients through, once we get through those three things, [00:52:24] uh, we didn’t talk about Alzheimer’s, but everything [00:52:27] else feeds into that metabolic disease, right? Alzheimer’s [00:52:30] is when we then we start talking about functional medicine, that [00:52:33] that’s hormones, gut health and detoxifying someone’s [00:52:36] wife and also emotional health, stress, et cetera.

[00:52:39] Aaron. It’s so clear to [00:52:42] me, both men and women [00:52:45] suffer needlessly from the kind of [00:52:48] the backlash of Western medicine towards hormone [00:52:51] replacement therapy. And there’s so much suffering that’s happening. [00:52:54] Why

JJ: is there a backlash with [00:52:57] Western medicine? Is it because it can’t be [00:53:00] that the best ones are compounded?

And [00:53:03] what is it? It’s

Dr. Darshan Shah: multifactorial. I think that people are [00:53:06] stuck in kind of some of these bolder studies [00:53:09] where, you know, just having [00:53:12] Optimal testosterone levels can lead to worsening [00:53:15] of arterial plaque. We know that’s not true. [00:53:18] We know that, you know, hormones don’t lead to [00:53:21] breast cancer, um, for women either.

And [00:53:24] so, I think a lot of people in the Western medicine [00:53:27] world were educated when those, that was the party [00:53:30] line, the studies. And now, We’ve turned all that [00:53:33] around, but there’s not new education. People are just [00:53:36] entrenched in their opinions. I think that’s the biggest problem, [00:53:39] actually. People are entrenched in their opinions.

Um, and [00:53:42] then, um, the compounding thing is another big problem. You know, [00:53:45] like these are, these are compounded and they’re not [00:53:48] something that the pharmaceutical companies have available for [00:53:51] purchase. So

JJ: [00:53:54] someone now has cleaned up all of this. Um, how are [00:53:57] you, how are you Evaluating them [00:54:00] for hormone replacement therapy.

Are there people who are [00:54:03] not a candidate?

Dr. Darshan Shah: Yeah, I mean, there’s absolutely people that are [00:54:06] not candidates. Then we’re [00:54:09] doing a lot of other types of things, supplements, exercise, [00:54:12] nutritional support to get them to where [00:54:15] we know we can help them. But I think [00:54:18] that You know, the way we evaluate someone next is we [00:54:21] do a full functional medicine panel, because with functional medicine, [00:54:24] as you know, you’re really focusing on the root cause of all of [00:54:27] these issues.

And so a lot of people don’t even know what the [00:54:30] root causes are. So we do a lot of education [00:54:33] around that. Hormone dysregulation is one of them. [00:54:36] Um, you know, we’re checking for multiple different toxicities. [00:54:39] Um, we’re checking, Having metals, [00:54:42] molds, you know, indolent, uh, infections. [00:54:45] We’re checking for, um, uh, mitochondrial [00:54:48] health as well is another root cause.

Gut health. How are you checking for [00:54:51] mitochondrial health? Well, that’s a really tough one. , [00:54:54] and I, I knew you gonna ask me that, but there’s a [00:54:57] new test out there that you, I just did it today. You, you’re getting [00:55:00] amazing. So

JJ: we’re so excited about it. I’m so excited about [00:55:03] it. I’ve always used organic acid and I’m like, just like [00:55:06] looking at the exhaust in your car.

I’m like, this is so cool. Yeah. [00:55:09]

Dr. Darshan Shah: Yeah, wait, I can’t wait either. And there’s a new [00:55:12] NAD level test coming out as well. Um, so we’re going to [00:55:15] have ways to check for mitochondrial health that I think are extremely [00:55:18] exciting. Um, and then we’re checking gut health [00:55:21] as well. I mean, you know, so much of [00:55:24] our inflammation begins in our gut.

And so we’re, we’re [00:55:27] looking at all of this together in You know, [00:55:30] the best part about root cause medicine is number [00:55:33] one, you avoid disease, but the second best part is that you [00:55:36] end up having people feeling incredible again, right? They’re more [00:55:39] vibrant, they have more energy, they’re

JJ: sleeping better. Maybe not even again, [00:55:42] maybe for the first time ever, you know?

I [00:55:45] mean, you think about it, there’s so much, like, I wish I’d had this [00:55:48] information, and I’ve always been in the field, [00:55:51] but gosh. You know, I

Dr. Darshan Shah: mean, [00:55:54] well, this is what changed my life, you know, because I think that [00:55:57] even though I did not, you know, I did all the [00:56:00] calcium scores and things like that luckily I was in the clear, [00:56:03] but I felt horrible.

And really what I [00:56:06] went to the functional medicine courses, And fix [00:56:09] my gut health, fix my hormone with hormone replacement [00:56:12] is when I finally felt Yeah. Much, [00:56:15] much better. And really reversed the course of my health and my, you know, [00:56:18] my destiny. I think

JJ: so. Right. Yeah. And now you can have [00:56:21] quality years and lived to a 120 plus.

[00:56:24] Absolutely. Right? Yes. Cool. So now you have [00:56:27] these clinics you started with, you have, I think six [00:56:30] now. Six of them. And now you have 44 popping [00:56:33] up. Right. So this will be fantastic ’cause it’s, it [00:56:36] is. One of the challenges is people start to learn [00:56:39] about this and they don’t know where to go. [00:56:42] So your clinics are called Next Health?

Dr. Darshan Shah: Next Health. Right. [00:56:45] And so, yeah, so the other big piece of what we’re doing [00:56:48] too is we are actually a one stop [00:56:51] shop to do all the fun stuff that, you know, you and I [00:56:54] use around longevity. So things like, you know, [00:56:57] Sona therapy, cryotherapy, we have a little bio acting lab [00:57:00] too. Yeah. So we call it our longevity [00:57:03] circuit.

And so we have people come in, we’ve done all the [00:57:06] diagnostics, and now we also have these. things that you can come in [00:57:09] once a week and do so. And what do you have? [00:57:12] Hyperbaric oxygen. We have infrared light. We [00:57:15] have heat sauna and cryotherapy. Some people do [00:57:18] that. We also have IV therapy in all the locations.

So [00:57:21] we do nutrient IVs and AD. And we’re [00:57:24] doing some of the advanced longevity things, things like therapeutic plasmids, [00:57:27] pain, stem cell, exosome therapy, [00:57:30] ozone. That’s kind of like the [00:57:33] high level of what we’re doing. And we’re doing hormone replacement [00:57:36] therapy as well. Um, and we’re working with some [00:57:39] people in weight optimization as well.

Cool. You got it [00:57:42] all. All under one roof.

JJ: Fun. Yes. Yes. [00:57:45] It is a lot of fun. I used to have girls night [00:57:48] out at the plastic surgery institute where we bring all [00:57:51] sorts of different people in and do, but now like next level, now we [00:57:54] can go to the biohacking lab. Exactly. We actually did that in [00:57:57] Tampa with one of our doctors, Dr.

Lisa coach. She had a biohacking [00:58:00] lab. We brought all the mastermind members in and had a great time. [00:58:03] Evening event. We’re all doing cryo. And they had the [00:58:06] cryotherapy that was like the size of a huge walk-in [00:58:09] freezer. Yes, yes. Which was crazy. And then we had a salt [00:58:12] room. Yes, yes. And I mean, it was, it’s so much [00:58:15] fun.

So fun. So fun. We do that all the time. Fantastic. [00:58:18] Yeah. . Yeah.

Dr. Darshan Shah: We don’t have a salt room, but we do have that big cryo [00:58:21] jade merchant. So you have the big one. Yeah. We get like four people. [00:58:24] It’s

JJ: and everyone’s sitting there jumping up and down. [00:58:27] I’m [00:58:30] going [00:58:33] to put into the show notes all of the [00:58:36] information about the centers, how to get more [00:58:39] information, how to get on your newsletter.

I’ll put that at [00:58:42] jjvirgin. com forward slash next health. [00:58:45] And I just love your really revolutionizing things. [00:58:48] I love it. Thank you so much, AJ. A lot of fun.[00:58:51] [00:58:54]

Be sure to join me next time for more [00:58:57] tools, tips, and techniques you can incorporate into everyday [00:59:00] life to ensure you look and feel great. And more importantly, [00:59:03] that you’re built to last. And check me out on [00:59:06] Instagram, Facebook, YouTube, and my [00:59:09] website, jjvirgin. com. And make sure to follow my [00:59:12] podcast so you don’t miss a single episode at [00:59:15] subscribetojj.

com. See you next time.[00:59:18] [00:59:21] [00:59:24]

[00:59:27] Hey, JJ here. And just a reminder that the Well Beyond [00:59:30] 40 podcast offers health, wellness, fitness, and nutritional information [00:59:33] That’s designed for educational and entertainment [00:59:36] purposes only. You should not rely on this information as a [00:59:39] substitute for, nor does it replace, professional medical [00:59:42] advice, diagnosis, or treatment.

If you have any [00:59:45] concerns or questions about your health, you should always consult with a [00:59:48] physician or other healthcare professional. Make sure [00:59:51] that you do not disregard, avoid, or delay obtaining medical or [00:59:54] health related advice from your healthcare professional because of something [00:59:57] you may have heard on the show or read in our show [01:00:00] notes.

The use of any information provided on the show [01:00:03] is solely at your own risk.
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