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The Neuro Experience
Longevity Surgeon: The Biomarkers That Predict If You'll Get Cancer or Alzheimer's
01:12:03
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- [00:00]
Dr. Darshan Shah
If you look at half of my head, you can almost see my skull through my forehead skin. I myself got very unhealthy being a surgeon. It kind of all came to a point when I got an autoimmune disease on top of my uncontrolled high blood pressure, diabetes. And I decided like, you know, I can't live this way. I'm just feeling horrible all the time.
- [00:19]
Louise Nicola
Dr. Darshan Shah, the surgeon who got diabetes, high blood pressure and an autoimmune disease, and then built one of the largest longevity clinic networks in America to make sure it never happens to you.
- [00:29]
Dr. Darshan Shah
I think people are just trying to get through a clinic day. They have 50 patients, here's a statin, you know, which is exactly what the pharmaceutical companies want. They just want to put people on these medications for a long time. There's many other things that you can do that are not pharmaceutical. Making sure you're staying away from ultra processed food, exercising, getting good sleep, fiber, all these things are so important.
- [00:48]
Louise Nicola
What are you most excited about? As we move further into AI in
- [00:52]
Dr. Darshan Shah
this realm, what's incredibly exciting right now, using artificial intelligence, we can regenerate the nerve itself. Could you imagine what that's going to do for the brain?
- [01:00]
Louise Nicola
I'm Louise Nicola and this is the neuro experience. Dr. Darshan Shah, my friend. So I want to know how you went from being a surgeon, both a general surgeon and a plastic surgeon, to now going into the longevity space. You're a longevity doctor, you see patients, but you've also got this massive longevity clinic that split spans all throughout America.
- [01:26]
Dr. Darshan Shah
Yeah. Next. Health. Yes, thank you. Well, thank you for the question. I think since childhood I knew I wanted to be a doctor. I was one of those nerds. I made these little plastic anatomy models of the human body. We have a lot of family members that are doctors. I was just exposed to it a lot and it just seemed like the thing I wanted to do. I went into medical school at a very young age. I graduated from med school at a young age. I spent the next 10 years of my career, like doing a deep, deep training in general surgery and trauma surgery. So I spent the first part of my career in surgery as a surgeon. And the second part, I then went to Mayo Clinic to train in reconstructive surgery. So cancer reconstruction, because I just wanted another challenge. And cancer reconstructive surgery for people that don't know, it's extremely challenging because we were trying to make new parts of the human body and it's not just like superficial, it's Also, like, you know, when you remove pieces of places where people get cancer in their gut, you have to, like, reconstruct the esophagus, for example. And a lot of this is done in the microvasculature. You know, like what you, you do in the operating room is you. You look under a microscope to sew tiny blood vessels together. So for a very long time, I was deeply in the Western medical system and also into surgery. And I say all of that because, you know, I had deep training, board Certified surgeon, spend 12 to 14 hours a day in the operating room. And when you do surgery at that level, you're also spending a lot of time in the intensive care unit and also in the hospital just taking care of people after surgery as well. So in everything I knew about Western medicine, which I had deep knowledge, I did not have any knowledge, however, on the science of health. Mm. And I say that because I myself got very unhealthy being a surgeon. You know, I was very stressed, obviously, but I was working very long hours. I wasn't sleeping well due to stress and also just the intensity of work. My cortisol levels were through the roof all day, being in the operating room with these incredibly complicated cases. And then lastly, I just didn't take care of myself because I didn't really know, like, what a good diet was other than what other people knew. I thought the Atkins was the best diet, you know, and I didn't really prioritize exercise. I love going to the gym and working out, but I would just, you know, go to the gym and do 30 minutes on a treadmill and then do a little bit of weightlifting. I wasn't very intentional about it. And so all of this added up to me personally becoming very unhealthy. And it kind of all came to a point when I got an autoimmune disease on top of my uncontrolled high blood pressure, diabetes, hypertension, all the. All the constellation of chronic diseases. And I decided, like, you know, I can't live this way on high doses of methotrexate, which is an immune suppressive medication, and just feeling horrible all the time. I've always been like a lifelong learner. So I decided I just want to dive deep into the science of health, which is nutrition, exercise, sleep. And then through that, I discovered functional medicine, which is root cause medicine. So now really getting to the science at a cellular level, how we age and how we become susceptible to chronic disease. And when I learned that, it was a game changer for me, not just for my Personal health, but also for my mindset. And what I mean by that is I discovered that there was this whole other flip side to western medicine, which was a science of health, and it was very different than what you learned in medical school. And I always say, thank God we have this western medical system. Right. Like, if you have a brain tumor, if you get hit by a bus, if you have a heart attack, you need that system.
- [05:20]
Louise Nicola
Yeah. It's like, who's going to defibrillate you right at the scene? Who is going to give you cpr? We need it. And I'm, you know, you mentioned earlier reconstruction surgery. You know, I'm in neuroplastic.
- [05:30]
Dr. Darshan Shah
Right.
- [05:30]
Louise Nicola
Surgery, which is literally reconstruction of skulls that have defects. And so you're not going to learn that from functional medicine. So we do need that. But I want to just go back. You said autoimmune disease.
- [05:42]
Dr. Darshan Shah
Yes.
- [05:42]
Louise Nicola
What is. What's autoimmune?
- [05:44]
Dr. Darshan Shah
So my autoimmune disease. There's many different types of autoimmune diseases out there, but my particular one was called coupe de sabre, and you might have heard of it being in skull reconstruction. I was developing rapid progression of coup desabre. Coupesabre is where your immune system is attacking the subcutaneous tissues of your forehead and your scalp and also your bone.
- [06:10]
Louise Nicola
And it comes out as a rash.
- [06:11]
Dr. Darshan Shah
It comes out as tissue involution, which is. You lose. Start losing tissue. So if you look at half of my head, the skin is much thinner. You can almost see my skull through my forehead skin.
- [06:26]
Louise Nicola
If you're watching, I can't see his skull.
- [06:29]
Dr. Darshan Shah
Well, yeah, but. But if you really look closely, I have no muscle on one side of my forehead and the other. Yeah. And then back here, the. The back of my skull. The skull, if you look at my mri, is like paper thin. And so this was happening to me and it was rapidly progressing. Meaning if you look at people with advanced coup de sabrae, they almost look like they have a skeleton face on one side. It's very deforming.
- [06:58]
Louise Nicola
So this is caused entirely by stress. This is not a genetic disorder.
- [07:02]
Dr. Darshan Shah
So they don't know what really causes it. It is not a genetic disorder. It is a autoimmune disorder, and it can. No one knows what causes any autoimmune disorder. Right. It's just. They just somehow occur. And we think that it's a defect in our immune system, but the reality of autoimmune disorder is that it's not a defect of the immune system. It's an overstressed over taxed immune system that is now malfunctioning.
- [07:30]
Louise Nicola
So we know that 80% of all autoimmune diseases are female.
- [07:35]
Dr. Darshan Shah
Right.
- [07:36]
Louise Nicola
So when I look at that, I think about Ms. Yeah. And I think about demyelinating disorders, you know, the immune system literally attacking the myelin part of the axon, and that starts to degenerate. And that's quite scary because we don't know why. We still don't know why. And that. That bothers me a lot.
- [07:55]
Dr. Darshan Shah
I think the reason it bothers us as clinicians that we don't know the why is because somehow it's ingrained into us that there must be one singular why. Is it a defect of the genetics of the T cell, for example? Right. Or is it one hormone that we're missing? We're somehow trained that there has to be the one nail that we can hit with the one hammer that will somehow fix this. But the reality of disease and all chronic diseases and many of the neurodegenerative diseases and autoimmune diseases is they're immensely multifactorial and they're connected to every system of our. So in traditional Western medicine, you have the rheumatologist, which is assigned to autoimmune disease, but the reality is an autoimmune disease should have a rheumatologist, a neurologist, a gastroenterologist, a cardiologist, because it affects every system and every system is affected by it. And also every system of the body affects the immune system. And they're all interrelated and all intertwined. And that's where kind of a systems biology approach really is, where we need to be looking.
- [09:10]
Louise Nicola
That's like for Guillain Barre as well. You want an entire team around you to assess this situation.
- [09:15]
Dr. Darshan Shah
Exactly.
- [09:16]
Louise Nicola
I think what's really interesting with what you do now is you're in Western medicine, you're taking care at the scene, and then you move into this functional medicine area where you're learning so many new things. What I think is so interesting as well with medical trained doctors is they hardly ever go deep on blood work. Right. I'm sure you've learned so much more today than the regular CBC and just a normal lipid panel. Like you've gone deep into that.
- [09:42]
Dr. Darshan Shah
Yeah, yeah. So the traditional Western kind of protocol for blood work, at least when I was a doctor, was a CBC and a cmp. A CMP is a complete metabolic profile. And both of these blood tests are very useful if you're in the emergency room or if you're in the icu and then there's deeper blood work that we can do. There's thousands of pieces of blood work we can do. But, you know, the problem with the traditional blood work is that, number one, it's only useful for diagnosing bad problems. Right. There's very little there predicting if you're going to head towards a chronic disease. Okay. And so there's different blood work for that that we should be checking on people. And once you discover what's available out there, that can actually tell you whether or not you're going to develop a chronic disease, sometimes decades before you develop it. It's incred. Useful for. For, you know, just humans. Right. Every human should know, are they headed towards a chronic disease or not?
- [10:47]
Louise Nicola
Well, yeah, but you have to kind of investigate. Now we've got social media. I actually wanted to ask you what you. What your take is on longevity and social media, but quite specifically when you said, you know, looking and being proactive. I was on Instagram last night. I was scrolling and I don't know why my algorithm fed me this, but it was a girl documenting her diagnosis of colon cancer at the age of 31. And it was stage four. And, you know, you watch these and, you know, I credit her for giving us her journey online. And it was so brave of her. She documents over three reels and she said, I had no pain, I had nothing. There was nothing. And then boom, stage four. But I think for cancers like this, you can. You can assess that through a colonoscopy. The problem is a colonoscopy. We aren't meant to get them until age 45.
- [11:35]
Dr. Darshan Shah
Really.
- [11:36]
Louise Nicola
So how do you go and tell your doctor to be proactive at the age of 30 to prevent something like this? By the way, no history of colon cancer in the family. She had no blood in her stool or anywhere else. She had mild GI distress one day after eating, I think, something like a banana, and she went into the ER and they couldn't. They looked, they did full, complete metabolic panel. They did everything for her blood work, even her white blood cell count. Everything was perfect. Then they gave her a CT of the abdomen and they saw that her liver had multiple lesions on it. They biopsied one of the lesions and they saw that it was cancerous. And they wanted to find out why this is metastatic at this stage. They wanted to find out where the root was. And that's when they found, I think, like a 3 centimeter tumor and the descending colon. So that was the root of It. But how is she to know this? You guys know how much I believe in testing instead of guessing. Especially when it comes to longevity and brain health health. I do my blood biomarkers every three to four months because I want to know how I'm moving forward. Function health gives you access to over 100 biomarkers from insulin sensitivity and inflammation to liver and thyroid health, all tracked over time. I use function health every three to four months. I know that's crazy, but this is how you catch quiet issues before they become problems. If you haven't had your function health labs done before, you need to check this out. Visit functionhealth.com louisa or use code neuro100 to get started. I've also linked this below. Go through and just simply research about what blood work can do for you. That is functionhealth.com louisenicola or use code neuro100 to get started. When we talk about aging, well, we're really talking about mitochondrial health and how to power up our mitochondria and how to produce better functioning mitochondria because that's where we produce our energy. Now mito pure from timeline supports mitochondrial renewal which is helping cells produce energy more efficiently over time. I take it daily for steadier energy and better cognitive endurance. And I have to say by far this is the only supplement other than creatine that I solely think that everyone should be taking. It really helps as well with muscle health. Go and check it out. Read more about it and you can get 20% off@timeline.com neuro p s their gummies taste so good. I just want to finish off by saying that I always like my area of expertise is Alzheimer's disease and we can see 20 years in advance if the bus is coming to hit you. But cancer is the only one that is non discriminative, meaning it doesn't care about your age, it doesn't care about your race, it doesn't care about how many times a day you pray. It doesn't care about any of that. It just, I don't know what it is. It's just like fertility. It's just luck.
- [14:37]
Dr. Darshan Shah
Yeah. Yeah. You know, I'm so happy you asked me this question because colon cancer is a massive problem. And when I did general surgery, one of our jobs was to remove colon cancers and the metastases. Right. So I saw a lot of it. And I could tell you this was, you know, 25 years ago. Almost 100% of the people that we would see with colon cancer were older people. That, you know, ignored their recommended colonoscopy back then it was a 50 year old diagnosis.
- [15:08]
Louise Nicola
I love how they've brought it down now to 45.
- [15:10]
Dr. Darshan Shah
Yeah, it needs to go down even further. But you know, the problem that has happened over the last few decades is that colon cancer has become not a disease of old people anymore. 10% of colon cancer is actually found in young people and this number is rising very quickly. And there's all sorts of theories as to why. My theory is there's an immense amount of toxic exposure to our colon cells that we've never had before. And you know, our gut cells are some of the most rapidly replicating and replacing cells. So you're making a lot of new ones all the time. And if there's inflammation, if there's microbiome disturbances, microplastics, you know, chemicals like bpa, PFAS in your gut, then that replication process is going to happen with damaged DNA. Right. And so that's kind of like the genesis of colon cancer. And colonoscopies are very useful because all colon cancers start off, not all. Most colon cancers start off as a polyp, which is a non cancerous out pouching of the colonic cells that you can remove way before it infiltrates or goes through the wall. And so that's why colon colonoscopies are super, are super important. But there's other tests that you can do if.
- [16:35]
Louise Nicola
And endoscopy on top of that.
- [16:36]
Dr. Darshan Shah
Yes, and endoscopy where you look on the upper side as well. But there's other tests that you can do. And you mentioned one of them, which is, you know, check for bleeding. So in Europe they do what's called the fit test. You can buy these over the counter on Amazon. That is a test, the test for blood marker in your, in your stool. Basically you just wipe a little stool on it. It'll tell you. And so that's something that's available to people.
- [16:59]
Louise Nicola
So people in the US and in
- [17:01]
Dr. Darshan Shah
Europe, it's, it's, it's given to people in Europe as part of their, the National Health Service and the insurance there. But in the United States, it's not United States, if you're lucky enough that your primary care doctor actually does a, a rectal exam on you and checks for blood, then that's fantastic. 99% of time that does not happen. So you should do it for yourself. Once a year you can buy the fit test on Amazon. I think it's like 20 bucks and you can do it once a year. And that Checks your blood. Now, what's important to realize is that bleeding happens with cancers mostly. Okay, so you're, when you, when you're checking for blood and you fight, you see blood, oftentimes you've already developed a potential cancerous lesion, so you still don't want to wait that long. So now there's other tests out, like cologuard, and there's more tests coming out, actual blood tests that can detect colon cancer as well. But none of them are ever going to be as good as colonoscopy. So you should advocate for colonoscopy. I know a lot of gastroenterologists are doing colonoscopies now for cash. So even if your insurance doesn't pay for it, you can pay a few hundred bucks and get a colonoscopy. And it might be worth it for you to do that.
- [18:12]
Louise Nicola
And even if you do find lesions and they remove them, not lesions, polyps. And they remove them, you don't have to go back for another. Is it mandatory that you go back every year? I think it's only every two or three years.
- [18:23]
Dr. Darshan Shah
Yes, every two or three years. And your gastroenterologist will determine that frequency based on the number of polyps seen and how advanced they are. And also, you know, whether or not you find cancer in one of them.
- [18:36]
Louise Nicola
I think as well, the diagnosis may be going up because we are screening better than what we were 20 years ago.
- [18:44]
Dr. Darshan Shah
Is that, that, that is a. That is a theory, but that has not proven out because we've been doing colonoscopies now for a long time in medicine at the age of 15 now, it's recently been reduced to 45. And the reason those numbers were put into place by the American preventative medicine task force was because that's when you found the majority of colon cancers. But now with the age of colon cancer going now as young as in your 20s, and the increase in the velocity of the number of people in their young ages getting colon cancer, we know something else is going on. Right. And so it can't just be screening, because otherwise the preventive task force would have asked for screening starting at age of 20, not 50. And so there's definitely something else going on. And the biggest things that have changed in the last few decades are exposure to toxins, exposure to ultra processed foods, stress, changes in microbiome, maybe more stress as well. You're right. So, you know, but just to kind of zoom out even more, like 10,000 Foot View colon cancer is a perfect example of we have a screening modality for it.
- [19:54]
Louise Nicola
Exactly.
- [19:55]
Dr. Darshan Shah
And we're not using it effectively and we need to use it more. But there's 50 other common cancers out there that we're not screening for. Right.
- [20:04]
Louise Nicola
And so what I've got the grail test.
- [20:06]
Dr. Darshan Shah
Right, Exactly.
- [20:07]
Louise Nicola
You're going to bring that up? I was going to bring. Sorry. Because you do that. Yeah, yeah, we do.
- [20:11]
Dr. Darshan Shah
We do grail at Next Health. And the reason I bring this up is the 50 other kinds of cancers that we don't screen for. The traditional paradigm is to wait for symptoms like the girl you described and then start looking, you know, and unfortunately, that doesn't work. You know, it's just symptoms occur way late in the disease. Sometimes you're already at stage three or stage four. This is what happened to Steve Jobs. He had, you know, advanced stage pancreatic cancer because no one was even looking for it until symptoms came about.
- [20:42]
Louise Nicola
But even pancreatic right now is still. We can't find that out until it's stage four, can we?
- [20:47]
Dr. Darshan Shah
Well, you can. And this is where the entire paradigm is changing with technology. So we have two modalities right now that we can use to our advantage. One is MRI scanning. So MRI scanners can find pancreatic tumors before they turn stage three. And stage four.
- [21:03]
Louise Nicola
Is that like the full body MRI or you want to like localize the area?
- [21:07]
Dr. Darshan Shah
It's hard to localize the area to the degree you need to, to really, but you only do that for once you get diagnosed with cancer. But full body MRI is an incredible tool to look for solid tumors way earlier. And then the second tool is what we call the liquid biopsy, which is a grail test that you mentioned that finds cell freeze fragments of DNA of tumors in your blood. And that technology is getting better and better as we're using machine learning algorithms to get better resolution on those results. But what I submit to people is we have preventative medicine, which is population based preventative medicine. This national task force that suggests tests at certain ages is because they're looking at not the individual they're looking at. At a national scale, where can we expend resources, money towards potentially preventing advanced cancer from being diagnosed? And so far they've only come up with PSA testing, skin cancer checks, colon and mammograms for breast. Right, but there's so many other things you can do. And so what you want to do if you're an individual is how can you go from preventative medicine to hyper preventive medicine medicine? Hyper preventative medicine is looking at all the Other tools that are available that you can do to potentially diagnose these cancers way before they become advanced. I always say that cancer's biggest enemy is being diagnosed as stage one because then you're talking curates, you're not talking five year survival rates.
- [22:39]
Louise Nicola
I wanted to simplify my nutrition without sacrificing quality. That's why I use cachava. It's an all in one nutrition shake with plant protein. So much better for you. It tastes so much better than whey, protein, fiber, greens, adaptogens and essential vitamins. I use cachava on busy days, which is seven days a week. It keeps me full first and foremost. It satiates me and it gives me steady energy and a clear head. If you want to rewild your nutrition, you can. @cachava.com and use code neuro. At checkout, new customers actually get $20 off an order of two bags or more. That is cachava.com code neuro. So it's February now. It's still the start of a new year. And what always makes me super excited is making my home feel calmer and more supportive. So I've been using Wayfair to refresh a few spaces. My most sacred space in my New York City apartment is my space where I read. And being able to use Wayfair for everything, even from, you know, smaller details that make room feel finished for a couch, for bookcases, and for lighting. It's so easy what love is, how easy it is to find exactly what fits your style and budget in one place. I don't know where I would be in New York if it wasn't for Wayfair. Now I know you feel the same, therefore I want you to head to Wayfair.com to check it out. Every style, every home matters. Wayfair.com so I'm mid-30s, I'm a female. What do I do if I am so scared of getting cancer? I want to be proactive and I want to go and do all the screenings. The first ones are you mentioned Colon guard. We can check for blood in the stool. We can go and get an endoscopy, colonoscopy. What else can we be doing? We can do the grail test.
- [24:35]
Dr. Darshan Shah
Okay, so let's start just from the outside and work our way in. So one thing that you can do is don't ignore skin cancers. Skin cancers are extremely prevalent and many times are caught way too late because you know your primary care doctor doesn't have time to look at all of your Skin and find the moles and
- [24:51]
Louise Nicola
all of this stuff, even under your nails.
- [24:53]
Dr. Darshan Shah
Yeah, yeah, It's. It's a. It's an interesting. It's an interesting topic, and melanoma being the worst one. And so now you can seek out these centers that do full body scanning with. With photography. And then they use AI to photograph every mole and compare it to how it's doing over time. And so a lot of dermatology offices have these scanners. You can find them online as well. Full body scan, mole evaluation, and then also there's apps on your phone you can also use to take pictures of moles, submit them to a dermatologist, and also to follow them. So don't ignore skin cancer. Then I would say the next thing that you can add to this regimen is. And this is going beyond the traditional kind of, like, screening modalities, Right. Like, you know, as a woman, you need to see your ob gyn, get pap smears, do mammograms and ultrasounds of your breasts, but what can you do on top of it? So full body MRI is another incredible tool, because now you can add that to your breast screening modalities. And also that's looking for solid tumors in your entire body as well. I would say also for men to start earlier in life checking their PSA levels, because, you know, prostate cancers, aggressive ones, can develop earlier in life as well. And then for women, make sure your ob gyn, whoever is ordering your mammograms, is also getting an ultrasound of your breast as well. So that's. That. That can help, because the mammogram combined with ultrasound is much better resolution. You combine that with an MRI?
- [26:31]
Louise Nicola
Yes, because sometimes on MRIs for women, they'll pick up on something called dense breasts.
- [26:36]
Dr. Darshan Shah
Exactly.
- [26:36]
Louise Nicola
And you'll need to do both MRI and. Yeah, no, I did it. And look, quite transparently, I did it because I felt a lump. And I swear to God, I thought my life was over that day, you know, no matter how much you know. And it was just a. It was just a cyst. And then I realized, you know, the woman who performed this test, you know, she first of all, too young, indicated to get a mammogram, but still pushed for one, and they had no problems there. And then they said, you know, some women come in with, you know, thousands of tiny, little benign lumps all over their breasts, and sometimes they just enlarge and then they pop, and then they come back. And that's why that's so important to get.
- [27:16]
Dr. Darshan Shah
Yeah, yeah. I Think, you know, it's. Most women have some degree of density in their breast, and so you really can't see through that with a mammogram. That's why an ultrasound is an important modality to add it to that.
- [27:30]
Louise Nicola
Yeah, yeah. We, you know, we, I, I planned this episode, you know, to be all about blood work. The fact that we've gone into cancer is really interesting. I just did an episode on the effects of exercise on cancer. But the reason why I wanted to talk about blood work is because I came into your clinic and I got something really exciting done. What we actually now are able to pick up on Alzheimer's disease depositions, you know, these different toxins in the brain almost. With this, I think it's around 98 accuracy of getting what we call a PET scan, which is where, you know, we can scan the brain and we can look for these two proteins, which is amyloid beta and tau proteins. And now we can actually get them in a blood test. And you know what's interesting, Darshan? So, you know, we've, for the, for the last, you know, 10, 20 years, we've been able to assess the body, right, and be out in terms of blood work. You know, you can look at electrolyte panel, you can look at all these different biomarkers, but we didn't really have like, you know, what is the brain biomarkers that we can test to assess the health of our brain. And we can do that. Now. I wanted to talk to you about it because. Let's talk about the first one, P Tau181, which is phosphorylated Tau181. And that's basically picking up on if we have this protein called tau in our brain. And I'll just give a quick background for everybody. 70% of all Alzheimer's disease cases are female. 95% of all Alzheimer's disease cases could have been prevented through lifestyle. So this is not a disease of genetics, it's a disease of midlife, where these proteins are starting to build up in our brain due to a wide variety of factors. Right. Sleep deprivation, stress, foods that we're eating, lack of exercise. They build up over time. And we don't feel these symptoms until, you know, 70s and 80s when we can't do anything about it. But now we can get blood tests. Right? What have you found with these, with these brain biomarker blood tests?
- [29:36]
Dr. Darshan Shah
Yeah, it's an incredible time we live in and for way of some background is, you know, we have thousands, if not tens of thousands of biomarkers in our plasma. And we're just now discovering a lot of these and how they can be very useful in diagnosing certain chronic disease conditions decades before you see symptoms. And also radiographic changes, like with the PET scan that you mentioned, and P Tau 217 and 181 are both fragments of the whole P Tau process. Right?
- [30:12]
Louise Nicola
Yeah.
- [30:12]
Dr. Darshan Shah
And I think 217 from my memory is actually more well correlated with PET scan changes than even 181 is. And these are just, you know, markers that were found in the bloodstream. And then the scientists evaluated these and they're like, wait a minute, this is the same one that we see in the brain in people with Alzheimer's. Now we can find it in the blood. So now we actually have a marker that correlates to what we're seeing in the brain. And then they found it correlated to PET scan abnormalities. And the other one, there is also amyloid ratio.
- [30:48]
Louise Nicola
We've got the amyloid.
- [30:48]
Dr. Darshan Shah
Yeah, yeah. And then, you know, there's also other ones like GFAP and neurofriendamine.
- [30:53]
Louise Nicola
I'm getting there. I'm getting there.
- [30:54]
Dr. Darshan Shah
So, like, we were finding all these markers and they've been there the whole time and just were finding finally now correlating them with actual disease states. And so what's really powerful about this is no longer do we need to wait for symptoms or radiographic changes. And, you know, the PET scan, it's a lot of radiation.
- [31:10]
Louise Nicola
A lot.
- [31:11]
Dr. Darshan Shah
A lot of people don't even get it until they already have a diagnosis of Alzheimer's. Just confirmatory.
- [31:16]
Louise Nicola
You can't. Yeah, it's not indicated. Yeah, but it's also not indicated. A neurologist wouldn't send you off until you've been symptomatic for quite some time.
- [31:23]
Dr. Darshan Shah
I know. Right.
- [31:23]
Louise Nicola
And those symptoms happen to be severe.
- [31:25]
Dr. Darshan Shah
Yeah. Unfortunately, now we use this test, the PET scan, to determine whether or not your candidate to get very costly medications.
- [31:33]
Louise Nicola
Right, yeah, right.
- [31:33]
Dr. Darshan Shah
Yeah, exactly.
- [31:34]
Louise Nicola
Which I would caution against. I've been very upfront and transparent about the newly approved FDA drugs that are causing these horrific brain bleeds, microhemorrhages. You've also got tissue breakdown as well.
- [31:49]
Dr. Darshan Shah
But, like, you know, that's how medicine is designed now. Right. Like, let's wait for symptoms to get so bad, Then we order this expensive high radiation test just so we can order more expensive medication. But that is one. That is the western medical system. Right. But if you go outside of it and you start looking at P Tau and amyloid ratios. And now you have a level that changes sometimes decades before symptoms develop. And then what's even more incredible, and just like, I get so excited to be involved in this field right now because as you put into place lifestyle changes, you can see those levels come down.
- [32:24]
Louise Nicola
Yeah. You can actually track and measure it over time.
- [32:27]
Dr. Darshan Shah
Exactly.
- [32:27]
Louise Nicola
Well, what could you do if somebody went and did this? Right. And I just wanted to let everybody know that you're obviously looking for, on the P Tau 181 and P Tau 217, you're looking for a negative result, evidently. But when we're looking for the amyloid, so you've Got beta amyloid142. If it's high, obviously if there's an amyloid, you've got a lower amyloid burden in the brain, whereas if you've got low amyloid beta 42, you've got higher amyloid burden in the brain. Which is interesting. Right. Which means that you are pre clinical asymptomatic for this. So let's just say somebody goes there and they've looked at the ratio and it's a bit off. What. What can we do?
- [33:10]
Dr. Darshan Shah
So there's a lot of things you can do. This is what's really exciting. Number one, I just think just to be complete, you want to get a gene test done. That's where, you know, I think so too.
- [33:18]
Louise Nicola
Right, APOE4.
- [33:20]
Dr. Darshan Shah
Yeah. Four gene tests. Right.
- [33:21]
Louise Nicola
Exactly.
- [33:22]
Dr. Darshan Shah
I think just to be complete, you should get that one done. And then, you know, if you have obviously two copies of the E4 gene, you're at 16 times increased risk. One copy is 4 times increased risk and amyloid and APOE2 is actually protective. And so then you can kind of see, like, what is your real risk, risk genetically now that a genetic risk doesn't really mean that you will definitely get Alzheimer's. So I just want to put that out there because a lot of people are scared to get the test because they feel like now they've given themselves a death sentence. Right. But the reality is it just means you have to be that more, much more intentional about what you're going to be doing to lower some of these markers and to prevent Alzheimer's disease in your future. And so there's a. This whole host of things you can do. What are some of them?
- [34:08]
Louise Nicola
Well, I just want to also touch on the fact that the reason why we have an increased risk of getting Alzheimer's with the, you know, the genetic mutation of the APOE 4 is because APOE 4 helps with transporting fats and cholesterol through the brain. So if this transporter is dysfunctional, well, you know, I'm just trying to lay a picture. If it's dysfunctional, which it is, in APOE 4 carriers, you have an increased likelihood of getting the disease because the cholesterol can't travel through the brain and you end up getting. It's like cardiovascular disease, but a buildup of plaques in the vessels of the brain which can cause obviously strokes, which can lead to Alzheimer's disease. It can cause so many different things in the brain.
- [34:54]
Dr. Darshan Shah
Also, the other big problem is that it causes blood flow abnormalities and also clearance of toxins from the brain as well. And so that's why some of these proteins build up is because they're more of like a reaction to the damage that's being done from poor blood flow. And so, you know, blood flow is incredibly important. How do you increase blood flow? Well, you just did an episode on this exercise, right? Exercise is a very powerful way of increasing blood flow to the brain. Particularly hit exercises can be extremely powerful. You also want to optimize your nitric oxide levels. This is a chemical in the brain and in the blood vessels that allow blood to flow more freely through the vessels, allows the vessels to be more pliable, allows it to open up. And so getting more nitric oxide can be helpful. One way to get more nitric oxide is this nitric oxide supplements out there that are come from.
- [35:48]
Louise Nicola
I had a chewable one.
- [35:50]
Dr. Darshan Shah
Yeah, they're chewable. They're made from beetles. Beetroot. Yes. That's a very powerful supplier of nitric oxide. Other ways to improve nitric oxide are once again exercise approved. Nitric oxide LED light, believe it or not, improves near infrared. LED light, improves nitroxide. So, and then also you want to get high blood pressure treated, because when you have high blood pressure, your vessels are not as pliable. You're affecting blood flow to your organs. Your brain is obviously the biggest consumer of oxygen and glucose in our body. And so getting high blood pressure treated is one very important aspect of improving blood flow to your brain. So there's all different. There's all different things that you can do, but that's improving blood flow is just one bucket, right? There's other buckets of things that we can do.
- [36:40]
Louise Nicola
Most people know how omega 3s are important, but what you don't realize is that very little of what actually reaches the brain is what matters. Right? That's why I'm excited to finally start taking Accentrate Omega with Lyso Vita lpc. It delivers DHA and EPA in a form the brain actually recognizes and transports across the blood brain barrier. So instead of all of it being used up by the heart or the muscles first, these Omega 3s are designed to target the brain directly. And we know that we need that. The brain is rich in dha. We need it for cognition, mood and long term neurological health. That distinction matters. This is one of the most interesting developments that I've ever seen in brain directed nutrition. So if you want to try omega 3s, and I think you should, I think omega 3s have a very high safety profile. You should be trying a liposomal one that actually gets into the brain. And if you want to try these ones, go to accent rate.com and look through all of their products available. If you're starting to get gray hair, then this is for you. I still remember the first gray hair I noticed, actually I was in Italy and it wasn't just the color, it was how coarse and different it felt. It actually made me cry. That's why I have started using array instead of covering grays. Array focuses on slowing their progression and supporting healthier fuller hair from both the inside and the outside. And this system combines a supplement that supports melanin production with a lightweight scalp serum that helps maintain hair quality at the root level. What I like most is the mindset shift because treating the scalp like skin and hair like part of the aging process, we can actually support it. So if you want to slow the growth of grays and support healthier hair, you can get 15% of off with code neuro@array.com a r e y.com I think one of the most low cost, non invasive, easiest interventions that anybody could do is investing in a blood pressure monitor, an automatic one, and learn actually how to take your blood pressure and document it over time and see if there are any changes. Prime example. I got my parents, parents 1 and my mother does my father's blood pressure every single morning. And when I was home over the holidays, I said, can I see how you're doing it? And you know, he was walking around, then he crossed his legs, he was sitting down, he was, you know, left arm right. And I was like, let's, let's just take a crash course on how to do it effectively. And if you can do that, it can yield, you know, dividends in how your brain is aging. And it can show you, because let me tell you, even having. And this was shown in the sprint trial, it showed that, you know, hypertensive states are now, anywhere between 130. Right. You know, the gold standard is 120. That's not much, you know, 130 over 90.
- [39:45]
Dr. Darshan Shah
Right.
- [39:45]
Louise Nicola
And that when you're hitting that prolonged periods of time, you know, every single day you're sitting at 130, even 135 to 140, you are killing the tiny little blood vessels in your brain, which are one cell thick, and they deliver oxygen and nutrients to the brain. And we don't want that.
- [40:04]
Dr. Darshan Shah
Yeah. And you're doing that every organ of your body, by the way, your kidneys, your heart. It's a huge problem to be living with high blood pressure. Now, I'm a huge advocate of making sure you're checking your own blood pressure at least once a month. If you're over the age of 40, but even younger, like people in their 20s, have high blood pressure now and just watch a good YouTube video. How to do it, do it correctly.
- [40:26]
Louise Nicola
Yes.
- [40:27]
Dr. Darshan Shah
Right. You got to do it correctly. You got to do it first thing in the morning at home. Don't rely on the one in the doctor's office. And to your point too, the Sprint trial very clearly shows that for every increase you have 130 over 80 or higher, every 10 point increase increases your all cause mortality by 15%. So you really want to aim for as close to 120 over 70 as possible. But what I will tell you is that blood pressure is not like a once in a moment thing. Your blood pressure first thing in the morning is not your blood pressure throughout the day. And so just like a continuous glucose monitor, if you monitor your glucose throughout the day, those curves and those spikes tell you a lot about how you need to be treating your glucose levels. Right. It's not just a fasting glucose first thing in the morning. So what I'm really excited about is now they have continuous blood pressure monitoring.
- [41:19]
Louise Nicola
I was about to say, why don't we have that? Do we have that? Is it accurate?
- [41:22]
Dr. Darshan Shah
It's very accurate. In fact, they just got FDA cleared for this. The device is called Helo.
- [41:28]
Louise Nicola
H E L O H I L O H I L. Hello, Hilo.
- [41:33]
Dr. Darshan Shah
Yeah, Hilo. And this is a device. I actually interviewed their chief medical officer about a year ago on my podcast when it wasn't approved by the fda. And I got it through Canada and I did it for myself. And I found I'm on blood pressure medication. It's the only medication I take now. And I found with monitoring my blood pressure that my blood pressure was not controlled. And even though my first morning blood pressure was okay. I was spending about 50% of the rest of my day with high blood pressure. And so then I.
- [42:02]
Louise Nicola
130.
- [42:03]
Dr. Darshan Shah
No, it was more like 140 over 90. Yeah.
- [42:06]
Louise Nicola
Continuously.
- [42:07]
Dr. Darshan Shah
Well, no, you would have spikes yesterday. And so this monitor tells you what percent of time you're spending in that zone. Right. And then once you can see that, then you can find what activities are leading to high blood pressure. What things can you do in your lifestyle that can lower your blood pressure? So, for me, a great example was when I went for a walk after dinner that lowered my blood pressure overnight. You would never think that.
- [42:32]
Louise Nicola
No.
- [42:33]
Dr. Darshan Shah
Right. But it works.
- [42:34]
Louise Nicola
My blood pressure is on the low side. It's generally 95, I would say. And I never know why. I don't know why. It's rarely. Maybe I've. Maybe it's 110 sometimes, but it's.
- [42:49]
Dr. Darshan Shah
Yeah, yeah, It's a very common thing. You know, I think a lot of people have low blood pressure and they're not affected by it because they're super healthy. You know, we know a lot of athletes also have low blood pressure. So I wouldn't worry too much about it. Unless you're symptomatic and then you have to get worked up. And low blood pressure is a very different beast than high blood pressure.
- [43:09]
Louise Nicola
Oh, yeah.
- [43:09]
Dr. Darshan Shah
High blood pressure leads to chronic disease like Alzheimer's, cardiovascular disease, et cetera. Low blood pressure is mainly just symptomatic in that moment in time.
- [43:17]
Louise Nicola
Orthostatic, like you get up off the ground and you feel a bit dizzy. Let's now zoom in just on two biomarkers, which is lipids, because, you know, we used to. For a long time, we never thought that lipid panels mattered when it comes to. To the brain. And this is still controversial. Right. But I have to say, across all of the data that I've looked at, when it comes to dementia, you do want to maintain a low LDL and apob. Right. And this is why I'm not against statins, and I'm very. I put that out there. So let's talk about two, which are LDL and apob. I think they're the most important numbers that you want to look for. Apob, it's the structural protein of all atherogenic particles, ldl, vldl, and lp. Now, I have a cutoff for apob, by the way. I exceeded my own cutoff. I just got mine done, and it's like 98. So I want to bring that down to below 80. What are your thoughts on that?
- [44:20]
Dr. Darshan Shah
Yeah. So, you know, it's a really interesting topic, and I talk about this almost every single day. I'm a big believer of making it simple for patients, right? And so I really get them to focus on APOB as the key biomarker for them to track for themselves. Like, I want to go up to my patients if I see them in the store or something, be like, hey, what Was your last APOB? And they have it memorized. They also have their HSCRP and their hemoglobin A1C memorized. They know what those numbers are because they're so critical to your biology. Right. And they're so critical to your overall health. So here's how I think about APOB and I explain it to my patients. I say APOB is definitely causal to cardiovascular disease. Your heart, cardiovascular is part half of cardiovascular. The other part is vascular. Vascular means your blood vessels. And so blood vessels are all over your body, including in your brain, right? So what's affecting your heart is also affecting your brain, affecting your liver, your kidneys, every organ in your body. So let's look at cardiovascular disease as just being vascular disease. Right? And so one of the things that we know is that cardiovascular disease is multifactorial. There's lots of steps that lead up to cardiovascular disease. They are damage to the endothelium of the blood vessel that occurs with high blood pressure. It occurs with overtraining, sheer stress, combined with APOB particles going into the blood vessel wall, causing inflammation as well. And then if you have metabolic disease on top of it, then you have a repair issue and also a further damage issue as well. So it's like a combination of all these factors. So I've seen people with high APOB120,130,140 with zero cardiovascular disease. And I've also seen people with low APOB and cardiovascular disease as well. And I would say that, you know, just because you have a high APOB doesn't necessarily mean you currently have cardiovascular disease. However, over time, we're all exposed to inflammation. We're all exposed to times when we're under stress. We're all exposed to periods where our metabolic health is not optimal. Right. If there's a lot of APOB floating around, there's a chance that this can get into your blood vessel wall and cause blockages and plaque over time.
- [46:45]
Louise Nicola
I want to talk about this 2024 Mendelian randomized study, which was. It was in Jarming Urology, and IT analyzed around 22,000 Alzheimer's cases 370,000 controls and found that genetically predicted high APOB was causal and associated with higher Alzheimer's disease risk. And because every time I put this out there on social media and I talk about statins, which by the way, there's two great landmark studies to show that the effectiveness of statins on dementia, it's down regulating your risk of getting to all cause dementia by around 30 to 40%. I get a lot of heat and I'm like, but if I thought anything else else. Right. Because people believe. But we need to have, you know, the brain needs cholesterol.
- [47:30]
Dr. Darshan Shah
Yeah.
- [47:30]
Louise Nicola
And I remind people that dietary cholesterol cannot cross the blood brain barrier. So it's not like you're going to eat an egg or an avocado and that's going to go into your brain.
- [47:39]
Dr. Darshan Shah
Right.
- [47:40]
Louise Nicola
So we have to think about that, which is why we want to reduce it. And all of these studies suggest that if you do have an increased risk of getting Alzheimer's disease, you want to have your LDL actually as low as possible, which is around 60. They mentioned in this landmark study.
- [47:54]
Dr. Darshan Shah
Yeah. You know, I think there's also another study about zetia, which is ezetimide, which decreases absorption of cholesterol as preventative for Alzheimer's disease as well. So we have a lot of strong indicators showing that maintaining a level of APOB and or LDL that is below 100 LDL APOB is 80 could be protective against cardiovascular disease and Alzheimer's disease. What I will say is that there's potentially also pleiotrophic effects of statins. And so a lot of people just think about statins lower cholesterol. Well, statins are also anti inflammatory and inflammation is a big part of Alzheimer's disease and cardiovascular disease. Statins have other effects that we can see from a mechanistic viewpoint as well that have not been studied yet. So I'm not an anti statin person. I do think that a lot of times the frequency to which statins are prescribed is not responsible. I think people are just trying to get through a clinic day. They have 50 patients. LDL is this number. Here's a statin, which is exactly what the pharmaceutical companies want. Right. They want to take the thought process out of it. They just want to put people on these medications for a long time. And I think we have to be a little bit more thoughtful about really justifying the use of statins on people.
- [49:21]
Louise Nicola
Of course.
- [49:21]
Dr. Darshan Shah
Right. And so I do think that also, you know, there's many other things that you can do to lower your APOB in your LDL that are not pharmaceutical as well. And so I think, you know, making sure you're staying away from ultra processed food, exercising, getting good sleep, fiber, all these things are so important. Fiber is incredibly powerful for lowering ldl. Zetia is incredibly powerful and you know, that just decreases absorption in your gut. So I think there's other medications that we can use. But I also don't discount statins. I think that they can be very useful for certain patients.
- [49:56]
Louise Nicola
Do you want to hear an interesting story?
- [49:58]
Dr. Darshan Shah
Sure. Yeah.
- [49:59]
Louise Nicola
And this comes down to assays and where you get your blood work taken and anyone can take your blood, blood, you know, anyone. But it's about who is interpreting it and which company is. I had my blood taken from this new thing where you literally, it's a pin prick and they actually take a vial of blood right then and there. Right. And they send it off and they did that. And I got my results back and my lipid panel was so crazy. I've never seen anything like it. LDL came back as 180 and I thought this is not right. That can't be right. I check my lipids, I do my blood work like every three to four months. This can't be right. The LDL came back at like 150 and I thought what on earth? Homocysteine came back as 14. I thought this is absolutely insane. So I went and redid my blood work one week later and it came back completely different. APOB was 90. LDL was, you know, around 90 as well. Homocysteine was 8. And that really showed me that consumers, everyday people who don't know anything about, you know, bloods and what to do and where to go can be misinformed. Imagine somebody getting this and thinking that they've got cardiovascular disease because they see these markers, but it could just be a crappy assay that was done.
- [51:16]
Dr. Darshan Shah
Yeah, I think, you know, my general rule of thumb is when I see blood work, if there's something that's off that I'm going to institute a treatment protocol around or at least even cause an alert. I always confirm with the second set of blood work. I always tell people like, don't freak out about this, you know, let's get a second set and make sure that we're seeing high ldl, high hd, whatever it is. And I would say, you know, half the time things change very rapidly for people and when they don't change, then we know kind of directionally which direction we want to go. To. But you did bring up a very important point. Like, you know, thankfully in the United States that we have very strict laboratory standards that are put forth. And so most of the labs follow those standards, but there is methodology variances as well. So that device you had on your arm, that took some blood out. Well, it's not getting the same blood that comes from your vein. Right. It's getting probably capillary blood that's coming from your arm. And so that's different blood too. And so there's different interpretations about depending on where your blood is coming from that you also have to look at. Is it coming from a venous source? Is it coming from a capillary source? Where is it coming from? You have to look at that too.
- [52:26]
Louise Nicola
Oh, that's so smart. I never thought about that.
- [52:29]
Dr. Darshan Shah
Yeah, it's the reason, like, you know, continuous glucose monitors, that's interstitial glucose, that is not blood glucose. They're different measurements and that's why sometimes there'll be a different number. They just don't correlate because it's a different. You're getting it from a different compartment.
- [52:46]
Louise Nicola
I just did my homa ir came back, I believe as 0.4, which was great. What do you think about that? I think this is great, but it's also new.
- [52:56]
Dr. Darshan Shah
Yeah, well, I mean, you know, Homo IR is a newer marker that we're using to predict metabolic disease. And I really like it. What I like even better is fasting insulin. I think fasting insulin is really, really powerful marker of. The first thing that's going to change if you're developing metabolic disease is you're going to start secreting more insulin. So that's why fasting insulin can tell you way before a change in your hemoglobin A1C, which is also, you know, a hemoglobin A1C is a three month average of blood glucose and that changes before a fasting glucose does as well.
- [53:32]
Louise Nicola
So if you want to get a combination. Right.
- [53:34]
Dr. Darshan Shah
Yeah, yeah. I think having all the markers and looking at them and seeing kind of where you're at in the spectrum is very beneficial. And if you, you know, the first thing you want to do is aim for hemoglobin A1C around 5.2 or less. The second thing you want to do is aim for a fasting insulin level of 8 or less and then that's when you're really reducing your chance of metabolic disease.
- [53:54]
Louise Nicola
Yeah. And you know, this needs a lot of nuance, but they, they, you know, they do say that Alzheimer's is type 3 diabetes of the brain. And I don't think that, and I think that needs a lot more nuance. But, yes, it's true. If you are insulin resistant in your brain, then you're obviously going to increase your risk of getting Alzheimer's disease.
- [54:14]
Dr. Darshan Shah
Exactly. And so, like, you know, we're developing here now a list of all the things that we're talking about to prevent Alzheimer's disease. One is, you know, improve the blood flow. Second is treat hypertension. Third is get your metabolic health under control. That's extremely powerful leverage that you have in preventing Alzheimer's disease, is having excellent metabolic health and fasting. Insulin is a marker of that.
- [54:39]
Louise Nicola
This is why I. I think that GLP1s are remarkable drugs if used effectively. I don't really understand what the difference is now between tirzepatide, which is the GLP one, and GIP and this new one, retatrutide. Did I say.
- [54:57]
Dr. Darshan Shah
Oh, tried is how you say it.
- [54:59]
Louise Nicola
Say it one more time.
- [55:00]
Dr. Darshan Shah
Retatra tied.
- [55:01]
Louise Nicola
Retatra tried.
- [55:02]
Dr. Darshan Shah
Yeah.
- [55:03]
Louise Nicola
Okay. Tried is like. Okay, it's got three. So what? It's got GLP1. It's got GLP1, GIP, and I think it's.
- [55:12]
Dr. Darshan Shah
I don't remember. I think it's cck. We'll have to look at it.
- [55:15]
Louise Nicola
Okay.
- [55:15]
Dr. Darshan Shah
Yeah, yeah, but it's a third receptor agonist. Yep.
- [55:19]
Louise Nicola
And why is this one yielding better results than the other two?
- [55:22]
Dr. Darshan Shah
Yeah, I mean, the studies show that it's even more powerful for weight loss. And it just goes to show how multifactorial hunger is. Right. There's so many hormones. You have glp, you have gip, you've heard of leptin, Ghrelin, all these hormones work together to create hunger signals. It is just so deeply embedded in our biology. And I'm sure there's like, maybe 50 or dozen signals that control our hunger. Right. So, you know, the question is, like, how many more receptors can we add to this whole mix? Right. You know, I think also one really critical factor that people are not considering is, yes, now you can lose weight more rapidly into a higher degree, but is that a good thing? And I would say it's probably not a good thing for everybody. Right? Because when. When you lose weight too fast, your skin can't keep up, and so you get collagen. All these things like ozempic face that people talk about. Ozempic butt. If you're not really intentional about maintaining muscle mass, that can be hard to keep up with as well, because you Just cut your protein intake down to zero. And if you're not working out and you're not lifting heavy weights, that can be a problem. Also, your micronutrient levels can drop very dramatically as well, and it can cause hair loss, which is a symptom of micronutrient loss. Right, exactly.
- [56:47]
Louise Nicola
Muscle loss.
- [56:47]
Dr. Darshan Shah
Yeah. So, you know, I think we got to be very careful about trying to just lose the weight too fast. Right. My rule of thumb for my patients is lose about a pound a week. Any more than that, you know, we're getting into this territory where we want to be careful. And if you're losing three or four pounds a week, that's way too fast.
- [57:06]
Louise Nicola
Fast.
- [57:06]
Dr. Darshan Shah
Way too much too fast. And you're not going to be able to keep up with your muscle loss, your micronutrient deficiencies in your skin.
- [57:16]
Louise Nicola
I think with all of these modalities now, with all of this AI and with social media, I think we're forgetting what it means to live. Well. Longevity is fantastic. Right. We all want to live as long as we can, but in the best way that we can. I, I don't know if you find this, because now you're in this space and you're a longevity doctor. Do you think people are missing the mark? Like, you know, you. I could spend all my day doing crazy things. By the way, I love. I'm very bullish on red light therapy. I know. You're getting a new bed.
- [57:47]
Dr. Darshan Shah
Yes.
- [57:48]
Louise Nicola
Okay.
- [57:48]
Dr. Darshan Shah
Yes. Immortal bed.
- [57:49]
Louise Nicola
The immortal bed. I don't know what the difference is between what that is and what you have already. I want to get to that.
- [57:54]
Dr. Darshan Shah
Just.
- [57:55]
Louise Nicola
I just hear me out. Do you think, like, I'm seeing so many people doing crazy things for their biology? Brian Johnson is one of them. Do you think we're missing the mark on what longevity actually is?
- [58:05]
Dr. Darshan Shah
You know, a major piece of longevity is enjoying your life, being happy, having great relationships with friends and family, having just a social circle, not being lonely. And if your longevity biohacking routine is completely causing loneliness, is causing distance from friends and family, it's causing more stress, what is the point? Right?
- [58:30]
Louise Nicola
I mean, what's the point of having dinner at 2pm and not going out for dinner with friends? I don't get that.
- [58:35]
Dr. Darshan Shah
Yeah, exactly.
- [58:36]
Louise Nicola
Right.
- [58:37]
Dr. Darshan Shah
Yeah. I mean, and this is, this is the challenge, because we don't know how much of an effect eating dinner at 2:00pm has versus having that social interaction with friends at 8:00pm, for example. Right. Like, are we, are we just canceling each, each one out? Right. By doing that. So I think, I think there's a lot to be said about, you know, what you're talking about really being intentional also about kind of some of these softer aspects of longevity.
- [59:06]
Louise Nicola
We're closing out with red light.
- [59:08]
Dr. Darshan Shah
Okay.
- [59:08]
Louise Nicola
Okay, let's talk about. I think light, you know, in general is, is understudied. And we're getting so much more, you know, information on it. I love red light for numerous reasons. One, we know that it can penetrate the skin and even go through to the superficial organs and have an effect on mitochondrial health. So it can help mitochondrial health. And I know that it's great for hair follicles. Okay. That's another reason I'm like, oh my God, get the red light on my hair. But I also heard that it's great for fertility for both men and women, but for women, you know, studies have been shown that you can actually increase pregnancy rates. IVF can have better results by doing red light therapy. So I know it differs like the, the, the penetration of the actual, like the lighting and the hurts and everything. I don't know too much about that. But why do you like red light
- [59:59]
Dr. Darshan Shah
therapy for all the reasons you mentioned? And you know, it's a really interesting mechanism of action of how red light works. The red light penetrates the skin into the cells of the dermis and then also the blood vessels there. And it does a couple things. One is, improves mitochondrial activity. So mitochondria talk via light, you know, and so they. Light affects mitochondria. Light stimulates the mitochondria to make more energy. When you're making more energy, everything just works better, right? And so mitochondrial energy production is improved. The other thing is it improves that molecule that we're talking about called diagnosis, nitric oxide. So it improves blood flow as well. That's why those caps work so well for hair growth, is because you have improved blood flow to that, to the scalp, right? And so that's really helpful there as well. It improves fertility because it improves blood flow to the testes and ovaries. Right? And so I think, I think that the benefits of red light, if you can spend the. Some time in front of them, can be helpful to an overall great program. Right? And so I think you just gotta stack once you get the basics right of your nutrition, your sleep, your exercise, your stress management, and then you start stacking on top of that. Some of these better, some of these other interventions like hormone therapy and peptides, and then red light kind of fits up there more at the top of the pyramid of Interventions for someone like you is great because you have everything else going for you, you know.
- [61:30]
Louise Nicola
But why, why are you changing your bed?
- [61:32]
Dr. Darshan Shah
Amortal ammortal. Right. It's an excellent red light bed. And so we have red light beds at every single one of our nexhale facilities. But the immortal of which I recently came on board with them as a chief science officer.
- [61:44]
Louise Nicola
Oh, nice.
- [61:44]
Dr. Darshan Shah
As well. It combines multiple modalities, red light at a very effective dose, very consistent wavelength. Their engineers have done it a fantastic job of making the best red light bed combined with sound therapy and also electromagnetic frequency, so pmf. So it's all together in one device. And what I found, which was very powerful for me when I was in a mortal chamber, was I tracked my HRV all the time with this whoop in. And my HRV when I got out of the chamber was 50% higher.
- [62:19]
Louise Nicola
No, after doing acutely, like straight away.
- [62:22]
Dr. Darshan Shah
Acutely. Right away.
- [62:24]
Louise Nicola
What's your hrv?
- [62:25]
Dr. Darshan Shah
I have a very bad hiv. But everyone's HIV is their own number. So my Hiv hovers around 20 to 30 when I got out of the.
- [62:32]
Louise Nicola
But that doesn't matter even if you've seen an increase. It's about trends.
- [62:35]
Dr. Darshan Shah
Yes, exactly. So after the immortal chamber it was about 50. And so I was so happy about that. I'm like finally something to help me improve my hrv. And so I think you know that with consistent use it can be very powerful.
- [62:48]
Louise Nicola
So it's both red and near infrared.
- [62:51]
Dr. Darshan Shah
Near infrared light. Yes, exactly. It matters matters that it's near so it's having contact with your skin. So it can penetrate the skin and that's what's getting in the release the nitric oxide. Exactly, yeah.
- [63:02]
Louise Nicola
Oh my God. And I wonder like some of the studies are different. I like, I like the sauna combined with that. I mean I like both the finished sauna but also the near infrared sauna as well. Because you're getting, you know, more bang for your buck. But a lot of the studies suggest, you know, even like 20 minutes a week to get some benefits. It's not like an everyday thing. Even though I have a panel at home.
- [63:24]
Dr. Darshan Shah
Yeah, yeah. I just bring my. I have a panel at home too and I just keep it inside my sauna. So I try to do my sauna four or five days a week and then I just flip the red light on when I'm doing it.
- [63:34]
Louise Nicola
What are you most excited about as we move further into AI in this realm?
- [63:41]
Dr. Darshan Shah
Yeah, I'm super excited about this. So we're developing well, I've developed an entire panel, a dashboard for your health, which is fully enabled by AI. And I'm actually. Thank you for asking that question too, because I'm releasing a book in a few months about AI and health.
- [63:57]
Louise Nicola
Oh, my gosh, phenomenal.
- [63:59]
Dr. Darshan Shah
And so this dashboard that we're releasing can take your biomarkers from any place it can be from. Next, it can be from Function Health, it can be from your full body mri, from Prenuvo, whatever you have. And you can upload it all into the digital vault, totally secure, and the AI will read everything and plot it over time. And then it will ask you questions targeted to what could be potential signals about what the blood work is showing in your biology. Then it ties all of that together into number one, a full health summary. But then also you can talk to it. And so the way I've developed the talking piece of this is you can talk to the four different models. You can talk to Claude, Gemini, Grok or chatgpt separately, so you can get advice from each four of them. Because every model is built differently, right? And then there's also Personas in the system. So I put in all of my podcasts, all of my writings into the system. And as like a Dr. Shah Persona, we can have a Dr. Nicola Persona you can talk to.
- [65:05]
Louise Nicola
It's like a board of directors.
- [65:06]
Dr. Darshan Shah
Exactly. You have a personal health board of directors, fully enabled with AI that will have access to all of your biomarkers, your medical records, and also the questions. It asks you to get information about what's going on right now with your biology and putting that all together into one place, it can give you proactive guidance, like things to think about. Now, obviously this should not replace your doctor or real medical advice, so don't go out there and buy a prescription based on this. But definitely it's really good information about things to think about.
- [65:41]
Louise Nicola
I love that because it combines all of the specialties, right? You know, instead of, you know, what do we have right now in America, there's like over 30, 30 different medical specialties that you can become board certified in, and they all intertwine. To have them all in one passport is so effective in terms of prescriptions. It can't give you a prescription. It can tell you, listen, this is crazy. You've got a high LP, little A at 180 increases your genetic risk factor of getting cardiovascular disease. We looked at your. I don't. You can do a CAC score. Maybe you upload the CAC score and it's not zero. It's like, listen, and you're 7 70. I think you should go and see this cardiologist. Is that what it is?
- [66:18]
Dr. Darshan Shah
Exactly right. Yeah, exactly. And it says, here are the lifestyle interventions you can put into place. Here are some supplements you might want to think about, like Nattokinase, for example.
- [66:26]
Louise Nicola
Oh, that's brilliant.
- [66:27]
Dr. Darshan Shah
Yeah.
- [66:28]
Louise Nicola
We didn't even talk about that. Nattokinase is actually phenomenal.
- [66:30]
Dr. Darshan Shah
It is phenomenal. I'm a huge, hugely interested fan of nattokinase right now.
- [66:37]
Louise Nicola
Karen told me that Dr. Khan. Yeah, he told me me about that. I love that. I want to actually ask one more last question. I wish I could talk to you all day. Have you seen. I forget what it's called. Clearly. Yeah, clearly scan. Have you used it?
- [66:51]
Dr. Darshan Shah
We. I have probably 1000 clearly scans that I've done on my patients. Yeah.
- [66:56]
Louise Nicola
What in terms of. I love them. I've done them as well. What do you think of the accuracy?
- [67:01]
Dr. Darshan Shah
I think it's extremely accurate. It is a game changer in cardiology.
- [67:05]
Louise Nicola
Yes.
- [67:07]
Dr. Darshan Shah
Before, the only way that we had to look at blood vessels was with an angiogram. And that in fact does not give us the same amount of resolution that it clearly does now. Look, I'm not a cardiologist, but I've done a ton of surgeries on blood vessels in the neck going to the brain also.
- [67:23]
Louise Nicola
Have you done carotid enderectomy?
- [67:25]
Dr. Darshan Shah
Yeah. Yeah. And so when you do carotid endurectomy, what you quickly realize, and that's for those of you who don't know, is that's where you remove the inside of the blood vessels that go to your brain, your carotid arteries. And the reason you remove them is because they built a plaque. And what you quickly realize is when you do an angiogram which is shooting dye into a blood vessel, you're only getting like a glimpse of what's going on the inside of the blood vessel only. Right. Because it's just showing you blood flow through the blood vessel. It doesn't tell you you what's going on in the vessel wall. And when you can see with a clearly scan, which is an AI enabled CT angiogram, so a CAT scan of the blood vessel using AI and you can see exactly what's going on with the blood vessel on the inside and what kind of plaque you have. That's incredible information because you can find soft plaque, which is non calcified plaque, and also dangerous plaque, which is called un. Unstable plaque as well. You can see this in all Four of the major blood vessels of the heart completely laid out for you, and then you can make really great therapeutic choices. So who needs a stent, who needs an angioplasty? But here's where it's really powerful. When you put into place interventions like nattokinase, like statins, like PCSK9 inhibitors, you can actually see if that blood vessel wall, over time, is reducing its plaque burden. And we're seeing that in patients. We're seeing. We are seeing combination drug therapy reducing plaque burn, reversing cardiovascular disease in people. We actually are seeing dietary interventions like the Mediterranean diet, reversing plaque as well. So now we finally know what's going to reverse cardiovascular disease.
- [69:16]
Louise Nicola
Yeah, it's multi therapies as well, I think. I like when you can actually get the scan and it can put on a vertical axis where you can go down and slice every. Like, it's so small, it's so sophisticated. And it excites me for the future of AI, which I know hardly anything about, but it just excites me. And I don't know how to imagine what a future is in terms of brain health. I know what we're doing, doing in the or and what that's leading to. Like we're 3D printing these, you know, skulls, right. And that's giving people their life back. And I just can't imagine what else it's going to do for brain tissue. I mean, stem cells excite me. Being able to, you know, use stem cell therapy, I think that excites me.
- [70:01]
Dr. Darshan Shah
I mean, what's incredibly exciting right now is that David Sinclair is doing research in his lab for reversing nerve damage to, you know, for people that have vision loss. Human trial and these molecules were created using artificial intelligence to do this. These are the Yamanaka factors, and these are specific versions that we've created using AI and folding proteins differently and using different molecules in the protein. And so the previous Yamanaka Factors, for which Dr. Yamanaka won a Nobel Prize for, of which there are four of them, brought a regular cell back to a pluripotential stem cell. But now, using artificial intelligence, we can create Yamanaka factors that we can control the process. So we can do, very specifically for a nerve, how to regenerate the nerve itself.
- [70:55]
Louise Nicola
Oh, my gosh. Could you imagine the optic nerve?
- [70:57]
Dr. Darshan Shah
Yeah. So could you imagine what that's going to do for the brain or even for paralyzed people, Even for people that have, you know, ms, for example?
- [71:07]
Louise Nicola
I was going to say optic neuritis is one of the first symptoms of. Of Ms. You are one of the best people I know. I'm so happy that we are. We are friends. I think you're going to change the world. Thank you for coming on the podcast.
- [71:20]
Dr. Darshan Shah
Oh, you're so sweet. With your help, hopefully we make a difference.