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Welcome to xtend with me, Dr. Darshan Shah. A podcast dedicated to cutting edge science research tools and protocols designed to help you extend your health span. Having become one of the youngest doctors in the country at the age of 21 and trained and board certified at the Mayo Clinic, I've accumulated three decades of practice as a board certified surgeon and longevity expert. Over that time, I've discovered that a mere 20% of health knowledge yields 80% of the results. When it comes to your health span, we are living in a new era where we are creating a new healthcare system no longer focused on disease management, but achieving optimal health and vitality. Join me as I interview world renowned experts offering you a step by step guide to proactively avoid disease and most importantly, extend your health span. Welcome back to Extend the podcast where we take the 20% of knowledge that gives you 80% of the results for your health, wellness and longevity. I'm your host, Dr. Darshan Shah. Today we're diving into a topic that I discuss with my patients every single day. Supplementation. Have you ever stared at a wall of supplements in your closet or at the pharmacy and thought, where do I even start? You're not alone. It's a topic that almost all my patients have questions and concerns about. Because, no surprise here, everyone's views on supplements are a little bit different. So when I meet with the patient for the first time, I like to start with a simple question. Where are you on the bell shaped curve? So let me explain what that means. In medicine, we often use a bell shaped curve to describe how people are distributed across a spectrum. Picture a smooth curve that rises in the middle and tapers off at both ends. The vast majority of people sit right there, either slightly left or right of the middle, while smaller groups are more at the extremes. When it comes to supplements, I found patients generally fall into one of four groups along this curve. On one end of the spectrum are people who want absolutely no supplements. These patients believe they can get everything they need through their diet and are often concerned about wasting money and time on things that don't work. In some ways, they're actually absolutely right. The foundation of any healthy protocol should be nutrient dense whole foods. Large studies like the Nurses Health Study and the Health Professionals Follow Up Study confirm the undeniable role of diet in longevity and chronic disease prevention. But here's the Even the cleanest and most well intentioned diets can fall short in certain nutrients, and it depends on many factors. These factors include soil quality, where the food is actually coming from, and how long it's been stored and whether the crops have been genetically modified to grow larger but less nutrient dense. Multiple studies show that the nutrient density of our food has been dramatically reduced in the last few decades. In addition, our nutrient requirements have increased due to more demands on our cells to constantly detoxify us, due to living outside of our circadian rhythms and even due to our biology being in a constant state of chronic inflammation and metabolic disease. These two factors have widened the gap between nutrient requirements and intake, making it more necessary for supplements. To bridge this gap for these patients, I often recommend targeted supplements that are personalized to blood test results. We check vitamin D levels, vitamin B levels, inflammatory markers and markers of metabolic disease to assess what targeted therapies would work well for them. In addition, we have a frank discussion about foundational supplements and their proven benefits to reduce disease risk. Moving up the bell shaped curve, we have the people who only want foundational supplements, the essentials that have been shown to reduce the risk of chronic disease and and have an abundance of science around them. These supplements include the supplements vitamin D3, K2, omega 3 fatty acids and magnesium. I also add a high quality multivitamin with methylated B vitamins to the list of supplements we should discuss. Studies show that vitamin D deficiency affects nearly 40% of the U.S. population and is linked to everything from weakened bones to cardiovascular disease. Omega 3s are well documented for their anti inflammatory effects with research like the Reduce it trial demonstrating their ability to lower cardiovascular risk. Magnesium, which is often called the mission critical mineral, plays a critical role in muscle function, nerve signaling and even heart health, making it an invaluable addition to foundational supplements. For the reasons mentioned earlier on food nutrient density, I have people consider a multivitamin either in pill or powder form. I'm ensuring that this multivitamin has a special form of B vitamins called methylated B vitamins. 40 to 60% of people actually have a genetic deficiency in their ability to activate vitamins like B12 and folate and the methylated form bypasses this inefficiency. Further along the bell shaped curve, you'll find the group willing to experiment with a little bit more. This is where I find most people lean in if they have the financial resources to invest in supplements that have a lot of research behind them but are not necessarily foundational. Let's go over a list of some of these and their potential benefits that build upon the foundational supplements mentioned. First, let's discuss creatine, one of the most studied supplements out there. Creatine Monohydrate comes in powder form and is easy to add to any smoothie or even your morning coffee. For most of my patients, it has been shown to offer significant benefits, including improved muscle strength, cognitive function, memory and overall cellular energy, all supported by decades of research. If you're looking for the best in fitness equipment on the market, I found it for you. I've recently joined IFIT as their chief science advisor and I want to tell you why. Their commitment to science and research is commendable, and I see them doing more to incorporate it into their devices than any other brand out there. So whether you're aiming to crush your cardio goals or build serious strength, ifit's cutting edge treadmills, bikes and strength machines are designed to bring the gym to you. With world class trainers and interactive workouts built into every machine. Ifit doesn't just keep you moving, it keeps you motivated. So if you're looking to elevate your home gym experience with the best in Fitness tech, choose iFit. Another supplement on this list is CoQ10 or Ubiquinol. CoQ10 is a powerful antioxidant naturally produced in the body that plays a key role in cellular energy production, particularly within the mitochondria. Its benefits include improving heart health, reducing oxidative stress and supporting brain and muscle function, making it especially valuable for individuals with conditions like heart failure, migraines or those taking statins, which depletes CoQ10 levels. CoQ10 supplementation is ideal for adults over 30, any individual with a chronic health condition, or anyone looking to optimize energy and cellular health. Next, let's talk about the growing number of supplements now available to help treat metabolic dysfunction and to improve the health of our mitochondria, the powerhouses of our cells. These include NAD boosters like nicotinamide riboside nr, which increases mitochondrial ATP production. So every cell has the energy to do its job. NAD is the precursor molecule for the powerhouses of our cells, the mitochondria. There's a lot of talk about different forms of NAD and boosters like like NR or nmn, and I think there's still more research to be done. However, the research does look promising. I'm also a really big fan of using the $100 billion pharmaceutical factory that we're all born with in our gut. Probiotics are now available that utilize this system to make beneficial compounds for our biology. One of these, for example, is urolithin A. This promotes increased levels of mitochondrial health. Another one is a probiotic called AKKERMANSIA that increases production of the hormone glp, one that can lead to weight loss. This is the same hormone found in drugs like semaglutide or tirzepatide. Finally, at the far end of the curve are those who want to take everything their favorite longevity influencer is taking. These are the biohackers, the ones stacking 10, 20 or even 30 supplements into their daily protocol. My advice to them is to take all that enthusiasm and turn it into a personalized protocol that actually works with the help of a longevity minded practitioner like myself who can help curate a personalized protocol with high quality supplements. There are so many other categories of supplements that can be explored for specific situations as well. You have herbs like turmeric, ashwagandha and echinacea. You have mushrooms like chaga and lion's mane. Then you have protein powders and fiber and nootropics and adaptogens. There's almost an endless list of choices, so working with a professional is key. In my clinic, I design protocols for patients based on three things. Number one, their desire and tolerances for how many supplements they want to take. Number two, their blood work and genetic tests. And number three, their medical history and what conditions they're trying to treat. Using these data points, we can triangulate what's going to work the best and then constantly make adjustments every few months by checking another blood panel. Another critical piece of this conversation about supplements is quality control. The supplement industry is unfortunately, largely unregulated. Research has shown that many supplements sold online or even in pharmacies have inconsistent ingredient volumes or worse, contaminants. Stick to brands that prioritize third party testing or have a CGMP or NSF logo. Some companies, for example, sell exclusively to doctors offices and undergo rigorous quality assurance, including third party testing. Apps like Supp Co can help you research supplements and websites like Vitaboom.com can help curate the recommendations based on your biology. And they only list high quality supplements from proven brands. These tools can be game changers in helping you make informed decisions. At the end of the day, supplementation is a tool, not a magic bullet. For some, it can breach critical gaps. For others, it can push the boundaries of what's possible for longevity and and performance. But wherever you land on the bell shaped curve, make sure your choices are grounded in science, quality and your unique biology. If you found today's episode helpful, share it with someone who's curious about supplements. And if you're enjoying Xtend, please don't forget to subscribe and leave us a review. I'm Dr. Darshan Shah and I'll see you next time as we continue to explore the science of living longer and better. Thank you so much for listening to the podcast today. Please remember to subscribe if you like this episode and give us a good review and share a link with your friends. It really helps to support all of our efforts. I also want to remind you that the information shared on this podcast is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Please consult with your healthcare provider or physician before making any decisions or taking any action based on what you hear today, especially if you have any underlying health conditions or or on any medications. Your doctor knows your personal health situation the best, and it's always important to seek their guidance.