S2 E3 Longevity Without The Gamble: Telomere Medicine 1.0

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Welcome to the Dr.
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50 Something Podcast.
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I'm your host, Dr.
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Nicole Norris.
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Whether you are in the midst of midlife or you want to prevent the physical and mental signs of aging that occur in midlife, this is the podcast for you.
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This is a show where I share my knowledge, gleaned in family practice, preventative medicine, and aesthetic medicine to shed light on aging, or better yet, how not to feel or look like you are aging.
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We should be taking an active role in how we age from an early age.
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We should not settle with growing old gracefully or letting nature take its course.
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How we age directly affects our confidence, which impacts all of our relationships with those around us.
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The length of time in our lives that we feel really good in terms of energy, aches and pains, and thought clarity has a definite impact on the mark we can leave on this world.
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My wish for my listeners is to always be mistaken for being 50-something or less in mind, action, and appearance.
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Let's go.
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I just got back from a fascinating conference in Las Vegas.
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The American Academy for Anti-Aging Medicine calls it longevity fest.
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This is an international conference of thought leaders talking about not just living longer, but living longer better.
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Yes, four days of immersion in the most up-to-date science of how we age, why some of us age faster than others, and most importantly, how to live longer while keeping our brain and our physical abilities intact, right?
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It's not really useful to live longer if you are bedridden and have no idea what day it is.
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Some people go to Vegas to gamble, but I go to eat at great restaurants, take in a show at the sphere, and spend my money on information.
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Not just any information, but the top longevity researchers in the world all together sharing their randomized controlled trials about aging.
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Remember my first podcast when I told you I would only share health information with you gleaned from randomized controlled trials?
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My promise still stands.
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Information gleaned from randomized controlled clinical studies is the closest we can get to getting accurate answers to our health questions.
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I may not gamble in Vegas, but I, like most of you, have definitely gambled on my lifestyle choices.
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We gamble with our longevity all the time when we make poor lifestyle choices.
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Too much alcohol, not enough sleep, not enough of the right kinds of exercise, poor food choices, using personal care or food products potentially full of toxic chemicals and microplastics, the list goes on.
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For example, making the right lifestyle choices in terms of food means treating food like medicine.
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Which diet has been shown to decrease inflammation in the body and increase muscle mass and make our cells produce more energy over a lifetime?
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The Mediterranean diet wins the prize every time.
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This is essentially a whole food diet focused on plants and lean meat, with the main oil being olive oil.
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It is very rich in polyphenols.
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There are people who spend their lives studying diets and nutrients and how they affect our longevity.
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One of the keynote speakers started her talk at this conference with a giant blueberry on the screen in front of 1,500 physicians.
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Her lecture was all about why you should eat red or purple fruits every day, which are high in polyphenols.
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In a large randomized control trial that she was one of the lead investigators, it was found that people who have more polyphenols in their diet have a 50% decreased risk for all-cause dementia and slower speed of brain aging.
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Her study also suggested eating at least one of the following foods daily was the strongest predictor of biological age reduction.
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A half cup of berries, a half teaspoon of rosemary, a half teaspoon of turmeric, two cloves of garlic, or two cups of green tea.
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These all have different amounts of polyphenols present in them, so ideally you would mix it up every day.
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There was also a lecture about a plant native to the Himalayan mountains called tartary buckwheat that has over 120 different polyphenols present, which is the highest amount known in one food.
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You can get it on Amazon, of course, and put it in your smoothie or your oatmeal.
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I'll put a link in the show notes for any of you reaching for your phone to go grab it right now and put it in your cart.
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I listened to so many lectures in Vegas about peptides and supplements that can extend a good life, but in each of those lectures, it seemed the expert also mentioned that all the patients in the study were also assumed to be getting enough sleep, making good nutrition choices, and exercising at least 150 minutes per week.
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And of course, all of them had optimized their hormones.
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I came away with two lessons from this conference.
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The first is that lifestyle choices and hormone balance are foundational to biohacking your longevity.
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You must really do the basics before you branch out to peptides and the newest, latest, greatest supplements.
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My second takeaway was that making decisions about your lifestyle and your longevity should be based on science, on good randomized controlled trials.
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And this is essentially the opposite of gambling.
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Please do not base your lifestyle choices for longevity on TikTok.
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The scientific data that I learned at this conference about key lifestyle choices that make a real difference in your longevity was life-changing for me, my family, and my patients.
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Over the course of this season of podcasts, I will continue to share the most recent good data about how we can live healthier so you can gamble less with your longevity.
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So, what is longevity medicine?
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Longevity medicine is the new preventative medicine.
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It is the management of aging and is based on the premise that aging is a modifiable process and not a destiny.
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Most longevity medicine physicians like me agree that our treatment plans are focused on keeping the mind sharp and the body able at the macro level.
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And at the cellular or micro level, the focus is to decrease inflammation and decrease toxins to improve the function of our mitochondria in our bodies and especially in our brains.
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Mitochondria are the power supply for every cell in our body.
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They are what keep our major organs functioning.
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Without mitochondria supplying power to our cells, we die.
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Without the appropriate nutrients and enzymes, our mitochondria cannot function properly and the cells of every organ system flounder.
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NAD or nicotinamide adenine dinucleotide is a coenzyme in our mitochondria that helps convert nutrients into cellular energy.
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NAD is also necessary for our body to repair damaged DNA.
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At this conference, we did talk a lot about NAD's ability to activate sertuans, which are also referred to as longevity genes.
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These genes regulate the aging of our cells.
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Your interest is peaked right now, right?
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There is a lot of talk these days about NAD in popular culture and on social media.
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Should I do pills, a four-hour IV treatment that gives you chest pressure, just use it topically, or should I just take the precursors of NAD?
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Guess what?
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None of those questions matter if you have not established a healthy longevity lifestyle and optimized your hormones.
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All longevity medicine physicians agree that there are foundational aspects of lifestyle modification that you must be attentive to first before you dabble in cellular interventions like NAD.
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And again, hormone balance is also so, so key.
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Shout out to my first 10 podcasts of why you must optimize your hormones for your best quality of life and to prevent the diseases of aging.
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If you have all the right lifestyle habits, but your hormones, which control all the messaging between organ systems, are not optimized, no amount of NED will matter.
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So once again, outside of hormone optimization, your big three non-negotiables in our quest for a better health span are food, movement, and sleep.
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First, food.
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Your food changes every aspect of who and what you are.
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Nutrients from food can change your brain function by affecting how your mitochondrial are functioning.
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Besides a whole food diet with little or no processed food, a protein-focused diet is key to keeping our largest organ system, our muscle, healthy.
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You can go back to listen to my episode on the importance of muscle in season two, episode one, for a review of why the stronger you are, the longer and better you live.
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Some other new relevant studies on protein suggest that 100 grams a day is key to longevity.
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And actually, the older you are, the more protein that you need.
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And another recent study suggested that eating at least 30 grams of protein at a meal sends your brain full signals and increases your metabolism.
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Further, your first meal of the day should always contain 30 grams of protein because this amount maximizes your metabolic function for the entire rest of the day.
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It turns out that the protein you ingest at lunch and dinner is important for building muscle, but does not affect your metabolic rate like 30 grams right off the bat.
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Another interesting study suggested that your first meal of the day should also include whey protein, which is high in the amino acid luchine.
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The rate-limiting step in muscle production is this tiny amino acid.
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If you don't have enough leucine in your diet, you don't make new muscle when you're over the age of 40.
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See, guys, food as medicine is not fringe medicine.
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The second foundational component of longevity is movement.
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I don't know a single healthy person who is sedentary.
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The randomized control studies on exercise are very clear.
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And to have a good health span and not just lifespan, you need 150 minutes of zone two exercise a week.
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Zone two means you can hold a conversation while exercising, but are slightly out of breath.
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Guys, you should not be able to sing while exercising.
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These studies also suggest two to three days of resistance training using our muscles to lift things that feel heavy to us, or even just doing body squats are key to longevity.
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Start slow, do Tai Chi, but just move and use your muscles.
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If you are trying to improve your memory, high-intensity interval training or HIIT exercise has been shown to increase the size of your hippocampus in your brain the most of any exercise.
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The hippocampus in our brains is key to creating and storing memories and is most active when we sleep.
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And last but never least, sleep.
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Sleep is absolutely foundational to longevity.
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We should be hyper-focused on how to get a good night of sleep.
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This is the time our brains recharge, our memories are formed, and our body goes into detox mode.
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We need six to eight hours a night without repeated disruptions or awakenings.
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Did you know that if you sleep five hours or less at night on average, you have a three times greater risk of developing Alzheimer's disease?
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Everyone needs an aura ring or some sort of wearable to track their sleep.
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I even got my teenage boys' aura rings for Christmas.
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Whenever patients ask me about the secrets to healthy longevity, I start with asking them about their sleep quality, their sleep habits, and how to make modifications so I can assist them.
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In women, a key to good sleep over age 35 is making sure your natural progesterone levels are adequate.
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You can refer to episode 9 of my first podcast season for a full rundown on this.
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In men and women, magnesium glycinate supplementation, micronized melatonin, and making sure your growth hormone levels are adequate can all be life-changing for your sleep.
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These, of course, are used in conjunction with establishing healthy sleep habits, like no screens 30 minutes before bedtime.
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That may be the most challenging lifestyle suggestion I mentioned in this podcast.
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No scrolling 30 minutes before bedtime?
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That's like asking some of my patients for their right arm.
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The next thing we really need to talk about in this podcast is how do we monitor longevity?
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If we are evaluating the impact of our decisions in terms of lifestyle, our hormone balance, and other longevity medicine interventions, we need a report card for how we are doing with optimizing our longevity.
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Enter the telomere.
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The telomere is the cap on the end of our DNA.
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This little cap keeps the double-stranded helix from unraveling.
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Think of a telomere like that little plastic piece on the end of your shoelace.
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The length of our telomeres on the end of our DNA can be measured and act as a cellular aging clock.
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Telomeres naturally shorten as our cells and organs age, and when measured, can give us an idea of our actual biological age.
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In contrast, our chronological age is our age according to the calendar.
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Biological age tells us our cellular age.
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It tells us how our bodies are functioning compared to our calendar age and is a better predictor of disease risk and longevity than chronological age.
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So anytime someone wants to start working with a longevity medicine physician, they should get a baseline telomere test and probably have it checked at least yearly to make sure the interventions and changes that are being suggested are working for that individual.
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It is actually a very simple test and can be done in our office or at home.
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The kit comes with a cheek swap to gently collect DNA from the inside of the cheek and a short questionnaire to complete.
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Everything is shipped to our trusted genomics lab for processing and your results are usually back in two to four weeks.
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We then schedule an appointment with you to give your results and a personalized treatment plan.
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This telomere test has been studied in women and men over the age of 30.
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In many well-done studies quoted at this conference, telomere length shortening, which correlates to cell aging, may be slowed when sustained changes are made through, guess what?
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Yes, nutrition, exercise, stress management, and improved sleep.
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Some patients have said to me that they have good genes and they don't have to worry much about their longevity.
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I remind them that 90% of our aging and telomere shortening is actually due to environmental and lifestyle factors, and only a mere 10% of aging is based on our inherited genes.
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Another interesting study has shown that those who have had COVID more than once have significant reductions in their telomere length compared to prior having COVID.
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And they also have a higher risk of death due to COVID when their telomere is shorter.
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So when patients have a history of repeated COVID infections, I encourage them to be more aggressive with their longevity treatment plan.
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So what if we have done everything we can do to slow shortening of our telomeres with lifestyle interventions most days?
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No one is perfect every day.
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What other synergistic therapies are out there to help us with our telomere length?
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Are there any interventions currently available to actually lengthen our telomeres?
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Why, yes, there are.
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I am so glad you asked.
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In my next several podcasts, you are going to learn about them all.
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So think of this podcast as Telomere Medicine 1.0 and the next ones as telomere medicine 2.0 and beyond.
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In Telomere Medicine 2.0, I will be talking about the first ever dietary supplement that has been shown to lengthen telomeres.
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It is fascinating, and everyone over 30 should be on it.
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But first, your next move should be to get your telomeres measured.
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You absolutely need a baseline telomere test before you go any further.
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Get your report card on your current lifestyle in terms of your biological age.
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You can contact my office through my website in the show notes, and we would be happy to have you come in for a telomere test or we can have one drop shipped to your home.
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I had mine done after being on hormone optimization with testosterone, progesterone, thyroid replacement, vitamin D, and a low dose GLP1 for a year.
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My chronological age is 52 and drum roll, my biological age was 48.
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Pretty good, right?
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So technically, I might have to change the name of my podcast to Dr.
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40 Something if I keep up this biohacking.
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Thank you for joining this episode of the Dr.
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50 Something Show.
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If you are intrigued by this show and never want to miss an episode, click follow.
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If you are a really great friend, share it.
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The content of this episode is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
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Always seek the advice of your physician or other qualified healthcare provider to answer any questions you may have about your personal medical conditions.
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Until next time, get fit, get fabulous, get firm, and take care of yourself.