
Hosted by Darshan Shah, MD · EN

Mitochondrial decline is one of the most overlooked drivers of aging, impacting energy, muscle function, cognitive performance, and immune resilience long before symptoms become obvious. Many of the changes we associate with aging may actually stem from a loss of cellular efficiency and the body's ability to renew itself. In this episode of Extend, I sit down with Dr. Anurag Singh, Chief Medical Officer at Timeline, to unpack the science behind urolithin A and how mitochondrial health shapes longevity. We break down how the gut microbiome influences cellular function, why mitophagy declines with age, and what clinical research shows about improving muscle strength, recovery, metabolic health, and immune function. We also explore how targeted supplementation and lifestyle strategies can help restore mitochondrial quality and support long-term performance and resilience. Dr. Anurag Singh is a physician-scientist with an M.D. in internal medicine and a Ph.D. in immunology, currently serving as Chief Medical Officer at Timeline, where he leads the development of advanced nutritional and skincare products focused on mitochondrial and cellular health. What We Discuss: (04:58) Drug vs nutraceutical and what urolithin A actually is (06:23) Gut microbiome differences and why most people don't produce it (08:11) How urolithin A is made from diet and polyphenols (10:25) Effective dosing and supplementation strategy (15:32) What mitochondria are and why they matter for aging (21:26) Mitophagy and how mitochondrial quality declines over time (23:43) Main drivers of mitochondrial damage (26:24) How urolithin A supports cellular renewal (28:55) Muscle aging, strength, and performance (33:07) Clinical trial results in older and sedentary adults (35:32) Effects on recovery in elite athletes (37:07) Brain health and neurodegeneration research (43:00) Immune system impact and inflammation (47:29) When to start and how to think about supplementation Thank You to Our Sponsors: Timeline: Visit timeline.com/drshah for 20% off a subscription on top of the new starting price of $79. Learn more about Dr. Shah: Website: drshah.com Clinic: next-health.com Instagram: darshanshahmd Learn more about Dr. Anurag Singh: Website: https://www.timeline.com/

Modern life is quietly accelerating biological aging, from posture and movement patterns to sleep disruption, chronic stress, and constant digital stimulation. Many of the symptoms people experience daily, like pain, fatigue, brain fog, and disconnection, may reflect a deeper misalignment with how the human body was designed to function. In this episode of Extend, I sit down with Dr. Kavin Mistry, board-certified neuroradiologist and author of Primal Health Design, to unpack how modern lifestyles are reshaping our biology and accelerating aging. We break down how posture, movement, circadian rhythm, nutrition, and environment influence brain and spine health, and why reconnecting with our primal design is essential for long-term resilience and performance. We also explore how daily practices like morning sunlight, grounding, deep work, and intentional routines can help restore alignment with your biology and create more energy, clarity, and longevity in a fast-moving, AI-driven world. Dr. Kavin Mistry is a board-certified neuroradiologist, author, and thought leader in longevity and human performance, known for developing the Primal Health Design framework to help individuals reconnect with their biology and reverse the hidden effects of modern living. What We Discuss: (05:04) Seeing accelerated biological aging in brain and spine scans (06:02) Childhood exposure to primal tribes and longevity insights (10:19) Tech neck, posture, and modern spinal degeneration (12:09) Nerve compression, numbness, and daily symptoms (15:03) Primal posture and how alignment reduces aging (18:07) Strength training, hanging, and back development (21:17) Deep squat and reversing sedentary damage (24:14) Walking, movement, and daily activity patterns (25:01) Grounding, inflammation, and connection to earth (28:01) Morning sunlight and circadian rhythm optimization (31:27) Sleep, stress, and parasympathetic recovery (32:11) Nutrition, microbiome diversity, and prebiotics (36:44) Stillness, presence, and flow state (42:20) Tribe, relationships, and loneliness in modern life (48:44) Purpose, service, and greater cause (51:02) Finite life awareness and long-term decision making (56:07) AI, time leverage, and becoming more human (59:47) Morning and night routines as the foundation Thank You to Our Sponsors: IM8: Try IM8 today with a 30-day money back guarantee. You can get 10% off your first order with code DRSHAH at https://im8health.com/discount/DRSHAH. Momentous: Head to livemomentous.com/fiber and use code DRSHAH for up to 35% off your first order. Learn more about Dr. Shah: Website: drshah.com Clinic: next-health.com Instagram: darshanshahmd Learn more about Dr. Mistry: Website: kavinmistrymd.com Instagram: kavinmistry.md LinkedIn: Kavin Mistry MD YouTube: @kavinmistrym.d

Allergies, chronic inflammation, and constant exposure to environmental toxins are reshaping how our immune system functions, often in ways that go unnoticed until symptoms appear. What many people see as isolated issues like gut problems, skin reactions, or fatigue may actually reflect a deeper immune imbalance. In this episode of Extend, I sit down with Dr. Tania Elliott, double board-certified physician in internal medicine and allergy and immunology, to unpack how the immune system operates across infection defense, hypersensitivity, and autoimmunity, and how modern exposures like microplastics, synthetic chemicals, and ultra-processed products are disrupting this balance. We break down how chronic inflammation begins, why gut health is central to immune regulation, and how everyday products in your home may be silently driving immune dysfunction. We also explore how simple, high-impact changes like reducing toxin exposure, improving indoor air quality, and retraining the immune system through targeted therapies can restore balance and reduce long-term disease risk. Dr. Tania Elliott is a double board-certified physician in internal medicine and allergy and immunology, focused on helping patients understand immune health, reduce toxic exposures, and apply practical, science-backed strategies to improve resilience, longevity, and overall well-being. What We Discuss: (09:07) Immune system explained in three core functions (10:42) How chronic inflammation begins (11:13) Gut health and microbiome disruption (12:50) Signs your immune system is out of balance (15:39) Environmental toxins and ultra-processed foods (17:39) Skincare, sunscreen, and endocrine disruptors (21:33) Microplastics and hidden daily exposure (24:00) Teflon, PFAS, and long-term health risks (30:01) Building a healthier home environment (40:07) Why allergies are increasing (41:40) Hygiene hypothesis and early exposure (45:10) Peanut allergy and early introduction (50:01) Recurrent infections and immune deficiency (51:21) Immune testing and biomarkers (52:30) IVIG therapy and immune support (57:11) Allergy immunotherapy and long-term solutions Thank You to Our Sponsors: Function Health: Learn more and join using my link. Visit www.functionhealth.com/drshah and use gift code DRSHAH25 for a $25 credit toward your membership. Momentous: Head to www.livemomentous.com/fiber and use code DRSHAH for up to 35% off your first order. Learn more about Dr. Shah: Website: drshah.com Clinic: next-health.com Instagram: darshanshahmd Learn more about Dr. Tania Elliott: Website: Dr. Tania Elliott Instagram: drtaniaelliott LinkedIn: Tania Elliott, MD

High-performing individuals often appear successful on the outside while quietly experiencing a loss of joy, emotional numbness, and chronic internal stress. This disconnect, often overlooked in traditional diagnostics, may signal a form of depression that goes unrecognized for years. In this episode of Extend, we sit down with Dr. Judith Joseph, psychiatrist, researcher, and author of High Functioning, to unpack the science of high-functioning depression and how anhedonia can manifest even in highly productive individuals. We break down why traditional mental health models often miss these patients, how pathological productivity masks deeper issues, and how the biopsychosocial model helps identify where joy is being lost across biological, psychological, and social domains. We also explore Dr. Judith Joseph's 5 Vs framework and how tools like validation, venting, values, vitals, and vision can help systematically restore daily points of joy and long-term emotional resilience. Dr. Judith Joseph is a board-certified psychiatrist, researcher, and media educator specializing in high-functioning depression and the science of happiness, known for translating complex psychiatric concepts into practical, evidence-based tools that help individuals reclaim joy and optimize mental well-being. What We Discuss: (06:03) High-functioning depression explained (08:50) Pathological productivity and busyness (10:07) Limits of traditional diagnosis (12:28) Anhedonia and loss of joy (14:00) Happiness vs joy (16:45) Biopsychosocial model (19:57) Biological drivers of mood (21:56) Metabolic health and inflammation (24:00) Social factors and relationships (26:09) Validation and venting (29:07) Values and meaning (31:39) Vitals and lifestyle factors (35:29) Technology and disconnection (37:18) Vision and planning joy (42:02) Psychoeducation and awareness Thank You to Our Sponsors: IM8: Try IM8 today with a 30-day money back guarantee. You can get 10% off your first order with code DRSHAH at https://im8health.com/discount/DRSHAH. Momentous: Head to livemomentous.com/fiber and use code DRSHAH for up to 35% off your first order. Learn more about Dr. Shah: Website: drshah.com Clinic: next-health.com Instagram: darshanshahmd Learn more about Dr. Judith Joseph: Website : Dr. Judith Instagram: drjudithjoseph LinkedIn: Dr. Judith Joseph MD MBA

Cognitive decline, mood disorders, and persistent neurological symptoms are often treated in isolation, even as underlying drivers like inflammation, infections, and blood flow dysfunction continue to go unaddressed. Emerging research suggests that brain health requires a root cause approach that integrates physiology, environment, and lifestyle over time. In this episode of Extend, we sit down with Dr. Eboni Cornish, Associate Medical Director at Amen Clinics and President Elect of ILADS, to unpack the science of neural longevity and how brain imaging can reveal hidden drivers of mental health symptoms. We break down how SPECT scans uncover patterns of neuroinflammation, why conditions like ADHD and depression may stem from infections, toxins, or hormonal shifts, and how blood flow and cerebellar function play a central role in cognitive performance and emotional regulation. We also explore how factors like sleep apnea, perimenopause, chronic infections, and metabolic dysfunction quietly reshape brain activity and how targeted interventions can restore function over time. Dr. Eboni Cornish is a nationally recognized expert in neuroinflammation and complex chronic illness, integrating advanced biomarker testing with brain imaging to uncover root causes and translate cutting edge science into practical strategies for long term brain and body resilience. What We Discuss: 04:17) Neural longevity and why brain health is missing from longevity conversations. (05:23) SPECT scan imaging and how it reveals brain activity and blood flow. (08:55) Neuroinflammation and root causes behind mental health symptoms. (14:13) The cerebellum as a central regulator of brain function. (17:06) Perimenopause, estrogen decline, and changes in brain perfusion. (23:22) Depression and mood disorders as physiological and blood flow issues. (25:56) Lyme disease, infections, and neuropsychiatric symptoms. (32:21) Brain scan patterns of inflammation and diagnostic insights. (36:05) Sleep apnea and its impact on brain function and cognition. (40:00) A systems approach to brain and body longevity. (45:43) What a healthy brain looks like on imaging. (48:01) Dementia risk, progression, and early detection. (52:09) Practical steps to assess and improve brain health. Thank You to Our Sponsors: Function Health: Learn more and join using my link. Visit www.functionhealth.com/drshah and use gift code DRSHAH25 for a $25 credit toward your membership. Learn more about Dr. Shah: Website: drshah.com Clinic: next-health.com Instagram: darshanshahmd Learn more about Dr. Cornish: Website : Dr. Eboni Cornish Amen Clinics Dr. Cornish on Instagram: dr.ebonicornish Amen Clinics on Instagram: amen clinics Learn more about ILADS: ILADS

Mental health conditions like depression, PTSD, and trauma related disorders remain difficult to treat, especially when underlying cognitive and emotional patterns persist over time. Emerging research suggests psychedelic assisted therapies may work by temporarily changing how the brain processes information and the sense of self. In this episode of Extend, we continue our conversation with Dr. Rick Doblin, founder of MAPS, to explore the mechanisms behind psychedelic therapy. We break down how compounds like LSD may reduce activity in the default mode network, how this shift affects perception and emotional processing, and why integration is essential for translating short term insights into lasting change. We also explore how traditional practices like ayahuasca combine psychological and spiritual frameworks, and how these approaches are shaping new perspectives on trauma, behavior change, and mental health treatment. Dr. Rick Doblin is the founder and executive director of MAPS (Multidisciplinary Association for Psychedelic Studies), the organization leading global research into psychedelic assisted therapies and working to develop evidence-based treatments for PTSD and other mental health conditions. What We Discuss: (1:01:22) LSD therapy for trauma and addiction (1:10:10) Psilocybin, creativity, and cognition (1:12:05) DMT, ego dissolution, and consciousness (1:18:21) Ayahuasca traditions and addiction recovery (1:26:39) MDMA therapy and intergenerational trauma (1:31:36) Ketamine clinics and treatment resistant depression Thank You to Our Sponsors: Timeline: Go to timeline.com/drshah to get 20% off your order. Learn more about Dr. Shah: Website: drshah.com Clinic: next-health.com Instagram: darshanshahmd Learn more about Dr. Rick Doblin: Website: maps.org Instagram: rickdoblinphd X: @RickDoblin

Depression, PTSD, and trauma related disorders continue to challenge modern medicine, even as our understanding of the brain and consciousness rapidly evolves. New research suggests that certain therapies may help unlock deeper healing by combining neuroscience, psychology, and carefully guided experiences. In this episode of Extend, we sit down with Dr. Rick Doblin, founder of MAPS, to unpack the science and history behind psychedelic assisted therapy and its potential role in mental health treatment. We break down the research behind MDMA assisted therapy for PTSD, how psychedelics influence neuroplasticity and emotional processing, and why therapeutic context, preparation, and integration are essential for safe and meaningful outcomes. We also explore how psychedelic research is reshaping conversations around trauma, healing, and the future of psychiatry. Dr. Rick Doblin is the founder and executive director of MAPS (Multidisciplinary Association for Psychedelic Studies), the organization leading global research into psychedelic assisted therapies and working to develop evidence-based treatments for PTSD and other mental health conditions. What We Discuss: (01:55) The political origins of psychedelic prohibition (04:40) Ancient psychedelic traditions and the Eleusinian Mysteries (08:01) Dr. Rick Doblin's path to founding MAPS (10:34) Science, policy, and the future of psychedelic medicine (11:00) Expanding research on MDMA therapy (12:21) Psychedelic churches and religious freedom laws (15:42) Why context and safety shape psychedelic outcomes (16:20) Neuroplasticity and emotional processing (17:36) Bromo-LSD and non-psychedelic therapeutic compounds (20:39) Psychedelics and rewriting personal narratives (23:22) The Good Friday Experiment and mystical experiences (25:23) MDMA therapy and trauma processing (27:47) Psychedelics and alternatives to alcohol (30:30) Ketamine therapy and pharmaceutical incentives (36:16) MAPS, MDMA development, and commercialization (41:56) The FDA pathway for MDMA therapy (47:00) Global psychedelic research initiatives (56:51) Early LSD research in psychology …to be continued Thank You to Our Sponsors: Timeline: Timeline powered by Mitopure just dropped the price. Check it out at timeline.com/drshah and get an additional 20% off your first month with code DRSHAH. Learn more about Dr. Shah: Website: drshah.com Clinic: next-health.com Instagram: darshanshahmd Learn more about Dr. Rick Doblin: Website: maps.org Instagram: rickdoblinphd X: @RickDoblin

Cholesterol remains one of the most debated biomarkers in cardiovascular medicine, yet many people still misunderstand what it actually tells us about metabolic health and disease risk. As research evolves, the conversation is shifting from simple cholesterol numbers toward deeper drivers of cardiometabolic dysfunction. In this episode of Extend, we sit down with Nick Norwitz, metabolic health researcher and physician scientist, to unpack the science behind cholesterol, insulin resistance, and cardiovascular risk. We break down the difference between LDL and ApoB, why insulin resistance may be a stronger predictor of heart disease, how statins work beyond cholesterol lowering, and what emerging research reveals about metabolic health, biomarkers, and individualized risk. We also explore how curiosity driven experimentation, data tracking, and deeper metabolic literacy can help people move beyond simplistic cholesterol narratives and better understand their own cardiometabolic health. Nick Norwitz is a physician scientist and metabolic health researcher who graduated valedictorian from Dartmouth College before earning a PhD in Human Metabolism from the University of Oxford and an MD from Harvard Medical School. Following a personal battle with inflammatory bowel disease, he became a leading voice in metabolic health education and the author of the widely read newsletter StayCuriousMetabolism.com. What We Discuss: (02:14) The biggest misconception about cholesterol, LDL, and cardiovascular risk (06:03) How sleep, inflammation, and plaque formation connect to heart disease (08:18) Why insulin resistance may predict cardiovascular risk more strongly than LDL (10:40) The atorvastatin study that showed suppressed GLP-1 levels (16:54) Statins, pleiotropy, and why lowering LDL is only part of the story (22:16) Coronary calcium scans and how imaging can change treatment decisions (24:48) The Lancet statin meta-analysis and how headlines distorted the findings (33:20) CoQ10, TUDCA, and supportive strategies for people taking statins (35:15) Ezetimibe, how it works, and why it may have neuroprotective potential (46:09) Bempedoic acid and how it compares with statins (51:47) PCSK9 inhibitors, pros and cons, and who may benefit most (54:20) ApoB versus LDL and why particle count matters (56:15) The Oreo experiment, lean mass hyper-responders, and individualized cholesterol responses (59:19) What to do after a high LDL result instead of automatically defaulting to a statin (1:02:00) Berberine, nattokinase, and other non-prescription options for cardiovascular support (1:06:03) The challenge of communicating nuance in health content online (1:10:18) Why personalized experimentation matters more than one-size-fits-all medicine (1:12:36) Lp(a), waist-to-hip ratio, and why cardiometabolic context changes risk Thank You to Our Sponsors: IM8: Try IM8 today with a 30-day money back guarantee. You can get 10% off your first order with code DRSHAH at https://im8health.com/discount/DRSHAH. Learn more about Dr. Shah: Website:drshah.com Clinic:next-health.com Instagram: darshanshahmd Learn more about Nick Norwitz: Newsletter: staycuriousmetabolism.com YouTube: nicknorwitzMDPhD Instagram: nicknorwitz Twitter: Nick Norwitz MD PhD

Chronic stress, cognitive overload, and neurodegenerative disease are rising as modern life pushes the brain beyond what it was designed to handle. At the same time, most people still have almost no visibility into how their brain is actually performing day to day. In this episode of Extend, we sit down with Ramses Alcaide, founder and CEO of Neurable, to unpack how brain computer interface technology is moving from research laboratories into everyday wearable devices. We break down how non-invasive EEG sensors built into headphones can track brain age, cognitive speed, mental recovery, focus, and stress, and how AI is making brain data accessible without the complex lab equipment historically required. We also explore how continuous brain monitoring could transform prevention by identifying early patterns linked to burnout, ADHD, traumatic brain injury, and neurodegeneration years before symptoms appear. Ramses Alcaide is the founder and CEO of Neurable, a neurotechnology company developing non-invasive brain computer interfaces built into everyday wearable devices. He earned a PhD in Electrical Engineering and Neuroscience from the University of Michigan, where his research on EEG biomarkers and brain computer interfaces laid the scientific foundation for Neurable's technology. What We Discuss: (06:00) What brain computer interfaces are and how EEG measures brain activity (10:45) How Neurable uses AI to isolate and upscale brain signals (14:00) The limits of snapshot brain testing and the value of continuous brain data (18:00) ADHD, attention patterns, and biofeedback training for focus (22:00) Brain training through gaming and performance optimization (26:30) Why brain wearables may become the next generation of health trackers (28:00) The cognitive metrics Neurable measures including brain age and cognitive speed (30:00) Tracking brain age and how daily habits influence cognitive aging (35:00) Meditation training and future sleep optimization tools (39:00) How people can start using brain wearables in everyday life (40:00) Personal experiments to reduce brain age including sleep, exercise, and creatine (45:00) How clinics may use brain data to personalize treatments (50:00) Stress detection and the future of wearable brain monitoring (52:00) Barriers to adoption and the future of neurotechnology Thank You to Our Sponsors: Next Health: Your destination for cutting-edge health optimization—from IV therapy to hormone balancing. Explore at https://www.next-health.com/ Learn more about Dr. Shah: Website: https://www.drshah.com/ Clinic: https://www.next-health.com/ Instagram: darshanshahmd Learn more about Ramses Alcaide: Website: neurable.com Linkedin: https://www.linkedin.com/company/neurable Instagram: ramsesalcaide

Chronic inflammation, environmental toxins, and metabolic dysfunction continue to accelerate aging and chronic disease across modern populations. Many of the biggest drivers of health decline remain invisible, quietly accumulating in the body for decades before symptoms appear. In this episode of Extend, we sit down with Dr. Terry Grossman, physician, longevity expert, and co author of Transcend and Fantastic Voyage with futurist Ray Kurzweil, to unpack the science behind therapeutic plasma exchange and its emerging role in longevity medicine. We break down how environmental toxins, microplastics, heavy metals, and chronic inflammation influence aging biology, why traditional medical testing often misses these risks, and how therapies like plasma exchange may help remove harmful compounds while improving key biomarkers linked to healthspan. We also explore how advanced diagnostics, hormone optimization, peptide therapies, and targeted longevity protocols may help individuals move beyond disease management toward true biological optimization. Dr. Terry Grossman is a pioneer in anti aging and longevity medicine who operates longevity clinics in Colorado and co authored two best selling books with Ray Kurzweil. He is also the author of Plasma Reset, the first book focused on therapeutic plasma exchange as a strategy for detoxification, anti aging, and long term health optimization. What We Discuss: (01:54) How Dr. Terry Grossman entered longevity medicine (05:19) The shift from traditional care to prevention and wellness (12:45) The core pillars of longevity and health optimization (16:30) VO2 max, HRV, and modern longevity metrics (20:00) Genetic testing and personalized lifestyle strategies (22:40) Environmental toxins and the rise of microplastics (33:20) Simple detox strategies for daily life (37:55) What therapeutic plasma exchange actually does (46:55) Plasma exchange for toxins, autoimmunity, and long COVID (51:45) Senescent cells, inflammation, and biological aging (1:06:00) Hormone optimization and healthspan (1:14:20) Peptides and emerging longevity therapies (1:20:10) Rapamycin and metformin in longevity medicine (1:24:00) Foundational supplements for long term health (1:29:00) AI and the future of longevity medicine (1:34:30) Longevity escape velocity and the future of aging Thank You to Our Sponsors: IM8: Try IM8 today with a 30-day money back guarantee. You can get 10% off your first order with code DRSHAH at https://im8health.com/discount/DRSHAH. Vitaboom: For supplements you can trust and wellness solutions tailored to your health, visit https://vitaboom.com/ Learn more about Dr. Shah: Website: https://www.drshah.com/ Clinic: https://www.next-health.com/ Instagram: darshanshahmd Learn more about Dr. Terry Grossman: website: grossmanwellness.com