Data-Driven Health Radio

Drea Burbank is an M.D.-technologist and serial entrepreneur whose work is focused on applying high-tech from hard science into critical sectors. She has projects from artificial intelligence, cryptocurrency, to stem-cells, and microbiome science. 

Her interdisciplinary skill set comes from a dedication to reducing barriers to innovation at the intersection of medicine, technology, and research, and the pursuit of enriching public health through these developments. Drea Burbank brings so much to the table in the world of medicine and tech, and it was insightful to hear what she had to share. 

Tune in as she talks about struggles inherent in healthcare technology, her passion for public health, spirituality, and her work with indigenous groups. 

HIGHLIGHTS

[00:46] Drea Burbank in Background in Medicine and Technology

[06:59] Her Current Projects

[08:04] Challenges of Electronic Healthcare Systems

[12:09] Bringing in More Tech to the Healthcare Industry in Terms of Security and Care

[19:07] Lifestyle Approaches to Healthcare

[22:33] Drea’s Interest in Public Health, Preventative Medicine, and Spirituality

[26:21] On Spirituality and Medicine

[33:43] Drea’s Thoughts on the Intersection of Medicine and Technology with Spirituality

[38:37] More on Drea’s Current Conservation Project 

[42:59] Takeaways from Working With Indigenous Cultures

[47:05] Importance of Health Data and Sensor Technology 

00:02 Dave: Hey everyone, welcome back to another season of Data-Driven Health Radio, I’m your host Dave Korsunsky. On this show we dive deep into how you can use data to measure, manage and optimize your health with the latest science and technology. This show is brought to you by Heads Up which is our web and mobile app designed for individuals and healthcare professionals who need a precise way to measure and manage health data. Check us out on headsuphealth.com. If you’ve got comments, questions or feedback on this show shoot us an email [email protected], we’d love to hear from you, and with that said let’s get into our next exciting episode.

00:47 Dave: Hey everyone, welcome back to Data-Driven Health Radio and I have a very special guest today Drea Burbank, she is an MD and a technologist and a million other things that I could not actually have time to finish going through in anticipation of this interview but I just went down the rabbit hole of Drea in all of the interesting projects that she has her hands on so, we are gonna get into all kinds of really, really interesting topics related to health, optimization, technology, some of Drea’s personal passion projects that she is working on that she wants to share with the world. So, Drea, we first got on your radar screen because you had written some content around the struggles that are inherent with electronic record systems and that’s actually why I started my whole company in the first place. So, we will have lots to talk about there, really just like, can I even get a trend line of the most important health metrics that matter to my existence above ground, it was a nightmare. It was like paper records and patient portals and I was trying to work on a health issue and I just needed a simple trend line of like inflammation markers and to this day that is still impossible so I would really like to dig in there and we’ll branch off from there.  But Drea, if I may, I would like to take a crack at your background just from like the initial cursory research I did cause there was just some absolute gems on your website, can I and then you can correct me.

02:17 Drea: Yeah sure, I’m curious to see what your takeaway was.

02:20 Dave: Alright, so I just scribbled a few things here but Drea is an MD-technologist and she is a digital nomad with a yoga addiction, love that. She pretends to live San Francisco but we don’t actually know if she lives in San Francisco, yoga dirtbag, professional pyromaniac, uptight uber nerd and smartass. So those were the nuggets I pulled off the site. Welcome Drea to our show.

02:48 Drea: Thank you, I am so happy to be here.

02:50 Right on. Well, let’s just start with something simple like the content, the piece you put out there around inherent challenges with electronic health records, technology like I said that’s why we built our company but I’d love to hear about your background as an MD first and foremost, sounds like you probably ran into a lot of those challenges but maybe we could just start with your background in healthcare and the types of work you did or maybe still doing in the medical field and then lets go from there into all these other amazing worlds that we can open up.

03:23 Drea: Yeah, happy to talk to about it. So, I grew up off the grid in central Idaho, I did 9 years in forest fires and then I went to medical school in Canada. I was in a rural and remote training program and..

 03:35 Dave: Where in Canada? I’m from Canada.

03:37 Drea: Really? I was in Kelowna, I was the first of four medical students in the hospital in Kelowna.

03:42 Dave: It’s beautiful up there.

03:43 Drea: It was stunning. We were so lucky they had just, they had kept med students out of the hospital for a long time and a lot of the, you know, top clinicians across Canada would retire to Kelowna cause it was a kind of a beachfront property for Canada.

03:56 Dave: Yeah.

03:57 Drea: And they ran the hospital the way they had always wanted to run their hospitals so the nurses basically functioned like residents, and they had a really collaborative relationship with the physicians and they had a huge catchment area so they would pull all kinds of specialty cases but they still did overnight call from the hospital. So, I worked with mostly attending physicians and I had just had a really idyllic version of medicine. Yeah, it was like the best of specialty care with generalist care and like good working relationships, interdisciplinary, yeah and really, really talented physicians, clinically talented. So, we had a daw system in the hospital that had been introduced and I was watching these amazing physicians trying to use this daw system and I was like I could do better I started playing Plants vs. Zombies and I was like wow you could just do something like this it would be easy. Yeah, so, I think sometimes that naivete is necessary to do interesting things, you’re like oh this would be easy. So, I was like well I’m just going to do a year in Silicon Valley, I’ll design something and then I’ll, I’ll come back to medicine.

04:59 Dave: I got ya, so that was what kind of like, first of all you’re a US citizen but you went to Kelowna to do the training, is that correct?

05:06 Drea: So, I was a forest firefighter and I followed it north. I started following big stacks in British Coloumbia, all the best falling if your you know a logger or forest firefighter happens in Canada so I really wanted to learn that. I married a Canadian and I was already in Canada so when I went back to school I went to school for medicine in Canada.

05:24 Dave: And then that experience got you down to Silicon Valley to start working on technology centric problems in healthcare, is that accurate?

05:33 Drea: Yeah, I still think that if you want to get really hard tech skills you gotta go to Silicon Valley. I know that sounds exclusionary but the competition in Silicon Valley is global and so when you go there you end up working with the best people from all over the world. There are other tech hubs obviously, Toronto has a great tech hub, Vancouver does, Austin all these other placed I was just in Dubai and it’s great but if you want to get that really, really hardcore skillset I think you need to spend some time in the Valley.

 06:01 Dave: Yeah, I spent the better part of 10 years out there, I was in Paolo Alto working at VMware and that’s where I got to really like build my skills, work alongside all of these amazingly brilliant people just learn how that whole industry works out there. I don’t think I really could have started a company, I probably could have, but the skills I learned there are I think just inherently part of what’s helping me stay successful is just cutting my teeth in Silicon Valley basically.

06:32 Drea: You don’t have to stay there I just, they have got a really good ecosystem like if you go to Stanford hospital a lot of the academics will leave for a couple of years, start a tech company and then go back to Stanford so they kind of like cycle through and the hospital is pretty good, they have got a like a really nice like, I worked with Nirav Shah for a little bit he is a computer science professor who works with a lot of the doctors, Nimar Agaeepour so they are just super integrated with the clinical needs and that’s where, I don’t think I’ve ever seen it anywhere else.

06:59 Dave: So, are you practicing now or are you mostly working on other types of projects?

07:04 Drea: Yeah, I left clinical medicine in 2018, we got drafted to work on all kinds of high-tech stuff during Covid. We ended up running a concierge Covid testing network for Hollywood which was so random, I was just, they called us, they couldn’t work at all during the height of the virus and they asked us to get test results back and we were like yeah we can do that it’ll be easy. So we, they were getting their test results back in 7 days from Labgen it was our TPCR we got our first results back in 6 hours and then every producer in Hollywood  called us and we ended up testing like NFL players, sports broadcasters during the height of the shutdown. So, that was a lot of fun for us because it was basically using both sides of our head you know, like, the ability to scale really rapidly comes from my tech but the ability to do like serious work like a legitime RTPCR test that no body can question is, comes from medicine and we really like those kind of projects.  We’re highly serious but we can still access all these different skills.

08:03 Dave: Awesome, I love it. Well, just kind of going back to like how we first got on your radar it was really looking at the inherent challenges of EHR systems. I was reading through the article and there’s implications in terms of the amount of extra load that it puts on to a providers workday. There’s the challenges of actually how can we even start pulling the data out of these systems and doing more with it, that’s why Heads Up started because we wanted to find a way to allow an individual to pull in all of their information regardless of what system it’s in and then also the data that they are using on the sensors at home, you know, all these sensors, CGM’s different devices that we can use now are actually getting incredible data, patients now actually have incredible data they have higher fidelity data than the doctor does, they have more contextualized data than the doctor does. They don’t have the clinical expertise necessarily to do a lot of the interpretation but there is incredibly promising startups out there that are bringing medical technology to individuals and building user experiences that help them understand their bodies own bio feedback. So, what we try to do at Heads Up was say how do I get all that lab data in cause that’s stuff your testing once a year, once every six months and if you’re making correct modifications in diet and lifestyle or maybe you’re already in a good place, you’re making optimizations in diet and lifestyle or maybe you’re in a red zone state health wise and you need to change certain things in your daily routine so we wanted to find a way to overlay lifestyle metrics coming from sensors and devices with more like episodic clinical data. So, that’s what we do at Heads Up. I know you and I haven’t really had a chance to talk at any level of depth but we really wanted to build like the agnostic analytics layer in healthcare which was really lacking and we needed a way to quickly plug in new technology, new data sources, new devices, new types of information and then what we wanna do is build an analytics layer and then an intelligence layer on top of it but maybe you could just summarize like what some of the top pain points are that you put in an article for everyone who is listening and then we can kinda go from there, they were pretty succinct.

10:23 Drea: Yeah, I was, it was a little profane but that is one of my tendencies from firefighting

10:27 Dave: I saw that on your website that you dropped a lot of profanities and f-bombs, we are gonna get along great.

10:33 Drea: Yeah, there is something about the stress relief aspect of it for me, but yeah, I think so the first thing I wanted to say yes somethings going wrong, like a lot of doctors are so stuck down in their trees they are not realizing their forest is getting cut down and they’re feeling the pain but they’re feeling it without any kind of like conscious awareness of like why that forest is getting cut down when the larger market forest is behind it. So, I wanted to acknowledge that something is wrong and it’s so wrong that it has to change at some kind of a critical level. Yeah.

11:03 Dave: I would agree with that, I mean just, we had an experience recently working with a large health system and it was actually to the point where it was impossible to do business with them due to a lot of these limitations and we all just chased our tails around for 18 months and then the project got shut down and went nowhere. So like, that’s I dunno, that’s what we are up against basically.

11:22 Drea: Yeah, it’s literally like it’s become a complete heart block to use a medical term. The physicians are leaving the profession in droves right now and we hear all these statistics about burn out and physicians wanting to leave and it’s being attributed to Covid but I don’t think it has anything to do with Covid. I think Covid was just like you know, the straw on the camels back, what I think it’s about is like the quality of the workday of the average physician and these are sensitive people who are high performing who are intellectual, they are hardworking and if they are burning out there is something extremely wrong, and doctors in particular because we feel such a, you know, obligation to give more and more and more and more and that’s impressed on us from such an early age in training and we get a lot of like social positive social feedback for all the things that we give so when we are burning out there’s something wrong with that.

12:08 Dave: Yeah, and you were also making some comments around how do we help the profession as a whole bring in more technology. How do we help them bring in more of the latest types of things like digital health technology that could enhance what they do and provide better patient care but I think one of the points that you were making is that there’s really even an inability to bring in innovation at this point so even if there was a desire there is no innovation reaching these types of professionals. Did I get that right?

12:38 Drea: Yeah, well what I wanted to say was that this is not happening by accident there is a layer of for profit EHR systems that profit from not providing high quality technology and blocking high quality technology from entering, and the only people who can break through that membrane is doctors themselves and to ask them to do that is a lot because they are already like overwhelmed they don’t necessarily know what to ask for and they don’t feel like there is any help on the other side of that membrane. But, in reality there is all kinds of very useful technologies that cannot penetrate right now like what you are working on.

13:16 Dave: Yeah, so if we were to kind of like wipe the slate clean and start over again for example, when we work with physicians in other countries for example, there’s one system for everybody.  So, at least they’ve got all the data in one place, we’ve got the data in 30,000 places right now. So, there’s that issue of data fragmentation and then there’s obviously the inherent security challenges, like one of the challenges of trying to work with this large health system is just like the number of ransomware attacks that they’re dealing with on a daily basis and it’s like 9 months just to get their security team just to give you the thumbs up because they are under so much threat from a security point of view so like there’s that whole angle of it, and then there’s the ability to like also be innovate but also keep the Titanic moving in the right direction, you know what I mean? So like, how could we imagine a better way to do this type of thing, I don’t know that there is an answer right now but when you think about it what would the next iteration look like.

14:23 Drea: Well first I wanna go after the security thing cause the security thing is why doctors are always told you have bad health tech because there is a security risk. There is only a bad security risk because it’s terrible software, anybody at [unsure] nuclear power we have got a cohort that is nuclear power cyber security and everybody knows if you wanna hack somebody’s system you go after health tech because it’s so poorly designed. There’s just no excuse…

14:43 Dave: It’s a fundamental issue in the technology, that makes sense.

14:46 Drea: Yeah, it’s so badly built on the backend..

14:48 Dave: and 500 different servers connected to the internet…

14:50 Drea: Yeah, that’s why they’re so busy they are playing like whack-a-mole for like a terrible system with a bunch of holes in it.  So yeah, I see that a lot doctors are like oh I have terrible software because it’s so unsecure, no it’s unsecure because you have terrible software so yeah that first. Second off, so I have two solutions that I think are absolutely critical of physicians, you know I’ve been drilling down on them pretty hard because after 10 years you start to look at what’s the solution, like I just get tired of problems. So, the two solutions I think are absolutely critical is that medicine needs to create a technology specific specialty it’s become critical, I don’t like using that word but it’s become critical. Doctors do not own technology as a profession, they will continue to rely on external professions providing their technology and they’re never gonna have the context that clinical training is unique. Somebody asked me the other day what I meant by clinical, and I said I mean putting your hands on 1000 patients with undiagnosed conditions with legal skin in the game for their outcomes, that’s clinical and then once you do that, okay yeah, now you can start looking at if there’s any technology for doctors but if you don’t do that you don’t know what they are thinking and more importantly you don’t have the same risks like doctors have so much professional, legal and financial risk for any mistakes that happen in medicine that if you can’t have empathy for that you’re never gonna understand their aversion to experimenting so that’s the first thing. Second thing is I think doctors have a really good legal case for opening, for cracking the software interfaces open and I think if they were able to crack the interfaces open they could bring better technology in by default. Technology companies would flood in the door and then if they had an app like interface they could select the ones they liked and that would just solve so many problems all at once, cause I know probably like 20 different apps that are usable, solve clinical problems and do a great job, they are HIPAA secure, they are way more secure than most hospital systems but doctors can’t buy them or use them or get to them in their regular workday because they don’t run on top of these interfaces.

16:51 Dave: That’s the challenge we just ran into was we had medical professionals in the system that wanted to use our technology to solve a very specific problem and they introduced us to a group that could help us get shepherded in to the front door, you know, so we had a sponsor that was a very clear use case, it was a program that was going to integrate the oura ring into a sleep optimization type of a program a pretty simple thing and we went down the path of trying to make this available to this group which was super exciting for us and it was the most dysfunctional red tape failed project I have ever been a part of, we couldn’t even get it, it was impossible we failed after like 18 months of spinning our wheels. So like you said, even if there was an interface where they were like hey I love this I want to apply this it meets all the security requirements, it’s HIPAA, it’s validated it was not possible.

17:49 Drea: These are legal problems for two reasons and this is coming from, I did a year in tobacco control and I worked with Stan Glantz. Stan Glantz got the unmarked boxes of tobacco documents back in like the 80’s, somebody sent him like 20 boxes of unmarked documents and then he went to court and like you know he’s a pretty hard headed guy he took it across California, he legislated tobacco and his back take away I remember one day he was standing there and he was waiving his hands in front of me, I talked to him for like an hour, and he was like if it’s for profit it’s a legal problem. So the people that made it impossible for your doctors to get your technology and for your technology to get in benefitted financially and when that happens, when they have a financial incentive to block new software from coming in to block the data on the backend from going out the only solution is legal and I think in this case, the people with the best and sharpest legal case are clinicians themselves because they can just tag the extra 6 hours they work a day and for doctors that’s a huge financial pace. They can tag those 6 hours to a class action and they don’t even have to be at mass for it they have to be individually recognized but for a class action, you have to get enough doctors saying yeah I worked an extra 6 hours a day and here’s my salary and then a legal firm will litigate it on their behalf.

 19:07 Dave: Yeah, well when we started building out product and taking it to market we obviously were aware of the challenges of going into the conventional systems. We were well aware of the boneyard of startups that died on the vine trying to sell a great solution into a system and just ran out of cash even just like waiting to get a pilot agreement approved. It was extremely challenging and so what we did was we entered the market through what I would call more lifestyle medicine and we entered the market for us through the cash based side of healthcare and the types of practitioners that don’t take insurance, they used to work in the system and they have left and they are now in private practice and they are doing holistic or integrated or functional care, same types of things but they are now compensated in a way that allows them to spend 60/90 minutes with you going over a specific type of a situation. You’re paying them cash, you’re paying them out of pocket generally but those were the professionals who said okay I would pay this product and I’ll use it because it is giving me insights into what’s happening to my patients outside the office so now I can get a really, really precise view into lifestyle factors that are driving a health outcome like why does this persons blood sugar hit 180 every night at 9pm and then they have a crap sleep right, so like we started selling it to that market because they understood the value of the data, they could make really quick decisions, they could evaluate a product, sign with us and have this up and running in a week versus like what we went through at some of the larger systems. So, the way we though about it was well let’s go into this, I don’t even know what the right word for it is, I will just call it like integrative market for now, they were already doing a lot of lifestyle medicine they wanted to know what was happening to you during the day, they wanted to know what you were eating, they wanted to know certain information about maybe certain genetic snips, they wanted to run more advanced diagnostic testing in some cases that would be really hard to get a regular doctor to run something exploratory. Like, can you test these 10 things I don’t even know if there’s going to be anything there but I wanna keep going, I wanna dig deeper. So, we just kind of like found our tribe bringing our product in through that market and the reason I bring that up is because it looks like a lot of your professional interests are also in this world of integrative approaches to healthcare even just things like yoga it sounds like you are yogi. I also, I teach yoga, I teach kundalini yoga, Ashely who you connected with on my team. Ryan who you connected with on my team is a yoga teacher so like bringing that part in I wanna talk about your work in rainforests as well but you also dropped a little few clues on your book which I just ordered around shamanism so like there’s the plant medicine side of the house and that gets into mental health stuff which is like super important and I’m super excited to see things like ketamine and sustivan starting to come to life in clinical significant ways. So, it just seems that you also think that way and maybe you could just share on like some of your thoughts on the lifestyle approaches to health that are most interesting for you.

22:34 Drea: Yeah, so wow, okay, Canada is a great system and there is a lot of public health focus so I got a ton of public health training during my training and I was like dramatically interested in plastic surgery and micro surgery which is like the far end of down stream like and then I was really also simultaneously interested in preventative medicine and public health, and I ended up going the public health route. It was a tough choice, I loved both of them but my brain’s a little bit more lateral so I was like you know public health is going to be better for me. So I went into preventative medicine and then I started chasing that rabbit hole and I chased it around the world, you know, I looked at ayurvedic medicine, traditional Chinese medicine, indigenous medicine and the more I looked at it the more I saw like subtle effects of preventative medicine. It’s so holistic it’s hard to measure in the data, so I got really interested in that aspect and yes there is a tribe for that. I am a certified bikram yoga teacher so I did a project a few months ago, about 6 months ago, where I did twice daily 90 minute classes of bikram for 6 months and at the end of it…

23:33 Dave: You did it personally?

23:35 Drea: Yeah, it was fun and I did it in Thailand with […] and yeah […] a character and I’m a character we had a lot of fun. 

23:43  Dave: I wish I had the time to do two bikram classes a day. I’m lucky if I get in one a week these days.

23:49 Drea: It was post Covid I was like totally burnt out and I was like, cause we did that testing network and then when the vaccine came out I was like that’s it I’m never working again so I went off for 6 months and then of course it didn’t take and I went back to work again afterwards but at the end of it I wrote this book and yes, it is out there, it’s of the other side of my brain the one I don’t talk about very often in a professional setting. But, yeah I have a strong, personally I have a strong spiritual experience that I would probably compare mostly to Shamanism or Zen Juadism I guess the type of Buddhist Christian Marie and Jed McKenna are like my favorites.  I think in the western world we tend to differentiate between spirituality and medicine, they are completely independent things and we don’t talk about spirituality or we delegate it to other people but that split doesn’t occur in all cultures so I just spent the last month in the Peruvian Amazon working with indigenous Shaman and they were explaining that as a Shaman they were like well first off, I’m a community leader so the role of a Shaman is to be a community leader and also I mentioned this split between spirituality and medicine in the west and they were just kind of aghast they were like how could you separate the two? That doesn’t even make sense and I was like yeah it’s really interesting that for them that was kind of like outside of the bounds of acceptability. Whereas for us it’s just like a given in medicine and I wonder how much of our frustration with the system is also a frustration with the concept of what is health, because we are so busy treating disease and it’s a bell curve obviously you know, disease and health and so little of our training is in this concept of health, like if we want to fix somebody when they are diseased then what does it look like when they are healthy and you know we don’t know that much about it like how many doctors know about blue zones or you know the longevity science or you know how many of them study professional athletes when they study musculoskeletal injuries. You know we just always assume that we have understood everything about the human body cause we have studied pathology but no we just really studied one end of the bell curve and I think that without a concept personally and professionally of what health is we can’t truly treat disease and that’s what a lot of these guys bring it is this idea of holistic mental health and we don’t have that in our society right now.

25:58 Dave: Well that is incredibly fascinating insight to like have deeper in which is like we have this bifurcation of spirituality and medicine. Arguably a bifurcation of lifestyle and medicine and I think that’s like another major gap especially when it comes to things like food for example and stress. So, how could we start to bring that type of care more into the mainstream? I also think that our mental health, the amount of mental health disease in our country is maybe in a lot of developed countries is probably moving in the wrong direction as fast as what you would consider typical chronic illness like obesity and heart disease and stuff like that, this is just a completely subjective assessment but like the mental health, the number of people that could be diagnosed with mental health issues might even be climbing as fast as some of those like rampant Neolithic diseases and so like the spirituality and medicine idea is incredible and it’s so far outside of the purview of where we are now here I don’t know how we could close the gap on that. I can only say that I am encouraged by the FDA starting to fast track research into certain psychedelic medicines  and other compounds and I think that is a good start especially if that could be standard of care where you can get that type of treatment in a medically supervised environment with proper people who can help you integrate an experience and have that. I think that could be a huge step forward for us and it’s already happening with ketamine clinics, it’s not meant to be preventative at this point, it’s meant to be acute where typically you’re going in there with like extreme cases of treatment resistant depression or something like that. But the point is that you can go to a medical clinic and ask for that type of experience from a mental health point of view so what are your thoughts on bringing more of that into the mainstream and having that as a treatment option for people who may not be like at the extreme edge of mental health but they could just be dealing with everyday depression so there’s that aspect of spirituality. There’s also the aspect of spirituality that has nothing to do with plant medicines, it’s yoga and meditation and learning how to be fully present and aware with our own mind and our own body and that we’re part of a larger connected whole. So, when you think about spirituality and medicine, what comes up in terms of how we can change the status quo or what would you like to see happen in that domain?

28:43 Drea: Well, I like to call the attention to the work of doctors who are more embedded in the medical system cause I feel like I have the freedom to be you know to be openly spiritual cause I’m kind of outside of the medical system and I live in a much more like unrestricted environment so I like to call attention to the work of Eben Alexander who is a Harvard neurosurgeon who wrote a book about his near death experience and it’s brilliant, it’s compassionate, it’s kind and he has done a lot of work with death and dying. Another one of my favorite physicians is Gabor Maté, he is a Canadian physician and he wrote a book called “When the body says no”, I mean like everything he has written is genius and it’s very much integrable into western practice today as it stands. He has done his work, he has done his research and he can speak in kind of a code switching language. I wouldn’t call it spirituality but it’s kind of like applied spirituality within a western context. He has a new book coming out that’s “the myth of normal” and I strongly recommend it, I think it’s going to be genius and it’s kind of about this concept of health. And the last person I want to call attention to is Emily Silverman does a show called the nocturnist, it’s a podcast out of San Francisco and it’s storytelling for doctors and it’s kind of like it’s almost demonic in a sense of like catharsis that happens both in the show and then the storytelling and it’s very much a western, it’s a way to attach meaning to western experience that it kind of a religious. So, those are three doctors that are just you know straight up like super reputable but integrated in the system for a long time and they bring that aspect of meaning back to healthcare in a way that’s, I think, acceptable within current restrictions.  I wanna talk about psychedelics, we have a cohort that does legalization of psychedelics and we were working on a legalization project in Colorado that’s also partnered with John’s Hopkins for psilocybin and we have practitioners that use ketamine and psilocybin in Canada, in L.A. and these are chiropractors, clinical psychologists and we have death doulas so it’s a group of people who basically is looking at how to integrate this deeper meaning in more functional ways. I always say as a yogi, as a yogi who has been in indigenous settings with indigenous people using psychedelics I will say that I think psychedelics are a tuning fork for the mind, they can give you a tone like something that you can hit but you can access those states with other ways that don’t involve external substances, so yoga, meditation, all these things kind of teach you how to tune your mind to a different channel and the end goal of I think of either using traditional psychedelics if that’s in your path or using yoga or meditation is to have more control over your consciousness states and what frequency your tuned into. And you can follow clinical psychology for that too, you know, there’s all kinds of great work coming our of functional MRI and neuroscience that teaches you how to do the same thing with neuro feedback and stuff so I don’t think the path matters so much as the conscious control over where your mind is at. This concept of metacognition and doctors are really good this, either they are always thinking about thinking and many of them do it in very like, I see surgeons all the time you know I remember seeing these surgeons, they would sit down they would have a call or something with a family member before a case and they would be emotionally stressed out but when they got into the case this just kind of calm would settle, you know really experienced surgeons, and they would go into like an output state and it was just that moment the patient, you know and they wouldn’t think about the outcomes they would just think about the process and like that is, I see doctors doing this all the time, you know, they go from one room with an angry, stressed out emotionally uncontrolled patient to another room you know with a happy family and a child and they dump it in between so how do they do that? We have this capacity we can do this.

32:23 Dave: Yeah, I like the way you framed it which is there’s lots of way to get there in terms of developing more of an inner awareness, there are plant medicine, there’s yoga. For me, the kundalini yoga that I have been doing for the last 18 months, 24 months, has been incredible that I think has helped, I’ve been doing meditation for a long time but more of the deliberate breath work and the types of practices that are much more emphasizing around the auric field and the connection with infinite. So, I’ve had really strong experiences through yoga and mediation and also through plant medicine and then you also brought up technology that’s coming on the market. Where it’s bringing more tools downstream to more people like neuro feedback types of tools and this device I just tested Brain Tab where you can put on a binaural beat guided meditation and have a simulated light experience in front of your eyes, like anybody can do that and so, it’s happening it’s just not part of the traditional system that’s out there, it;s kind of in this other side of healthcare that you put more into like wellness and digital health and other kinds of things like that, and it’s there, it’s not part of conventional medicine so is it ever possible that those worlds come together where they co-exist or are they separate completely?

33:50 Drea: So, I think I would be remiss if I wasn’t clear about this because my book is very clear about it I’m just not usually clear about it in my professional context. So, I had a full kundalini awakening that was involuntary at the end of medical school and that’s not a common thing. I think in the medical literature it’s characterized as a physio-kundalini syndrome is kind of how they describe it and yoga, it’s kind of an accepted norm. In India it’s been researched for thousands of years but when I first experienced it, it was completely outside of the bounds of my clinical or western training and I had no preparation for it. I did find people that understood it and helped me with it and I wrote my book primarily to help with people like me who have a western life and they have a scientific life and they want to find a way in integrate these two journeys in a way that they can later function, and I think in my book I compared it to the particle wave experience, you know and physicists just kind of intuitively get this so like yeah it’s a particle and it’s a wave it’s cool it’s the same thing, and it’s not, you’re like you know maybe it’s gonna split on this but it doesn’t really and so you can have this intensely spiritual journey I think and still function within the parameters of science because to me, as somebody who’s like the biggest Richard Feynman fan in the world and I just love empiricism and data, if I can get my hands on it you know like I love facts and so , somebody who loves facts I’m okay to have my facts contained within a much bigger world that I don’t understand and maybe never will, maybe my memory can never encompass it so I don’t consider my work in science or technology to be exclusionary to my spiritual world, it’s just my spiritual world is much bigger and I’m very comfortable with the border of what can know at any given time.

35:33 Dave: Well everything that we do here is about what can we actually quantify health so everything I do in my professional life is how can I objectively measure, how can I get as much data as possible on my health because it has changed the way I manage my own health in ways that I can’t even articulate. In fact, the data has changed how I manage my own health so profoundly that I have gone on and started this company to try to make this available to other people. Simple preventative things that you can do on your own and get objective data immediately to know if it’s working or not every single day, it can calibrate your health and your life in real time. So, like I’m similar, I want all the data that I can possibly get and then the other side of me is this other realm that is much more vast and unknown and they co-exist beautifully. I haven’t really found ways to bring them together in a commercially viable sense yet but I live in both of those worlds quite successfully as well and I;m trying to think of ways, maybe they never will come together in any formal way, maybe they are just completely separate parts of consciousness and life that don’t have any overlap. But I’m starting to put together pieces like I’m gonna be offering a retreat in May of next year and it will be all about health quantification and all about kundalini yoga. So I don’t know what’s gonna come out of that but it will be like sensors and kundalini in the same thing.

37:05 Drea: No, you know what came out of my 6 month bikram process where I was just deep in the reams of kind of like just letting everything go which is a very like unknown space, and I was like what am I gonna do next, I don’t even know. What came out of that was this really amazing project where we’re just doing reforestation so we’ve got an app, we do fair trade carbon offsets, we work with indigenous farmers who are the most practical people on the planet by the way, if they didn’t have a really rock solid sense of reality they wouldn’t survive in their environment, and we are paying them for carbon offsets directly and it was funny because I thought, you know, I’m just maybe gonna be a yoga teacher for the rest of my life maybe I’m just gonna wander off to the edge of spirituality and never come back. And so what happened was I came back in very concrete actionable and more precisely intellectual ways. I feel like the fuzz kind of went out of my head and I was able to appreciate more what is, and I think that this exploration of the unknown kind of, if you follow it far enough will bring you back to tangibles like what is now. It’s made me a better scientist.

38:10 Dave: Totally agree, same for me and it’s made me better at everything I do in my professional life which is highly technical and analytical and building this crazy cloud platform and the spirituality makes me a hundred times better at what I do. I think clearer, I’m more emphatic, it clarifies my sense of why so they just seem to reinforce each other quite nicely.

38:33 Drea: Yeah, I think Victor Frankl said if you have a why you can do any how.

38:36 Dave: Well, I wanna hear more about this project, I know you wanted to share more on it so can you tell us more about that work that you are doing in the Amazon?

38:44 Drea: Yeah, it’s crazy, so much fun. It’s indigenous led so I traveled to Colombia during kind of this period of my life and the indigenous group I was working with said hey you know we really wanna conserve, we have our own organization, we have been fighting off the loggers for 10 years, can you bring us some resources to do this with but we want no strings attached. I love that concept of no strings attached cause I see so many indigenous groups around the world, I work with indigenous groups in Canada and the US and Latin America and this concept of no strings attached is so important to indigenous health so I thought okay how do we even do that so I started looking at trust less validation systems so like GPS, machine learning on smart phones the various cart drones to measure carbon sequestration and we looked at ways that they could prove that they were reforesting without having to do a lot of middle men and without having this people going onto their land and doing surveys who weren’t from their region and I think we came up with a pretty good simple method they can run outside of cell service on a cellphone. We also experimented we can pay them directly with micro-payments so I can conserve carbon for pennies on the dollar which is great because what’s actually killing tropical forests and consequently our atmosphere is 80% of the deforestation is happening on farms less than 5 hectares and it’s happening with about 1 billion indigenous people and small farmers who have no other method of transacting on the market. Their only income is pulling down the trees that surround them and selling it to the international hardwood suppliers but it’s not what they want to do, and I think this assumption in the western world is these guys don’t care. In fact, they care I think more deeply about their forest than anybody because they understand their forest better than anybody else and when they wanna preserve it I feel like it’s an energy that can be, you can tap into and so much of this is like I always go back to this concept of you can’t replace something with nothing. So, if you have intense pain in clinical medicine with software systems you can’t replace that with nothing, you have to replace it with something and it’s the same principle because when I look at the solution for technology and medicine I try and find doctors that are already doing it and when we look at the solution for carbon offsets we look for indigenous groups that are already doing it and we just give them more resources when they are out of something.

41:06 Dave: And so they now have a way to generate alternative income streams that do not involve cannibalizing the land.

41:15 Drea: Yeah, and it’s so cheap. I mean the amount, so for instance on one hectare of rainforest if you can grow a cow in three years and at the end of the three years the cow brings you $12, but I can pay about $12 a day for taking that same hectare and replanting it to conserve jungle, and the trick is because as a technologist and as somebody who’s adopting, you know, I can write NIH grant proposals unfortunately with my eyes closed at this point, so like it’s not that hard for me to sit down and like figure out all the fancy technology or the paperwork that’s necessary for them to get what they need, so that’s kind of what we are doing on our end it is just translating.

 41:53 Dave: Are there ways that people can support that project that you would wanna put out there?

41:57 Drea: Oh yes please, if you wanna support the project I would be delighted you can, so we have, we are BCorp, we have a non-profit and a for-profit and if people want to donate they can donate. The donations always go to expanding farmer capacity like getting them a bank account, getting them literacy training, silviculture training, so like ways that they can participate in the market and then the for-profit is you can buy carbon offsets at any point in our pipeline. If you want to resell them when they are you know fully certified or if you wanna wait and buy a certified offset all of that’s possible.

42:28 Dave: So where would people go you know in either case?

42:31 Drea: Savimbo.com so, our project is called the savimbo project that’s actually out of Kenya and it means trust so it’s the savimbo project and savimbo.com.

42:42 Dave: Cool, well we’ll link to it for sure, Heads Up’s officially on board to support financially, I love it and everyone who is listening if you wanna go and support its S as in sierra, A – apple, V – Victor, I – Indigo, M – Mary, B – Bravo, O, savimbo project. Any other things from the indigenal health world, you’ve had such an opportunity to spend so much time in these indigenous communities and with all of your technological expertise and your medical expertise like the lens you have coming into these cultures and the way you think about how they approach health and spirituality and medicine like it’s kind of an open ended questions but like are there some big takeaways you’ve learned from working in these environments that you can share? I know it’s kind of open ended but these indigenous cultures are fascinating and we can learn so much from them and such a small percentage of people ever get to experience them so like, what are some of the biggest takeaways for you personally from working with all of these incredible people?

43:46 Drea: Well, the first thing I would say is that while I am a good translator I am not indigenous myself and so the best people to speak about indigenous health is the indigenous people themselves. I do believe that people should do their best to find ways to interact with indigenous healers and learn from them and respect their ways. Whether that’s, you know, through a book that they have written or through community involvement that’s fine. One of my takeaways from indigenous health in general has been, one thing I didn’t realize about, so I work in Colombia right now, they were smelting platinum at the same time Europeans were so they were not a technologically backwards society by any means, they never have been. When the Spaniards showed up, you know it wasn’t super healthy for the local population and a lot of that knowledge went into the jungle and while Europeans have different natural resources, what they have in the Amazon is they have the most incredible array of biodiversity on the planet and so a lot of their technology which is by no means inept is biological technology. It’s knowledge of biota, of plants, of animals, of trees. I went out last week with an indigenous farmer and he showed me 30 different trees on his land, 30 different species of trees that the fruit, he knew all the names, he knew which animals ate them, he knew all this and it wasn’t really even like unusual knowledge for him. I grew up in central Idaho and we have several species of trees but we don’t have anything like that, just the variety. So, the technical knowledge in these societies is precious and it’s not shared often and one of the reasons is that is has them in safe for indigenous communities to share their knowledge because when it’s commercialized or taken advantage of they aren’t benefitting.

45:33 Dave: I’ve read about that where there is actual companies that will go down there specifically to look for things that are in their indigenous knowledge that could be then turned into or patented or not patented but can be commercialized and nothing goes back to the community itself.

45:50 Drea: Yeah, so ethnobotany is a branch of medicine that looks at how to commercialize plant knowledge in a way that benefits the initial community and if anybody wants to get a hold of me I will send you like some amazing like tree dust is like how to conduct this kind of collaboration. But it comes down to land rights primarily so if indigenous communities have land rights, if they have existing organizations like financial structures … and then finding ways to enable collective ownership of benefits. So, I grew up in central Idaho and tamoxifen originally came from yew trees in central Idaho and I remember living in central Idaho when they were cutting down all the yew trees and skinning the bark to sell for tamoxifen, eventually they synthesized it and it still remains one of our best cancer drugs and so I don’t know if the end result was bad but I think that the solution could have been much more integrative and that’s what I’m interested in because I think our biggest breakthroughs in science, in western science and western medical science are not going to be out of a lab with synthesized compounds. I think it’s going to be finding ways to access the biota that we already have so for us to do that we have to preserve what we’ve got and then respect the people that have this knowledge.

47:04 Dave: I love it. Well, we are coming up on the top of the hour here Drea, we have covered a lot of ground from like the limitations of EHR systems to all kinds of topics around yoga and spirituality and medicine and what we can learn from indigenous health. I think these are all incredible topics and even just starting to think this way can help to change peoples health when they start to think more holistically and think more about connecting with different parts of different cultures, different lifestyles, different mindsets around what health even means, the definition of that, we have our understanding but we’ve kind of touched on a lot of different exciting areas. In closing I wanna say a couple of things. 1, I would like to take your bikram class so when your teaching somewhere please let me know. That’s actually how I first started practicing yoga, it’s still my jam I might go today here in a few hours, we’ll see. So, that’s option number 1, if you ever wanna take a kundalini class with me I can send you information where I teach so that could be some fun follow up items and we’ll see what comes out of there. We touched on your work on the savimbo project and then just any other things you want to put our there on the airwaves for our people listening. It’s a bunch of health data nerds but we are all like minded so anything that we didn’t cover that you wanna put out there as we close out here.

48:26 Drea: Well, I just wanna give you some credit for what you’re doing because I am a massive advocate for primary data. So much of our health tech is looking at EHR records and I think that most of that data is fictionalized, it’s not really valuable when you look at scientific research and there is so much better primary data out there so I strongly agree with the use of wearables with the use of lifestyle sensors that can be integrated into clinical practice and then the more pristine the data like video footage or just the data streams just need to be better. If we applied all of the infrastructure that we are using on electronic health records towards primary data which is so available now, I think we would see really amazing things coming out for medicine.

49:08 Dave: Well I appreciate that you know 1 of my favorite examples are just these bloody continuous glucose monitors it’s like the data is incredible, it comes in every 5 minutes, I can immediately notice that someone is starting to go outside of range and do a preventative intervention in seconds that can be life changing and even just people who are trying to lose some weight the data is incredible and you can get it in real time and its amazing so thank you for acknowledging that. We’re incredibly excited about sensor technology because the data is getting better and better, the sensors are getting cheaper and cheaper, they are able to passively measure more and more things which means there is not even the friction point of asking people to take a measurement anymore it’s just happening and so, there is like incredible opportunities for us to do more with that. That’s why we try to get our hands on every sensor, plug it in and then find ways put practitioners on the other end, or technology that can start identifying anomalies automatically that’s an even bigger upside, or starting to look for signals in that data, they could be complex signals from multiple devices but that’s our jam so thank you for acknowledging that, appreciate that. I’d love to show it to you sometime.

50:18 Drea: I will definitely check it out. I wanna put a plug in for one of my friends, he makes a sensor that you can wear like a wristband that can distinguish between anxiety and happiness and I’ve just been really happy, I mean you see these kind of advances you think oh my god what can I do with that, like I can do so many things.

50:33 Dave: I wanna see the happiness light up all the time that’s like motivation for me. You get a little bit of bio feedback and you feel great.

50:40 Drea: Yeah, if you can measure it you can work with it and like you know when we, also when we look at a health record and we are tracking a diagnosis like a diagnostic term we don’t allow for that paradigm shift, you know the term ulcer and you know has now been replaced with the term H.pylori and the underlying data is about the same, it’s like pain in this one area. So, when we look at primary data we can adjust our paradigms, our disease paradigms.

51:05 Dave: I love it. Well thank you for taking our outreach. I know we hit you up cold on LinkedIn and I had no idea we were going to get into so many exciting and awesome topics so this was just completely unexpected and wonderful in every possible sense.

51:20 Drea: It’s serendipity for sure, thank you so much for having me.

51:23 Dave: Thanks.

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The post Episode 63 – Drea Burbank MD: Why EHR systems suck, Kundalini yoga, sustainable growth and other musings appeared first on Heads Up Health.

Latt Mansor shares his knowledge about exogenous ketones and their applications for peak performance, health, medical therapies, and more. In the show, Latt breaks down the differences between exogenous ketones and the evolution from ketone salts to ketone esters and now ketone IQ’s R-1,3-butanediol.

Latt and Heads Up founder Dave Korsunsky share their direct experience of using exogenous ketones and the benefits they experience. While also discussing their experiences fasting and getting into a ketogenic state with endogenous ketones. You’ll learn all the the benefits and new opportunities ketogenesis has for us and the many ways to apply it in your life.

Learn more from Latt and his expertise in the wonderful world of Advanced Ketogenics.

This podcast is brought to you by Heads Up, a web and mobile app designed to help both individuals and health practitioners centrally track the vital health data that matters. Instantly synchronize your (or your clients’) medical records, connect favorite health devices and apps, and use the data to optimize your health (and that of your clients).

Click on the button below to start your free 30-day trial. (Opens in new tab)

Hey, everyone. Welcome back to data-driven health radio. I’m your host, Dave Korsunski. And my guest today is Latt Mansor and Latt is from a company that we’re especially excited to introduce to the heads up community. This is the first time we really talked about an exogenous ketone product on the show, even though we’ve been doing metabolic therapy for years and years and years. So I think it’s, it’s definitely long overdue. Welcome to the show.

Latt is a PhD. His PhD is in physiology, anatomy and genetics from Oxford, also a master’s in biotech from Columbia. So he’s a smart cookie. He knows a lot about metabolic therapy and a lot about how we can use exogenous ketones and other products along the journey. And we’re gonna dive into how to put these products into use in, in day to day application, both for individuals, and then also for practitioners who are working with clients or patients, depending on the type of practice you’re in how to introduce these into the program and into the protocol. And then in the spirit of data driven health radio, we’re gonna talk about how do you, how do you measure the effects of these products both acutely and then over time and how can individuals and practitioners start to see the benefits of these products in some of the diagnostic lab data, maybe the data coming back from different devices. So welcome to the show, Mr. Latt,

Latt Mansor

Thank you very much, Dave, Great to be here.

Dave Korsunsky:

Yeah. Thank you. You, you guys have been on our radar screen for a long time. You guys were the OGs in, in exogenous ketones. So you guys have been doing this for a while. Tell us just a little bit of, of the history about the company and, and how you guys really, in my opinion were first to market with this. And, and, and how did that all come about?

Latt Mansor

I think it started all the way in like 2016 where our co-founders Jeff and Michael decided to look into the science around bio hacking, cuz they were already quite big around nootropics and intermittent fasting, metabolic health. So exogenous Ketone was just the next step where, you know, how do we hack the system so that we can get all the benefits of fasting and calorie restriction or ketogenic diet without going through that sort of grueling, you know, diet or grueling, like, you know, fasting period and still get the ketones. And that was when they started doing the research and then they spoke to the University of Oxford, professor Kirin Clark got their license to market. The first keto ester in the world in 2017, I believe I didn’t join the company, unfortunately until 2019 where they already got a phase two STTR, which is a contract with the government military contract, cuz they did a phase one before showing a Exogenous ketones managed to mitigate the decline of cognitive function in hypoxia.

Latt Mansor

So then the government was like, well, you’ve, you’ve done the proof of concept. You, you’ve proven that it works. So let’s expand this research into a bigger population with more data points, again, data driven, right? This is very relevant. How do we convince everyone that this actually works, especially for military personnel who are operating in high altitude where they’re always exposed to low oxygen environments, which is hypoxia. So I came in, joined the company in 2019, became their research lead and also became their principal investigator for this particular project. So yeah, there you go. A little bit of a ketone history with HVMN

Dave Korsunsky:

Yeah, I, I recall from the early days that, while the original studies on exogenous ketones were in hypoxia environments, it did come out of military applications where they did see a big benefit in a very specific use case. And, I’ve personally been involved in the world of ketogenic therapy for a really, really long time. And I remember some of the first products and, and they’re still on the market are actually the salts and that was kind of the, those came out first. But for those who are listening and, and who have never used these products before, could you just maybe distinguish between the two in terms of the difference and, and just give us like a really basic newbie overview on exogenous ketone. And, then I’ll go into some more specific questions around how can we strategically apply these products?

Latt Mansor:

Of course. So let’s start with the definition of Ketone bodies. So Ketone bodies are essentially substrates that our body makes from fat when we are running low on sugar carbs and glycogen stores. So that is achieved via ENT fast orogenic diet. So the three main keto bodies that our body make are beta-Hydroxybutyric, aco-acetate, and acetone. The first one, beta hydroxybutyrate is the main keto body that is used for metabolism and energy. Having said that, exogenous keto is one form or another that increases the beta hydroxybutyrate levels in the body. Keto salt are essentially beta hydroxybutyrate bound with a salt, whether it’s sodium potassium, magnesium. So you have BHB bound to a salt because BHB is an acid. So it can be bound to a salt chemically, and you’re consuming the BHB directly. And then your body processes it and increases your blood BHB ketone esters on the other hand are BHB bound to a butanediol. The difference is the, the bond itself is an Esteban and that’s why it’s called ketone ester. And when you ingest ketone esters, you will then cleave the molecule into half. So you get a BHB molecule and a butanediol molecule. The BHB molecule will go directly into your bloodstream and increase your blood BHB level. While butanediol will go to your liver and gets converted into BHB as well, giving that extra boost of elevated blood BHB level.

Dave Korsunsky:

Nice. You get two for one. So

Latt Mansor:

The, exactly. So, so the difference here is that ketone salt, it can’t elevate your blood ketos level too high because you, it, while it is, it may be dose dependent, you can’t really pile up the consumption of ketone salts because it does increase the risk of GI issues with the increased salt load.

Dave Korsunsky:

Okay. That’s extremely helpful. So then hypothetically speaking, if, if you were to take a normal serving of the esters, the HVMN esters, for example, or maybe maybe a, a normal serving versus a large serving and, and you were testing your, your blood ketones with a meter, for example. When might you start to see the numbers go up, you know, in my own, just kind of like anecdotal testing it’s somewhere between 30 and 60 minutes, I’ll start seeing the curve come up. What kind of curve could I expect? Like how high would I, obviously it’s gonna be dependent on the individual.

Dave Korsunsky:

Yeah.

Latt Mansor

There’s tons of external factors. Like was the person even in ketosis before they started, et cetera, et cetera, but just general rule of rules of thumb. What are you seeing out there in terms of like, how long does it take to kick in and, and what might I see on the meter at various stages, all else being equal?

Dave Korsunsky:

So, so let me clarify this first as well. So the Ketone Ester that we talked about was pretty much our version one, and we no longer sell Ketone Esters. And right now what we have is ketone IQ, which is not a Ketone Ester. So it’s made of entirely pure R1-3 butanediol. So remember what I said about Ketone Ester it’s BHB bound with butanediol. So we took half of that and made it our currently pure R13 butanediol. And that’s what ketone IQ is. Now. The reason we, we came up with that is two twofold, right? One, we want to still keep that efficacy. And we know that, you know, from the ketone ester studies, we know that BTL does increase blood BHB two. We want to improve the taste. Oh, and the three, the third point is also price point, right?

Latt Mansor

R-1-3 Butane allow us to really scale up production and also allow us to start with a lower price point program of, of exogenous ketones here.

Dave Korsunsky:

Gotcha.

Latt Mansor

For consumption, especially for people for therapeutic health, for metabolic health and, and therapeutic users where people might have to consume it on a daily basis. So that, you know, compared to our previous ketone esters, which was $33 per dose, which is around 25 grams, it seems too expensive to have multiple dose per day or even one dose per day. Whereas now we have a $40 per hundred grams of R13 butanediol. And that is why, you know, it became much more practical option and for consumption. So in terms of elevation of blood, blood Ketones. So the curve that we have seen Ketone Ester versus ketone IQ, Ketone Esters, you will see an elevation up to three to five millimolar within half an hour, and it will stay up for about four hours depending on your activity.

Latt Mansor:

And, and that’s a very high spike because of the presence of the BHB and Beto, right? So you get both the BHB and Beto and the BHB is the quick spike. And then the b is the slower releasing spike by the liver. Whereas keto and IQ, you won’t see that huge spike in the beginning. It will start elevating within half an hour. You will still see elevation within half an hour, but I, I would say around like, you know, one minimal and then it will continue going up. We have seen, we have seen peaks at about two to three hours where it’s dose dependent as well. It goes up to like 2.5 and it will stay up if you, you know, if you’re at rest and not doing exercise or activity, it stays up above 1.0, millimolar up to six hours.

Dave Korsunsky:

Nice.

Latt Mansor:

Depending on what usage you want. So in our sort of conversations with all the researchers in Metabolic health, they want something that they can easily take without having to top up often, you know, cause obviously they’re, they’re cognizant of, of the costs as well. Something that tastes better than Ketone Esters, because they are terribly bitter. And they want something that can last, you know, elevate the blood ketone levels as long as possible so that they can reap all the benefits, you know, throughout the day. And then they can take another dose before they go to bed and just keep that ketosis.

Dave Korsunsky:

So there’s a lot of really, really incredible information that you just dropped on us there. So let’s just unpack it a little bit. Yeah. So there are different applications than it sounds like if, if you did need for a very specific use case, you know, just a shorter, higher spike for example. Yeah. Okay. And, there may be reasons to do that. Like I used to back in the days of the salts, for example, if I had a big presentation at work, for example, or I was speaking like you and I were talking about ketocon, which is right around the corner and I was giving a presentation in front of a large group, or I was doing anything where I just needed a performance edge. I would, I would pop it 60 minutes before and pretty much without failure, this was subjective. But I, I always felt like I was delivering a really, really high performance output whenever I did that.

Dave Korsunsky:

Yeah. So I was just using them as a short term performance hack, but, and I’m just sharing some examples that may be helpful for the listeners. But I also coach a lot of people. For example, I work with a number of professional poker players and they’re sitting at the table for a very long time and they need to perform at an extremely high cognitive level for a very hard, long time. They probably would not want the quick spike and then the tail off they’d want a slow burn. And then I also, we also work with a lot of people who deal with things like epilepsy, for example, or they have other issues, conditions, let’s call them where they need the long term elevation, where they may need to stay in a state of elevated ketosis for a very long periods of time. So that, that would be an application for the, a better application for the IQ.

Dave Korsunsky:

Just knowing that you’re gonna stay in the sweet spot. If you’re staying above 1.0 for up to six hours, man. It’s incredible. Yeah. So that helps me understand. And then the price point as well, like you said, if you’re using this for a medical application and you’ve gotta be taking this thing several times per day. Yeah. It’s, it’s gotta be affordable as well. So it sounds like that’s how you guys have come at it, which is how can we then optimize this thing for continuous application consistent daily use, affordable daily use and long sustained performance boost. Is that a fair assessment?

Latt Mansor:

That is a fair assessment. And in fact, you know, before this, we always thought higher is better. You know, more ketone is always better, but certain papers have actually illustrated, you know, in the past year. So that higher does not necessarily mean better because one paper says between zero to two millimolar blood BHB, you get a high oxidation of ketone. You get an elevation of oxidation, which is what we expect. But

Dave Korsunsky:

When yeah, you wanna burn them, you wanna uptake them

Latt Mansor:

When you go from two to four, that oxidation rate reduces significantly. So you get a diminishing return. So you, you still get an improved oxidation rate, but not as high as, you know, zero probably makes zero to two. Yeah. And then another paper also showed for athletes. They, when they are blood, BHB is too high. They increase their cardio respiratory stress biomarkers because they saw a decrease in BHB pH because BHB, as I said earlier, it’s an acid, right? So you are decreasing the blood pH and increasing acidity here. So what they are feeling is they are increasing their heart rate. They’re increasing their breathing rate to expel the carbon dioxide in order to buffer out their acidity. So they have a higher rate of perceived exertion without an improvement in performance. So you’re just working, granted. They did not do worse compared to placebo, but they did not improve either. But you just feel like you’re doing more work. So who won that? If you just feel like you’re doing more work, you’re not actually winning the race.

Dave Korsunsky:

That’s not biohacking. We, we wanna, we wanna feel like we’re doing less work and get better output.

Latt Mansor:

Exactly, exactly. So, so that, you know, so far there is one only one paper. So I think a lot more to unpack a lot more to investigate there. What is the sweet spot? What is the goldilocks zone of blood BHB level for performance? What is the go deluxe zone for diabetes, for, you know, glucose control, what is the goldilocks zone for best, you know, sleep performance, you know, recovery. So I think there’s so many areas now. And so many researchers are, are, are increasingly, I’m building all the interesting questions around exogenous ketones and its use cases that it’s such a, a vigorous area of, of research at the moment.

Dave Korsunsky:

Yeah. It’s incredibly exciting that, you know, it was not long ago Latt, that, that the whole world of even just putting your body into ketosis was like this novel idea, even though we’ve had this machinery since the Dawn of time. Yeah. Basically I remember just a few short years ago. Oh, wow. If I just restrict my carbohydrates or do some fasting, my body produces these magical compounds and, and that’s how the whole craze really started. And, and you get these wonderful appetite suppression benefits. I remember the first time I actually put my body into measurable ketosis, a little bit of backstory on heads up for whoever is listening. You know, I had built, I had built the dashboard basically. And as a free product that we had put out on the market, one of my early business partners and I, and the first people that really, really started using our system started seeing these people logging in 5, 6, 7, 10 times a day.

Dave Korsunsky:

And we were flattered that somebody, somebody thought that we had built something useful. So we emailed these people and they said, yeah, we’re on the keto diet. And your dashboard’s the only place I can like to record my ketones, record my blood sugar sync, my carbs, and my macros, basically from my fitness pal. And so in the olden days, you know, we used to have to do it the hard way to get these, these benefits. And, and now we have companies like yours that are basically bringing these products to market that can deliver those benefits instantly. And, and, and the amount of science and research coming into this field is incredible. We just came from the metabolic health summit, which is one of the premier scientific events of the year that are really pushing the forefront of ketogenic therapy into all kinds of different medical applications.

Dave Korsunsky:

Some of the new ones this year I saw at the event were around spinal cord injuries and, and the use cases keep expanding every year. Yeah. We’re like, we’re finding more places where this is helpful and, and.

Latt Mansor:

Now the cardiovascular disease.

Dave Korsunsky:

Yeah. And, and the tech, your technology is getting so good, you know, that it’s making this accessible to people, even for a lot of people who wanted ketone benefits in the early days, it’s still very hard for people to make the nutritional changes required when you’re heavily dependent on a Western diet and your body has been conditioned to carbohydrates for decades. You know, it honestly took me years of on and off the carb wagon before I, my body just completely became 100% metabolic flexible where I can just absolutely control it at will. But right. I remember for the first couple years, even if I fell off the wagon and had some refined flour or some, something like that, it would take me like a week or two to get back onto a low carb diet.

Dave Korsunsky:

I, I don’t, I think a lot of the reasons relate to the microbiome in addition to other reasons, but now you can use the technology of products like yours available to everyone. You know, some of the, some of the ways I’ve, I’ve seen these are especially helpful are for one people who are new to a ketogenic diet. And, and they’re trying to get into ketosis for the first time, but it’s really hard because you’re addicted to carbs or sugar or whatever, refined, whatever, you know what I mean? And, and so a few applications for anyone who’s listening are first of all, just taking them in the morning to just provide a little bit of a bridge into ketosis. Okay, I’m gonna go zero carb or low carb. I’m gonna be on the struggle bus here for a couple days until my body kicks into ketosis.

Dave Korsunsky:

You know, these are just a beautiful way to like smooth out the journey if you will. And it’ll, it’ll, it’ll provide some immediate appetite suppression, some immediate energy boost, some immediate reduction of food craving. I remember the first time I got my body into ketosis. Yeah. And I tested it with a blood ketones. It was the first time in my life where I felt like I had absolute 100% control over my food choices. Hmm. I I’d never had that level of control over craving or food in my life. And it was so pronounced that it was incredible aha moment for me. I I’d never felt that you could put my favorite food right in front of my face. And I could just push it away, like when your brain’s on ketones. That was the level of self-regulation that I had. And, and we’re all looking for that level of self-regulation, especially with food, because in many cases, food is engineered to be hyper palatable.

Dave Korsunsky:

Right. That’s how food companies exist and not all food companies, but, but a lot of food is engineered to be as tasty as possible. So you got food companies, building stuff to make it as hard as possible to resist. Yeah. Right. Irresistible, that’s their job. But, but, but what defenses do we have, we need to make sure that we have the self-regulation to resist said food. So even just getting it to Ketosis for the first time, but it was hard. It’s like, I’d never restricted carbs before I like, what does 20 grams even mean? It’s like, you know, for the average Joe, that there’s a, there’s a pretty big cognitive hurdle just to even figure out keto, honestly like, okay. So how do I figure out this whole macros thing? And like, I gotta read all the labels and yeah. Make sure there’s no hidden carbs. You’re, it’s a big leap for a lot of people. So what do you think of that first use case Latt, lot where it’s just like, this is a nice baby step into the world and it’ll make it easier for you to learn this whole thing and, and have some success. Is that fair assessment of the use case?

Latt Mansor:

Absolutely. I mean, we have been saying that to, you know, on our website and our FAQ as well. Like it, it serves as a bridge to people who want to be in ketogenic diet, cuz a lot of questions came about when customers ask, can I take ketone IQ if I’m not on ketogenic diet? And we are like, absolutely. You know, that’s the whole point of exogenous ketones is so that you can have the benefit of ketones regardless of the diet that you’re on and based on your own use cases and based on whatever goal you’re trying to achieve. And if you are trying to go into ketogenic diet, as you said, you know, you might struggle for a bit. You might, you know, you might have to reevaluate your relationship with food, your relationship with carbs. And you know, this will provide that, that appetite suppression that, you know, food craving suppression as well as, you know, if you are intermittent fasting, for example, that also helps in giving you energy throughout the day.

Latt Mansor:

Now granted what I tell people is like it, it does contain calories. So if you are doing intermittent fasting for autophagy, then it does break your fast because it contains calories. But if you’re doing intermittent fasting to get into ketosis or to lose or to calorie restrict yourself, then this could prove to be quite supplementary to your fasting regime because it does provide you with clean energy. It doesn’t have any carbs. It gives you mental clarity, but on top of that, it powers through, it powers you through the day without having a full blown meal.

Dave Korsunsky:

So what’s the next use case that’s really interesting is assisting with fasting, you know, for a lot of people, it’s just a miserable concept. You know what I mean? In general. Yeah. I’m at the point now where I actually love it. I feel so good after 36 hours into a fast. It’s amazing. I actually feel better than when I’m eating food, but it’s taken me a while to get there. You know, just the psychological idea of fasting. It’s a little uncomfortable, I’m hungry. So it’s also a really nice compliment to intermittent fasting where you may want to go 12, 18, 24 hours and use this throughout the experience. Just kind of like grease the skids a little bit as well. 

Latt Mansor:

Yeah.

Dave Korsunsky:

So that’s kind of the second one I wanted to call out was like as a compliment to fasting, I use that I do a lot of three day water fasting and I’m not in, I’m not maniacal about being completely zero carb, like a little bit of exogenous ketones I can tolerate, they actually make the experience better. It’s like, you’re already flying really high when you’re doing extended fasting and, and you’re on ketones and this just makes it better, but a, a bridge and a as a adjunct therapy to fasting, whether it’s intermittent fasting, I’d call that a shorter term type of a thing, 1824, or you’re doing extended multiple day. I think it’s another beautiful way to integrate this type of product. Would you agree? Yeah.

Latt Mansor:

Yeah, I would agree. But the only caveat, like I said, it really depends on the goal of the fast as well. Sure. Yeah. Like if you’re doing Autophagy you don’t want to have any calories in because you’re forcing your body to recognize that it’s in survival mode. Hence you don’t want to put any calories in, it’s gonna go into survival mode and it’ll start cleaning itself out of autophagy, reusing recycling and, and, and eliminating whatever waste that is in your body.

Dave Korsunsky:

Cool. Okay. So we’ve covered it just like a bridge into ketosis. We’ve talked a little bit about intermittent fasting. I think another area that would be really interesting to talk about is how can they help with, with glucose control? So, I mean, there would be obvious benefits. This is just my layman’s interpretation of it and you can correct me, but if I’m using, if I’m using an, an exogenous ketone product, I’m, I’m naturally gonna have increased ability to self-regulate my food choices. I’m naturally gonna have a little bit of appetite suppression. And just, just by default, it’s gonna help me make better choices and lower glucose, but are there other applications where even if I am making a bad choice and I have the ketones in me, do they somehow kind of cancel out the postprandial blood sugar or something like that. Can you educate us on, on how those things fit together?

Dave Korsunsky:

That’s a very interesting question. And it is an area that is still very new in research, probably in the past 2, 2, 3 years, professor Jonathan Little from university of British Columbia published three papers. At least I think she probably published more now, but the initial three papers were on acute use of Ketone Esters in healthy individuals, acute use of Ketone Esters in obese individuals and then use of keto Naster for 14 days in obese individuals. And all of them looked at, you know, insulin, blood glucose and all that. And they took it, you know, after they had food. So post prendale, beautiful. And they saw consistently there is a slight drop of glucose after they consume exogenous keto. Now exogenous, keto, meaning Ketone Ester, and so far keto, I’ve also shown the same pattern. I don’t believe ke salt has the same effect.

Latt Mansor:

I don’t know if it’s because it doesn’t raise the blood BHB high enough because the hypothesis around why blood glucose is going down blunted blunted a little bit. So the hypothesis around it is that if your blood BHB is high enough, it somewhat gives the signal to the liver to temporarily seize or downregulate gluconeogenesis, which is to produce its own glucose within, within your own body. Because your body’s saying that, Hey, you know, you’ve got enough stuff straight in the body to create energy. Now, why don’t you dial down the gluconeogenesis a little bit? So that is the, the, the theory, the hypothesis so far, but we haven’t really explored into, you know, confirming that or, or validating that. But surely, you know, it certainly has a place for people who, you know, want to go back, say, say you are on ketogenic diet and, and you were invited to a birthday party, you had a piece of cake, you know, you had a high glucose.

Latt Mansor:

Now you wanna go back into ketosis really quickly and you wanna lower your blood glucose, take a shot of, of ketone IQ. That’s why I usually do sort of cheating, but at the same time, like it does bridge that, that keto, ketone ketosis much quicker. And on top of that, I dunno if you, you feel like for me personally, if I have been on a low carb diet for a bit, and if I introduce quite a large amount of carbs and glucose, I have that glucose crash. Like I just feel very lethargic. I just want to have an app having a shot of ketone IQ actually stops that for me. Yeah. So, you know, I think it, it, it really depends on individuals and, and, you know, on another like point to prove the effect of, of ketones in, in, in glucose control and in diabetes as well. I mean, Verta health has been doing, you know, tremendous work in using a ketogenic diet to treat diabetes. But granted we know that, you know, ketogenic diet is naturally low, very low restricted in, in carbs anyway. So you are already restricting in carbs and then, you know, to add ketogenesis and, and ketosis on top of that is just a bonus.

Dave Korsunsky:

Yeah. You, you brought out Verta, it’s such an incredible example where they’re, they’re bringing ketogenic therapy into the standard of care, which is really cool. Just, just tangentially. Do you know if they’re using ex exogenous ketones in their protocols?

Latt Mansor:

No, no, they are. They are not at the moment.

Dave Korsunsky:

That would be pretty sweet. That’s a nice partnership opportunity there. AB absolutely. You guys are right down the street.

Latt Mansor:

Yes. And I did talk to no Dr. Steve Finney and he, he gave me a challenge essentially because, and he has a point and, and, you know, we here at HVMM, we always stand for the transparency and we stand for the science and we stand for a win-win situation for both the company and for the people. So Steve posts a challenge that, you know, he said, how much ketones can my body create in a day? Right. He said about like 75 to a hundred grams. And that is free from your ketogenic diet exogenous ketones can you make it free? Right. How am I going to compete with ketogenesis with endogenous ketones? If you, you can just use it as, you know, use ketogenic diet versus a fair point, ketone IQ. It’s just a matter of cost. Yeah. And, and, and I can always argue about the adherence, right?

Latt Mansor:

They have been proving that, you know, there’s quite high adherence amongst the people and they’ve published these papers. So one point to argue is, okay, adherence. What if some people, you know, the exogenous ketones might give these people some form of flexibility in ketogenic diet. It will allow them to at least have a bit of carbs. And then it boils down to the end user. Do they even want that flexibility? Or do they actually want a strict regime where they stuck to their ketogenic diet? So there’s still a lot of work to be done here to really optimize the final product of ketone IQ we can always, and we always do

Dave Korsunsky:

So already iterating on the product just based on the way you’ve kind of forked it from the original.

Latt Mansor:

Absolutely. I mean, they can, it can always be cheaper. It can always taste better. It can always act better. It can always be more efficacious. It’s science, it’s technology, right? Whatever data there’s other that’s, that’s the great point here that that’s the perk of my job is to be able to have these kind of conversations with all the researchers around the world who are doing research in different areas, but all involving both endogenous and exogenous ketones and really understand where the state of the art is and where the current state of science around ketones is. And, and that is very important because then we know where to steer our product towards, you know, what is actually proving to work, what molecule is actually proving to, what do people actually want? Do they want a big spike and then a drop, or do they want something that lasts as long as possible before they top up another dose? You know, do they want something that, you know, is between X and Y range of blood BHB? Or do they want a general, like anything above 0.5? So all those questions have always been asked consistently within our company and me as a research lead also, you know, it’s my job to go out there and find all these resources to be able to answer them to both internal and, and external parties.

Dave Korsunsky:

So you get to keep your hands in, all the different pies out there, all the research being done. You’re just kind of looking across the landscape and looking at what are the different types of studies coming out? What are the different demands from consumers? You guys have a huge direct to consumer business, a fantastic brand out of the market. So you’re obviously hearing it from the individuals who are using it, all the biohackers, all the people using ketogenic therapy. Then you’ve got the research aspect. Where, where is that going? How do, how do these products fit in? So you get to look across the landscape and then you’re bringing that feedback back into the product team. Is that correct?

Latt Mansor:

That is definitely a privilege. I’m very grateful to have.

Dave Korsunsky:

Cool. Let’s talk about high performance applications. I, I mentioned one example earlier where you have a use case around someone who is sitting at a poker table with some of the top players in the world going, you know, head, head to head, for example, long days, that would be one application sport, high performance sport. That’s a different type of application where it may not be sustained long term, unless it’s an endurance type of an event, for example. Yeah. So what are you guys seeing out there? What’s the state of the art in, in using these products in, in high performance applications, any specific nuggets you wanna share with us?

Latt Mansor:

Sure. I mean, exogenous ketones have been used very ubiquitously in enduring sports, especially in triathlon, in cycling and in the Tour de France. You know, they had a whole article published on how cyclists in the Tour de France used Keyes from the history of men before. So that was really big. And, you know, are

Dave Korsunsky:

They are allowed in this day and age? sorry to interrupt you. Is this, is this permitted in, in, in competitive sport?

Latt Mansor:

Yes, it is because all our products are also third party tested for band, substance and compliance. So all of that is covered. Usually athletes, they will ask for it and we’ll send them, you know, ask them what back they have, all the certificates everything is done. And obviously, we have the FDA grass as well, which is generally recognized as safe. So we get all the paperwork covered. And as I said, you know, earlier we are all about, you know, transparency and science and making sure that people are getting what we say they’re getting. So for endurance wise, we, we have seen papers and, and studies that showed improvement when faster. So that was the big paper in 2016 and some metabolism that showed 2% improvement when the cyclists were faster. And then another group repeated that study with fed cyclists because they were like, well, you know, no, one’s gonna go into a race faster.

Latt Mansor:

So let’s replicate a more ecological setting here. So they saw no, no improvement in the fed group. And then they repeat that again. But this time, knowing that the increase in blood BHB decreases blood pH and, and increased acidity, they added sodium by carbon and that improved performance by 5%. So, the current understanding of the protocol is that balancing or buffering the intake of Ketone Esters with Sodo by carbonate did improve performance in endurance athletes. Now people ask, how does that apply or translate into keto IQ? What I tell people is that keto IQ does not spike in blood be that high. And in fact, it’s a much slower releasing, slow burn. Yeah, slow burn. So you possibly don’t have to buffer it because it doesn’t go to that level. And it, it, because our blood, our body obviously, you know, in homeostasis balances and buffers itself out.

Latt Mansor:

So it gives the body time to, to balance that, that acidity out. And hopefully, you know, that way we can already see an improvement in performance without having to, to either be fasted nor having a sodium by carbonate buffer. So currently we are running a study with the University of north Georgia to replicate the use of Ketone Ester in cognitive and physical performance. But this time using keto IQ, hopefully the data data, data collection will be complete in August. And we are looking to present at the national strength and conditioning association conference next year, hopefully with that data as well.

Dave Korsunsky:

Cool. So you’ve got endurance athletes, and I think that was really kind of, you know, just going back to the old Steve Finney books, the art and science of low-carb living, the art and science of low-carb performance. It was really these ultra endurance athletes who had really put keto on the map because they had gone through a full four week fat adaptation, probably a little longer than that, even before competition. So yeah, this is not a matter of where they said, Hey, I’m just gonna carb restrict for a couple days before the competition and go in, they had car restricted and been in a ketosis for up to four plus weeks where according to the books, if my knowledge is still accurate, that that’s a full adaptation of every cell in the body, you know, weeks of, of ketosis. And then yeah, they went into the endurance ultra endurance race in this prime state and, and were not dependent on any type of external fueling at all like the gels and whatever the other people were using. And, and they had extremely successful

Latt Mansor:

Outcome. And, and I might, I might want to add as well that these protocols that I just mentioned for endurance athletes and endurance exercise is that they have been taking exogenous ketones, but also they have been taking their standardized fueling strategies, which means about 60 grams or one gram per one gram of carbs per kilogram or body weight per hour. So that’s what they have been using. So they’re using essentially a hybrid fuel gotcha system where they have both carbs and ketones. And somehow we have also shown that that system itself does have a glycogen sparing effect. And that is also what pushes these endurance cyclists or endurance athletes a bit further. And then the same group that used sodium by carbon to buffer the acidity of Ketone Esters. They also did another study to look at, to look at overreaching symptoms and recovery. So for a three weeks study, they gave the cyclist ketones and proteins and carbs after their workout, as well as before bed. And they saw an improvement of 15% work output at the end of three, the third week. So, you know, to me, that compounding factor of, of using it for recovery is definitely very significant.

Dave Korsunsky:

Well, it’s interesting that you’re starting to see hybrid strategies that that’s new to me where you’re using the exogenous keto, but you’re also taking 50 to 60 grams of carbs per day. And, and what you’re saying is that those protocols can deliver equal levels of performance relative to someone who has been purely ketogenic. Am I understanding that right?

Dave Korsunsky:

Yeah. Yeah. So, that’s a whole, that’s a whole idea. And the benefits of Exogen keto is that you totally, you don’t need to, you get the best of both worlds diet, you get the best of both worlds. So you can’t. So there, it is not a possible physiological state where your body has both carbs and ketones to, to choose from,

Dave Korsunsky:

Well, not in the natural world, but there is now exactly,

Latt Mansor:

Exactly. So this creates that. And, and what we have seen is that that gives your body because your body will just, you know, choose whatever that it can burn and it burns more efficiently. And that has been proven to really give your body the advantage to, to go further or go faster. And that is exactly why when athletes start using ketone IQ for performance, we always tell them to use it together with carbs because, you know, one dose of, of ketone IQ is like, what 70 calories, it’s impossible for it to sustain your whole, you know, endurance race, right? You are burning your own, your own storage. And if you are already on a ketogenic diet, you barely have any glycogen in your body. So you are burning your other, your fat storage and all that. And if the process of conversion is like lipolysis and all of that does not catch up to your activity, you’re just gonna bunk out.

Latt Mansor:

Right? So that’s where, you know, the hybrid fuel system is, is quite helpful because it lets your body balance itself out as well as it gives your body time to decide, okay, am I burning the glycogen now, am I, am I mobilizing all the fats now while I’m burning the glycogen or, you know, am I am running the ketones and all of that. And on top of that one thing that most people, because when these studies are published, they look at performance, they look at glycogen sparing, they look at muscle metabolism. Another point is also the subjective feeling of cognition like cognitive. I love the benefits. So that is another really profound effect of Exogen ketones that I have experienced is that when you are at the verge of passing out, you are so fatigued. And the only thing that is pushing you forward is your mental strength and resilience.

Latt Mansor:

This puts me in that zone and, and really gives me that, that clear thinking process where I can just, just hyper focus on one thing. And that is especially useful for, for me, going weightlifting, for example, and, and strength training, because I’m not going for the marathon, I’m not going for the endurance, right? So I, I can’t measure, you know, how long can I burn the substrate for, but instead it gives me that mental focus that, okay, I’m gonna do this heavy lift, get into the, into the zone, engage whatever muscle groups that I need to engage, make sure my form is correct. You know, I’m alert to everything. I can feel everything and, and do it correctly.

Dave Korsunsky:

Yeah. I love that. So I also really love the idea of having this flexibility to do a hybrid strategy. It doesn’t mean that you can smack back a few donuts and a pizza, but what does mean is you might have some really nutrient dense carbohydrate sources, for example, sweet potato, as an example, or, or other like the, the highest quality carbohydrate sources so that you get the benefit. And, and those have other benefits around just hormonal health and other things where you can still really give the, the amount of carbohydrates in the body to keep hormone levels optimal, do do long, long term ketogenic diets, maybe reduce a lot of the downside of, of long term keto, if, if that’s what you wanna do. So knowing that you can layer that in, and now you have a world where you can have both fuels in the body, which was largely impossible up until this type of product came to market.

Dave Korsunsky:

So it’s interesting to see that these hybrid strategies are coming out. I wanna just talk a little bit more about performance applications and then just recap it here for everybody. So if, if I’m understanding things, let’s just recap. So if, if I just want to use them acutely, right. I haven’t been following a ketogenic diet at all, but I wanna use these for a, you know, big presentation at a conference or something like that. Just acute applications. I carry this in my backpack with me everywhere. So like everybody listening needs to have a couple bottles of these in the backpack at all times. And you can just use them acutely, like, yeah, I need to snap in my focus for a couple hours. I’m a little lethargic, or I have a big performance event coming up. I play competitive tennis here. I’ll take them before I play a competitive sport.

Dave Korsunsky:

So there’s those acute applications. You can also use them. It sounds like if you are already in a state of ketosis and, and you want to perhaps amplify the effects of that, of that state. So you’d have the body producing exogenous ketone, maybe you’re at a low level of nutritional ketosis, 0.5 millimeters millimolars or something like that. And this can give you that little push, you know, up into like maybe the 1.5 LAR range. And then if you’re, if you’re already in a very, very deep state of therapeutic ketosis, maybe you’ve been fasting for several days, or maybe you’re on a, a cancer protocol or an epilepsy protocol where you have to be in a therapeutic ketosis, which is gonna be like a glucose keto to an index, like less than three I’ve even pushed mine less than one before, which is super intense. I would imagine that. Would you recommend it in that use case as well? Or you are already so deep that you wouldn’t recommend it. What’s the best practice there?

Latt Mansor:

So what we have seen, interestingly enough, unlike ketone esters, ketone IQ, if you’re already in a deep state of ketosis, let’s say you are already at two, right? It doesn’t increase your, it, it’s not directly proportionate to, it’s

Dave Korsunsky:

Not just gonna double it. 

Latt Mansor:

For example, it’s not gonna double. It’s gonna,

Dave Korsunsky:

Your body will regulate it somehow.

Latt Mansor:

Exactly because it’s being gate capped by your liver. So your liver is gonna have the signal that says, you know, your blood keto is quite high now. So it will. So what we have seen is like the person with, you know, 2.3, you know, 2.4, they’ll go up to 2.5 or six. And then now what does the ketone IQ do then? You know, people also like, why do I need it? It actually prolongs that period of high, high ketosis. Cool. So, so depending on what your goals are, you know, if, if you think at two millimolar, that’s more than enough, what you need, you already have the mental focus, you already have the energy, or if you are, you know, fasting and you are low energy, but you have high ketosis, then maybe one shot will, will give you that, that boost of energy. Right. Cool. Because there are calories going in. So even though you are creating your own ketones, this one is external calories that you’re putting in that would essentially, you know, create energy and vitality.

Dave Korsunsky:

Yeah. I, I also think it’s important that, that we mentioned for people listening, that you can test yourself if you’ve never tested ketones before, you know, that was something that even a few short years ago, I remember the days where we had to like scour the web for test strips from Australia, cause the precision extra strips in the us here were like $5 a strip. You know, it wasn’t that long ago that that was the, the, the, the state. I remember ordering on my ketones strips on eBay from pharmacies in Australia. They were like, I could get ’em for like a dollar 20th strip or a dollar 40th strip cuz in the us for lots of reasons, we don’t need to get into, you know, the companies could charge $5 a strip. Now we’re at the point where it’s like, I don’t know, it’s like down to pennies on the dollar to test ketones.

Dave Korsunsky:

So if you’ve never tested, that’s actually one of the most rewarding parts about this whole thing. Yeah. And you can get really, really good keto meters on the market nowadays. And, that’ll give you some really accurate biofeedback that you’re doing things correctly and you can start to see how the product is changing your metabolic profile, your blood sugar and your ketones. So lots of easy ways and affordable ways to test lots of incredible products. Like HVMN that are out on the market. Now that just have incredible benefits across the board, you know, EE provides just out of the box benefits of ketogenic therapy for people who are new or people who really struggle even to get into ketosis. And then on the other side of it, there’s the medical applications. And then there’s also the high performance applications and, and it just keeps getting better and better.

Dave Korsunsky:

And what tools are accessible, these are not expensive tools. These are not cost prohibitive. These are tools available to anyone who’s really interested in being their best self every single day, unlocking the secrets of your body’s performance. It’s just something that is incredibly exciting. So Latt in closing here, are there any recommendations you would give for people who are just starting out here or, or maybe if you could share some of your, the top resources on your website for people who wanna learn more and just, if, if they’re listening, how do they, how do they get started here, cuz I’m sure we’ve peaked to curiosity, not just of our end users on the system, but if you are one of the practitioners on the heads up platform, working with clients on metabolic therapy and, and you’re working with people who, you know, may struggle with a ketogenic diet or who need extra help or who want to use these in fasting, I use them with people I work with in high performance applications. It’s just an awesome performance hack. And if you’re a high performance coach on our system, layering this into the stack, incredible. So lots of ways to infuse these into different programs and protocols out there, but what’s the best way Latt for people to get access to your product? And if you could maybe share like your top one or two resources out there that you’d recommend to people to read or watch to learn more. Yeah, that’d

Latt Mansor:

Dave Korsunsky:

That’s amazing. You’ve got me sold. I was going old school. I like the slow burn. You know what I mean? I think that’s actually gonna be a better use case for me personally. And, and the clients I work with. That’s not to say it’s for everybody, but the clients I work with, they need that long, slow, continuous, like, just keep me above 1.0 for six hours. That is money. Yeah. So please, please keep iterating on the product. I know you guys have been really at the forefront of this science for years. You guys were really first on the market with this type of stuff. There may have been some other ones, but you guys really are first to bring it to the mainstream, to the masses. So keep doing all of the amazing work that you guys are doing. Yeah. We’re, we’re very grateful that you shared your expertise with us here today and there’ll be more coming between heads up and HVMN and the near future. So stay tuned and thank you Latt. We’re very grateful.

Latt Mansor:

Thank you for having me. Thank you.

HVMN.com

Free Trial Of Heads Up

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Dr. Sachin Patel of The Living Proof Institute and Perfect Practice Mentorship sits down with Dave Korsunsky to discuss how Dr. Patel implements the Oura Ring into his practice. The pair dive into their favorite metrics to monitor, how to build a successful practice, and how each of them got into functional medicine.

This podcast is brought to you by Heads Up, a web app designed to help both individuals and health practitioners centrally track the vital health data that matters. Instantly synchronize your (or your clients’) medical records, connect favorite health devices and apps, and use the data to optimize your health (and that of your clients).

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The Living Proof Institute offers personal and corporate health solutions. Our goal is to improve the health and wellness of our community by improving the health of its citizens. Our mission is accomplished by patient education, dietary and lifestyle consulting, exercise prescription, and advanced functional laboratory testing.

Perfect Practice is a world-class personal, professional, and practice development mentorship. Our mission is to provide simple, practical and affordable growth tools to help functional medicine practitioners and coaches deliver transformational care for their clients.

Sachin is a father, husband, philanthropist, functional medicine practice success coach, international speaker, and best-selling author whose philosophy is that, “The doctor of the future is the patient.” 

He founded The Living Proof Institute and coaches practitioners all over the world on how to step into their power and profoundly serve their communities.

And, he has taught thousands of functional medicine professionals how to start, grow, and scale their practices.

(2:10) Dave talks about how practices can use wearable technology to benefit their patients. Practices can get rapid feedback, personalized programs, and more.

(3:15) Dr. Patel started as a chiropractor for sports, soft tissue, and repetitive strain injuries. He ended up on the news, which resulted in more than 50 people calling his practices. All of these people had chronic health issues, as opposed to soft tissue injuries. This led Dr. Patel to functional medicine.

(3:43) Dr. Patel started the Living Proof Institute in Cincinnati, Ohio. The institute helps people get to the root cause using functional medicine, lifestyle, medicine, and mindset to help them heal.

(3:56) He moved back to Toronto to start another clinic. Other practices started reaching out to him about how he built his own practice. This led Dr. Patel to coaching. His goal is to establish a movement to create and deploy an army of practitioners that are making the world a better place and using technology in a responsible way to enhance their clinical outcomes.

(5:37) Dave reflects on how a functional doctor helped him identify the root cause of his health issues. This led him to move off of the Western diet and ignited a series of personal health changes.

(7:04) Dr. Patel shares how he grew up eating a bunch of grains as a vegetarian. He started removing gluten and dairy from his diet. This included meat substitutes which were stitched together with gluten.

(8:07) He would wake up tired, stiff, and achy every morning. He had major digestive issues. After altering his diet, his skin cleared up and many of his issues disappeared. He has now been gluten free for over a decade.

(9:44) Dave discusses how he is also now an early morning person.

(10:22) Dave shares how understanding Oura Ring metrics on himself now helps him interpret the data of his loved one’s through Heads Up.

(11:45) Dr. Patel met Harpreet Rai (CEO of Oura Ring) at Genius Network. This led him to invite Oura to come to Dr. Patel’s in-person event, which resulted in dozens of practitioners ordering rings.

(12:22) In Ontario, Dr. Patel had to figure out what claims he could make regarding his messaging. He decided to focus on vitality and health optimization.

(13:13) Dr. Patel realized that boards would go after practitioners requesting testing. Dr. Patel wanted to create a program that doesn’t use testing. 

(14:44) Dr. Patel wants patients to become their own doctor by having data. People who were put on a lifestyle design program were getting amazing results in 3-6 weeks. They got off their meds, lost 20-60 pounds, and transformed their health before getting tests done.

(15:44) By improving lifestyle and environment, there’s collateral benefit to their entire family. They want to teach the figurehead in the household how to create an environment of health in the home.

(16:17) In one family, a woman lost 27 pounds, the husband lost 45 pounds, and the daughter lost 27 pounds. Dr. Patel doesn’t want skinnier versions of people, but healthier versions of people.

(17:12) Dr. Patel focuses on heart rate variability (HRV). HRV correlates to bone health, muscle health, brain health, immune system function, digestive function, and other systems in the body. He tracks HRV through the Oura Ring.

(18:01) Dr. Patel gets 50-100 Oura Ring sizing kits delivered directly to his practice at a time. He includes a sizing kit in each client’s welcome package.

(19:11) Dave discusses the limitations of working within the Canadian system. Dave’s sister is a naturopathic doctor in Winnipeg and she can’t order labs for her patients, even a simple Vitamin D test.

(21:38) Dave talks about why it’s a great idea for Dr. Patel to stock the sizing kits for his clients to reduce friction when ordering the Oura Ring.

(23:50) Dave believes combining metrics and using that for engagement opportunities is the best approach for practices.

(24:36) Dr. Patel discusses how they use a health coach. Their patients can do a daily check. They can submit a journal entry, log their weight, hydration, bowel movements, sleep scores, and any other questions they may have.

(25:24) Dr. Patel’s practice shares patient progress, oftentimes through Heads Up Health Reports, during follow up meetings. The practice focuses primarily on sleep and HRV. The patient shares information the ring can’t tell them and Heads Up gives them information that the patient can’t tell them.

(26:53) Practices don’t need to be perfect to get started. You learn things and make improvements along the way.

(28:19) Dr. Patel enjoys gamifying within his community. He can hold sleep score contests with his clients.

(28:52) Dave talks about how the Heads Up employees all have their Oura Rings connected and a Slack Channel to discuss their scores. 

(29:59) Dave goes over some of the best metrics to monitor using the Oura Ring. These metrics include resting heart rate, temperature deviation, HRV, the actual readiness score, the respiration rate, and the sleep score. Temperature deviation can be a precursor to pending illness. Respiration rate can indicate impending illness and level of cardiovascular health.

(32:11) You can’t cheat heart rate variability. It shows how somebody is handling a stressful situation. Dr. Patel uses HRV as a measure of resilience. HRV is a good measure of parasympathetic tone; a good indicator of how well we’re recovering, repairing, and regenerating.

(34:50) Sleep is one of the most important things that we do. It is the most parasympathetic thing that we do. The Oura Ring shows how well protocols and recommendations are working.

(36:10) Dr. Patel had a friend who couldn’t sleep and Dr. Patel recommended that he turn off all artificial lighting after the sun goes down. His friend felt better, but the Oura Ring showed him the value within the data.

(37:18) Dr. Patel also focuses on respiratory rate. He uses a nose strip, mouth tape, and proper positioning when he sleeps.

(37:45) Dave tries to think about the central nervous system when he prioritizes his help. He turns the lights down early before bed and views it as the goal of meditation.

(39:07) Changing how you consume alcohol or cannabis can help with sleep onset. Water can also be used as an excellent source of relaxation therapy.

(40:28) The key to Dr. Patel’s program is to pair your nervous system with the activity that you are trying to accomplish. 

(41:18) Bob Rakowski shared a study that measured blood flow in extreme athletes. A sprinter, in a very fight or flight state, is sending only 5% of his blood flow to his liver and kidneys when he’s in that state. At rest, they send 50% to those organs.

(41:46) If you want someone to detox better, the key is to increase blood flow and nutrients to the organ system so they can function properly. By healing your parasympathetic system, that helps restore function and blood flow to their organ systems.

Your digestive system works better when you’re parasympathetic. Instead of changing your diet, slow down, chew your meal, enjoy it, and be grateful for it. Western culture views food as an inconvenience.

Our digestive system is most effective in mid-day when the sun is in the highest position (not necessarily noon). That’s when you should have your biggest meal. The most parasympathetic thing you can do right after that is take a nap and digest that meal, instead of going to exercise immediately after.

(43:24) Dave noticed that he should eat his biggest meal around 3pm.

(46:26) Dr. Patel noticed that food choices, meal timing, and stress affect HRV. You can’t eliminate stress, but you can change how they interpret it. If somebody’s HRV is not responsive, he starts to look into trauma. There may be something that is keeping them in a sympathetic state despite the fact that their physical health is improving.

(48:36) There are many things that are easily modifiable in our day-to-day life; our environment, lighting before bedtime, ambient bedroom temperature, meal timing, and meal choices.

(49:06) When you want to move on to the next level, you look at things that are psychospiritual including stressors in relationships with others and yourself.

(49:36) Dave and Dr. Patel discuss the power of plant medicines. Dr. Patel had a patient who had a 30% permanent improvement in their HRV score after a psilocybin ceremony.

(50:55) In Dave’s personal experience, if his HRV numbers are in the 50s, he feels there is nothing that he can’t accomplish. He also makes sure that he doesn’t overtrain.

(53:04) Dr. Patel looks at how long it takes him to sink into resting heart rate and calibrates his day accordingly. Sometimes our body will tell us one thing, but our mind can always tell us something else. He gives himself permission to override the data and choose how he feels about the day.

(55:40) Dr. Patel gives insight into how patients respond to remote patient monitoring. When he tells people that they offer remote patient monitoring, it serves as a filtration process. People who don’t like to be measured won’t want to sign up.

(57:03) Dave likes wearable technology and biometric data in the clinical setting because it holds both the patient and the practitioner accountable.

(58:40) Remote patient monitoring validates practitioners’ processes. It is evidence that their program works. There are practitioners that make big claims, but don’t have evidence to back that up. There are patients who say they’re doing certain things that may not be.

(1:01:23) The top three metrics that Dr. Patel personally lives by are HRV, fasting insulin, and high sensitivity CRP. HRV is instant biofeedback. Insulin resistance is a major predictor of many issues in your body or longevity. Fasting insulin shows how someone’s managing their metabolism, blood sugar. High sensitivity CRP is an inflammation marker.

Living Proof Institute

Perfect Practice Mentorship Program

Harpreet Rai

Dr. Bob Rakowski

Mymetabolicreset.ca

The post Ep. 60 – Integrating the Oura Ring into your Functional Medicine Practice with Dr. Sachin Patel appeared first on Heads Up Health.

Dr. Sheila Dean of the Integrative and Functional Nutrition Academy dives into how she started IFNA, what the academy’s courses teach, functional nutrition, becoming a VA vendor,  and where conventional and integrative medicine differ. She covers all this and more with Heads Up founder Dave Korsunsky.

This podcast is brought to you by Heads Up, a web app designed to help both individuals and health practitioners centrally track the vital health data that matters. Instantly synchronize your (or your clients’) medical records, connect favorite health devices and apps, and use the data to optimize your health (and that of your clients).

Click on the start link below to start your free 30-day trial. Or, read on for more information about our latest podcast episode!

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The Integrative and Functional Nutrition Academy (IFNA) is one of the most respected online functional nutrition training and mentoring programs in the industry. It was founded by two of the nation’s premier integrative medicine nutritionists, Dr. Dean and Kathie Swift MS.

Consisting of 5 tracks with 33 modules, the IFNA program teaches leading-edge, evidence-based, whole systems approaches to patient care.  This emerging medical nutrition model focuses on identifying root causes and imbalances to significantly improve health outcomes and combines the very best of modern science, clinical wisdom, and critical thinking.

Click to enroll in IFNA

Dr. Sheila Dean, DSc, RDN, LDN, IFMCP is a registered and licensed dietitian nutritionist, board certified integrative and functional medicine certified practitioner, clinical nutritionist, and exercise physiologist. She was a Certified Diabetes Educator with the NCDBE for 15 years.

She received her undergraduate training through Rutgers University, completed her internship and graduate training with University of Rhode Island and Brown University’s teaching hospitals, received doctoral training in nutritional genomics and pharmacology through the University of Medicine and Dentistry of New Jersey (UMDNJ) and completed her Doctorate of Science degree through Hawthorn University. 

Dr. Dean has received advanced training in functional medicine and nutritional biochemistry through the Institute for Functional Medicine and is a board certified IFM practitioner. She has also worked with the Duke University Medical Center’s Endocrinology and Metabolism Disorders Clinic and the Joslin Center for Diabetes as a certified diabetes educator.

She’s served as the consulting sports nutritionist for the Philadelphia Phillies, has consulted for the Tampa Bay Buccaneers, the Toronto Blue Jays and was the media spokesperson and columnist for the Ironman Institute and is the author of Nutrition & Endurance: Where Do I Begin? (Meyer & Meyer Publishing).

(4:29) Dr. Dean started incorporating her functional medicine knowledge into her practice. The types of patients who went to see her began to expand.

(5:26) Dr. Dean and Kathie Swift were constantly being called and texted by people asking for training. IFNA launched in 2015.

(6:54) Dave reflects on Dr. Dean’s journey and how she created her functional nutrition business.

(8:04) Dr. Dean and Kathie felt that dieticians were pretty ignored. They wanted to create a program for dieticians.

(9:30) Dr. Dean dives into her functional nutrition program and what people will learn from it. IFNA teaches people a specialized area. There are 33 modules and it takes about a year to finish. There are nine components. Track 1 covers everything from food is medicine, conventional labs, functional blood chemistry interpretation, dietary supplements, the science, and the art. Track 2 gets into all the different systems areas. Track 3 is about the application and building your own private practice. There is a track dedicated to therapeutic elimination diets. The final track, Track 5, is dedicated to case studies.

(15:35) Dr. Dean says the ideal scenario for her students is for them to setup an integrative-based practice. IFNA are VA vendors, so they have a contract with the government that pays for the all the programs that their VA dieticians go through.

(17:59) Dr. Dean believes that asking questions about root cause analysis is the foundation of trying to understand how to restore health and function.

(19:20) Dave narrows in on the issues with the standard American diet and lack of education for children.

(21:01) Dr. Dean and Kathie are focused on empowering as many functional nutrition healthcare professionals as possible. Heads Up Health’s mission is to give certified professionals the remote ability to measure and analyze how patients are doing.

(25:19) Conventional and integrative communities agree that autoimmunity is a condition where the immune system is hyper vigilant and maybe attacking its own tissue. The difference in the communities lies in the way the issue is handled. Once the patient is stabilizied, Dr. Dean thinks the physician should figure out or outsource the patient to somebody who will figure out the underlying issue.

(29:39) Dr. Dean cautions practitioners not to replace a drug with a supplement.

(31:51) If you take a personalized approach, there isn’t one or two panels that you need take. But, a really good overall panel is a nutra eval. It looks at many different biomarkers related to nutritional status.

(34:05) STAIN is an acronym used by IFNA. Stress, Toxins, Adverse food reaction, Infection, and Nutritional deficiency. Dr. Dean gives examples for each type. 

(37:52) Dave shares how he discovered an infection in his microbiome that showed up in a test once he started working with a functional doctor.

(40:06) Medications can cause nutritional deficiencies. Magnesium and CoQ10 can typically be depleted by medications.

(43:48) Dr. Dean says it is key for functional nutrition practitioners to track data and stay organized.

IFNA

Dr. Sheila Dean: LinkedIn | IFNA 

Kathie Swift

Stay Up To Date With The Latest News In Digital Health

The post Ep. 59 – Integrative and Functional Nutrition with Dr. Sheila Dean from the IFNA appeared first on Heads Up Health.

By using artificial intelligence with a human element, practitioners can design a functional health protocol that will allow patients to maintain their treatment plans.

Fullscript’s Dr. Alex Keller and Heads Up Founder Dave Korsunsky discuss how to deliver an entertaining and informative patient healthcare experience. Allowing patients to interact with and understand their data from their remote patient monitoring tools will drive them to stick to treatment plans long-term.

This podcast is brought to you by Heads Up, a web app designed to help both individuals and health practitioners centrally track the vital health data that matters. Instantly synchronize your (or your clients’) medical records, connect favorite health devices and apps, and use the data to optimize your health (and that of your clients).

Click on the button below to start your free 30-day trial. Or, read on for more information about our latest podcast episode!

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Dr. Alex Keller is a practicing naturopathic doctor in Ottawa, Canada and the Medical Director at Fullscript. As Medical Director, he oversees the Integrative Medical Advisory team (IMAT) and the development of educational content for practitioners across North America.

He is a graduate of the University of Ottawa with an HBSc in Health Sciences and Psychology. Although originally planning to attend conventional medical school, Alex shifted direction and completed a degree in naturopathic medicine at the Canadian College of Naturopathic Medicine. The shift followed a three-month internship at a rural Kenyan hospital where he worked with doctors who used local food to successfully treat patients, after which he felt compelled to practice a nutrition-oriented system of medicine. Today, he blends an evidence-based functional approach to care with his experience as an organic farmer and a passion for anthropology to serve as an expert in traditional and integrative medicine. 

Fullscript supports practitioners focusing on prevention and the connected, underlying causes of a patient’s symptoms. Thousands of integrative and functional health professionals are pushing for a shift to a more proactive perspective on lifestyle, patient care, and all of medicine.

These practitioners are on a mission to provide lifelong care that helps people discover and rediscover wellness for the rest of their lives. It’s Fullscript’s mission to support them — to help people get better. From practitioners to patients, partners, and colleagues, we build frictionless technology and personalized experiences to support those on their wellness journeys, whatever that means to them.

(1:50) A discussion around how medical professionals can design a functional health protocol for each patient and how you can track that functional health protocol through remote patient monitoring.

(6:33) Dave talks about taking the funnel concept of running a company and applying that to a medical protocol. Are patients opening the products? Are they even buying them.

(8:59) Providing patients with objective data will help them stick to the recommended treatment plan. 

(11:16) How patients who have not fulfilled the treatment plan got tripped up on simple tasks like opening the plan within the email.

(12:51) Dr. Alex Keller’s team has a human care team to help clients with following the treatment plan. This team helps patients interpret the plan and ensure that patients stick to the functional health protocol.

(14:59) Platforms like Heads Up Health that track biofeedback measures like heart rate variability (HRV) help to motivate patients. Patients can become discouraged if they don’t notice symptoms improving short-term, but seeing the data of the changes happening within the body assists in making the patient maintain compliance.

(16:44) Gamifying the healthcare experience can help facilitate behavioral change. 

(18:27) Blood glucose and HRV are great biofeedback markers to look for in patients within the first week of treatment.

(21:03) Dave gives a step-by-step analysis of how patients can understand their metabolic markers.

Step 1: Give patients an actionable target.

Step 2: Design a functional health protocol and set the second stage of the funnel.

Step 3: Confirm the person actually opens the email.

(22:30) Dr. Alex Keller does not see many integrative practices including a device that can do biofeedback collection (like a continuous glucose monitor). He gives diet, lifestyle, and supplement protocols. He also can tell patients to track blood values, biofeedback, and/or other markers.

(24:19) Dave talks about how patients develop awareness by using CGMs and platforms like Heads Up.

(28:26) Dr. Alex Keller discusses how the challenge in his field is what kind of standardization there will be. There are so many products that it can be overwhelming for somebody looking to track their biomarkers. Tracking the data with platforms like Heads Up can be used for large data-driven studies. Use Fullscript to initiate that process.

(32:49) Developing large data studies can help set treatment plans by aggregating data. The basic standard has been blood tests for the last decade. The next step forward could be much more in-depth.

(37:00) Keeping patients engaged in tracking will help them stay on their functional health protocol. It encourages the patient to maintain behavioral change and the practitioner can call the patient if they start to fall off the path.

(42:25) Dave discusses how using technology and AI could help scale the remote patient monitoring functional health protocol. AI can also be used to flag patients to their practitioners or lifestyle coaches.

(46:23) Dr. Alex Keller believes that AI will never replace humanity, but it can be used to help inform decisions. By including automated reminders in Fullscript, it helps keep patients on their treatment plans. His focus is to arm practitioners with tools to provide better user experiences for patients.

(49:21) Dave agrees that you need to combine AI and the human element. He sees positive change is happening with the new CPT codes and the payer system.

Fullscript

Dr. Alex Keller: LinkedIn | Instagram | Personal Website | Fullscript Website

The post Ep. 58 – Designing Functional Health Protocols with Dr. Alex Keller from Fullscript appeared first on Heads Up Health.

Are you a practitioner looking for an easier way to conduct functional medicine lab testing? 

Tara Viswanathan, Co-Founder and CEO of Rupa Health, discusses with Heads Up’s Dave Korsunsky how her company simplifies this process for medical professionals.

Dave and Tara also talk about why they believe root cause medicine will eventually become the standard of care, how Rupa Health and Heads Up are educating practitioners, and the origins of Rupa Health.

Rupa Health is a company that focuses on making the lab testing process easier for practitioners, so they have more time to focus on patient care.

Tara Viswanathan graduated with a Master’s Degree in Management Science and Engineering. She achieved her Bachelor’s Degree in Finance and Operations Management at Pennsylvania University. Tara previously did product consulting for consumer health startups.

Functional medicine focuses on the biological systems in the body. A single diagnosis can have multiple causes. Ultimately, the purpose of functional medicine is to identify and treat the root cause of the disease. 

This podcast is brought to you by Heads Up, a web app designed to help both individuals and health practitioners centrally track the vital health data that matters. Instantly synchronize your (or your clients’) medical records, connect favorite health devices and apps, and use the data to optimize your health (and that of your clients).

Click on the button below to start your free 30-day trial. Or, read on for more information about our latest podcast episode!

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Follow Tara:

Twitter @TaraViswanathan

LinkedIn Tara Viswanathan

In this podcast you’ll learn:

(2:25) How Dave and Tara became interested in health through their careers in technology. 

(3:57) How Rupa Health makes functional lab testing easier. The company has over 2,000 different tests that healthcare practitioners can order within minutes. Rupa Health manages the entire patient experience including support with phlebotomy, specialized instructions, and 24-hour customer support.

(5:40) Rupa Health supports everybody from solo, independent acupuncturists to small private practices to large hospital systems. Tara breaks down how a practitioner can enroll and ease the burden of ordering patient tests.

(7:33) Patients have access to 3-month payment plans through Rupa.

(9:13) The benefits of stool testing. Dave jokes about his experience presenting the Bristol Stool Chart at a conference.

(10:12) The information you can learn from checking your urine and stool.

(11:04) Rupa Health began in January 2020. Within months the company spread to clinics in 47 states. The company is continuously releasing new features.

(12:34) Tara believes root cause medicine is going to become the standard of care. Tara wants to enable all practitioners to be able to pursue root cause medicine. Rupa first built a matching service to help pair patients with practitioners. The company then built a clinic, discovered the issues with lab testing, and decided to shut down the clinic and focus solely on lab testing.

(14:50) One of the main issues with functional labs is that many of them do not have any web-based APIs (Application Programming Interface) to pull from. These labs and patients are stuck with a bunch of PDF files. Rupa Health has helped to build services around these facilities’ current systems.

(19:00) Rupa can help doctors process all of their lab tests without having to learn everything step-by-step.

(20:10) Root cause medicine can be the future of medicine. Root causes can be microbiome environment, heavy metal toxin exposure, and more.

(22:23) Remote patient monitoring is becoming widely accepted and there are now reimbursements from the payer system. Commercial insurance covers most microbiome testing.

(24:14) Rupa Health is working on helping educate practitioners through Rupa University. These courses teach practitioners how to understand and interpret lab testing. Heads Up Health has also launched Heads Up University, which aims to serve a similar purpose.

(25:49) Dave and Tara are super involved as patients when interacting with their doctors.

(26:43) Tara’s advice to practitioners is, “It’s not easy, but it’s worth it.” You can reach out to Tara at [email protected] where she can explain Rupa Health to you in more detail.

Rupa Health

Bristol Stool Chart

Rupa University

Electronic Medical Records (EMRs) for Functional Medical Practices

The post Ep. 57 – Simplify Functional Lab Testing with Rupa Health appeared first on Heads Up Health.

Curious how continuous glucose monitoring (CGM) can lead to significant behavioral change? Kara Collier of NutriSense discusses how this happens with Heads Up founder Dave Korsunsky. Constantly being exposed to how your lifestyle affects your blood glucose increases your personal health awareness and motivation for making change.

Kara covers how NutriSense came together, how the company is reducing the barrier for patients to get CGM, and how NutriSense’s apps and services help patients understand their data.

She also talks about how most Intensive Care Unit (ICU) patients are people with immediate complications from lifestyle-related chronic conditions. Kara campaigned to the hospital administration and nutrition department for a year asking them to stop serving sodas to patients because of its negative health effects. When no action was taken, Kara left the hospital, worked at a nutrition software company, and eventually founded NutriSense with two other people.

Kara Collier is a Registered Dietitian Nutritionist (RDN), Licensed Dietitian/Nutritionist (LDN), and Certified Nutrition Support Clinician (CNSC) who specializes in glucose control and metabolism. She graduated from Purdue University and previously worked at Memphis VA Medical Center as a clinical dietitian at Providence Hospital and in a management role at Nutritionix.

This podcast is brought to you by Heads Up, a web app designed to help both individuals and health practitioners centrally track the vital health data that matters. Instantly synchronize your (or your clients’) medical records, connect favorite health devices and apps, and use the data to optimize your health (and that of your clients).

Click on the button below to start your free 30-day trial. Or, read on for more information about our latest podcast episode!

START TRACKING!

Continuous glucose monitoring is the practice of using a device (like the FreeStyle Libre CGM) that automatically tracks your blood glucose levels. You can view how this data changes throughout the day based on what you eat, how you exercise, and other daily activities that you do.

Habitually viewing and understanding this data can lead to substantial lifestyle changes. This data can also be shared with your practitioner, so they too can monitor your health. Your practitioner can notify you if they think you need to take action on your health.

NutriSense

Freestyle Libre CGM

The post Ep. 56 – How Continuous Glucose Monitoring Can Lead to Health-Conscious Behavioral Change appeared first on Heads Up Health.

Dr Jessica Drummond, MPT, CCN, CHC, is the founder and CEO of Integrative Women’s Health Institute (IWHI). An expert on chronic pelvic pain and endometriosis, Dr Jessica Drummond is also an evidenced based practitioner who understands heart rate variability (HRV), lifestyle parameters, and how to apply this information with her patients for better health outcomes.

If you’re a practitioner listening to this, you’ll learn how Dr Jessica Drummond transitioned her practice from in-person to, now with Covid, 100% virtual. She is one of the rare practitioners utilizing HRV and wearables such as Oura and Garmin in a clinical setting to measure her patients’ baselines to watch it improve over time. With her team of health coaches, she uses a “nervous system out approach” to help her patients calm their nervous systems and balance stress, while optimizing their functional nutrition, deep sleep, exercise, and more. Learn how Dr. Drummond and her team are using Heads Up’s practitioner’s portal to track their clients’ lifestyle and health metrics.

If you’re struggling with chronic pelvic pain or other issues related to women’s health, you’ll be inspired and motivated to reduce your stress, and learn why tracking any progress to celebrate may help your own health.

And if you’re considering becoming a board certified health coach, especially for women’s health, you’ll learn how Dr. Jessica Drummond’s unique program is the first of its kind, the only Women’s Health Coach Certification in the world with over 1500 people enrolled from over 60 countries!

Join Heads Up Founder, Dave Korsunsky, as he talks to Dr. Jessica Drummond about her unique approach to women’s health, her health coaching program, and even advice for those health practitioners new to transitioning into a virtual model. 

Listen in iTunes!

This podcast is brought to you by Heads Up, a web app designed to help both individuals and health practitioners centrally track the vital health data that matters. Instantly synchronize your (or your clients’) medical records, connect favorite health devices and apps, and use the data to optimize your health (and that of your clients).

Click on the button below to start your free 30-day trial. Or, read on for more information about our latest podcast episode!

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How Dr. Jessica Drummond, Founder and CEO of Integrative Women’s Health Institute, first connected with Dave via their mutual friend, Aypril Porter, which led to a partnership between Dr Jessica using Heads Up with her own patients and program. [1:06]

About Dr. Jessica Drummond’s body of work, how she started the Integrative Women’s Health Institute over 11 years ago, and how from the very beginning, it was about training her colleagues in functional nutrition, lifestyle medicine, and the communication skillset of health coaching. [1:36]

How Dr. Jessica Drummond started her career, more than 20 years ago. First as a physical therapist, originally intending to focus on sports medicine in orthopedics because of her background as an athletic kid, but really quickly began to specialize in women’s health. [2:20]

How her focus on women’s health is from a physical standpoint. Basically, the muscular skeletal joints, muscles and nerves related to women’s health conditions. For example, shoulder injuries that happen after breast cancer surgery or rib pain, back pain, and pelvic pain associated with pregnancy, urinary incontinence, prolapse, etc. [2:40]

She did this for many years in a hospital based clinical setting, as well as outpatient practice [3:15]

How Dr Jessica Drummond discovered that the one population in women’s health that was particularly challenging was complex pelvic pain, sexual pain, or pelvic floor pain, pain in hips, back, radiation down the legs, organ structures, etc. [3:30]

Why anytime there is pain signaling, the nervous system is involved [4:00]

How she got sick in her early 30s and used the tools of functional nutrition to regain her own hormonal health. How pelvic pain can sometimes have a cyclical expression, and how to apply some things from a nutritional perspective to help her most challenging pelvic pain clients, using her own research around this [4:06]

What motivated Dr. Jessica Drummond to start building her own school. While working at a women’s specialty hospital in Houston, she began to teach her colleagues, offer courses, from the moment she began learning this information. [4:54]

That the Integrative Women’s Health Institute now has about 17 different courses and offers health coach certification that’s board-approved, with many certified health coaches come out of the program, focusing on women’s health. Not just in Dr. Drummond’s specialty, pelvic pain, but also fertility, perimenopause, period pain, and all kinds of women’s health issues. [5:14]

How Dr. Jessica Drummond has successfully shifted from a more in-person to 100% virtual now. [6:34]

Why she was ahead of her time, way before Zoom even existed, focusing on virtual appointments, telehealth, out of necessity. How she initially built a huge place in Houston, but switched to phone appointments, completely client-driven, eliminating unnecessary commutes to the doctor’s office. This also allowed her to fit in life as a parent raising young kids, as well as multiple moves (11 times in 13 years!). [7:00]

Advice for practitioners from Dr. Drummond if new to moving towards a digital model: why you should maintain your own office, even if it’s just a separate room in your home. [8:54]

Why is nutritional therapy so vital to health issues? How blood sugar dysregulation can be inflammatory? What does a functional nutrition template look like and how can it start the healing process? [9:28]

Dr. Jessica Drummond’s approach to functional nutrition: “It’s about optimizing systems. Instead of chasing the symptoms, we always say, optimize physiological systems.” [10:19]

Why Dr. Jessica Drummond is so interested in her patients’ heart rate variability (HRV). And why she takes a “nervous system out approach” instead of what she used to do, which is to start with digestion. That although digestion is used early in the process, she is realizing more and more that “calming the nervous system is so important to optimizing digestion function. Because you can’t absorb nutrients, calm digestion and general inflammation if someone is in chronic fight or flight.” HRV is the only way she “can objectively measure that.” [11:11]

On endometriosis, and how symptoms often begin for girls as young as 8 and 12 years old. How girls and women begin to learn to push that pain down and show up anyway.  [11:27]

Why the number one reason girls miss school is due to period pain [12:09]

How many people learn how to push through the pain, to suppress it, and no longer can even recognize when they are physiologically stressed, which is again why HRV can be so valuable, whether looking at a Garmin, Biostrap, or Oura. “Now you’ve got an objective measurement that you can then start to make changes, which will allow you to use the nutrition therapy to calm the nervous system.” [12:16]

How using HRV can help you as a practitioner to spot those who have a sympathetic overload, then begin to use other strategies such as mindful eating, chewing. [13:40]

Why an anti-inflammatory diet is important, yet how to create flexibility in that plan as there is no one-size-fits-all endometriosis diet. Or pain diet. [14:00]

What she does with the majority of clients who have bloating digestive issues, starting with blended soups, cooked vegetables, etc. [14:42]

Why a lot of times, women are lacking absorbable protein, and struggle with low neurotransmitters. Not only do they have pain signaling because of inflammation, but they may have low serotonin, low tryptophan, L-theanine, and GABA support, not actually absorbing the protein they are eating. Why healthy beneficial fats are important, etc. [14:53]

Using the urinary organic acids testing to make sure that people are absorbing nutrients. [15:44]

Why Dr. Jessica Drummond starts with what people CAN eat, because if you have a lot of digestive issues, and you’ve been afraid of food since you were a ten-year-old girl (there are a lot of eating disorders), this is important. Eventually we’ll move away from inflammatory foods like sugar and dairy. But we focus on EXPANDING what they can eat, so they don’t feel like it’s a restrictive diet.[15:53]

On how the auto-immune paleo diet is kind of a backbone for most people, but it varies: some plant-based, some leaning towards keto. [16:53]

Why endometriosis has auto-immune properties, often co-morbid with lots of other auto-immune diseases. After endometriosis surgery, auto-immune markers tend to drop, which is important for fertility and overall health, and how Dr. Jessica Drummond tries to support that both pre-op and post-op to improve the immune system.

On Dr. Jessica Drummond’s published research around vulvodynia, her focus on gut healing, immune healing, restoring the small intestinal barriers, taking out those inflammatory and processed foods, how the vulvodynia never came back.

What auto-immune markers she looks for. And why you usually see co-morbid things like Hashimotos, thyroiditis, celiac disease, or elevated ANA. Sometimes associated with psoriasis or lupus. Or elevated thyroid antibodies. [18:50]

How with her virtual clinic, she does a personalized nutrition plan, potentially looking at the gut microbiome, using urinary organic acids testing, sometimes hormone tests, depending on the client’s needs. Why clients have twelve sessions of health coaching to help them implement behavior changes that can be challenging, disordered eating issues, anxiety. [20:22]

Another reason why tracking can be so helpful: “Because not only is it motivating, but for most women in our programs, they never feel like they’ve done it well enough. So being able to see good progress, to kind of look back and celebrate ANY progress, makes a difference.” [21:18]

When you’re someone who has had chronic pain for a long time, there’s always a focus on pain (i.e., when, how much, how often, what’s causing it). Instead she has her clients journal and track those times when they feel better. “That’s how we shift it by using the tracking to demonstrate more objectively how things are starting to improve.” [21:53]

How Dr. Jessica Drummond personally uses HRV and interprets it in a clinical setting with her clients, a basic explanation of HRV for those practitioners listening, and how some clients are already using wearables such as the Oura ring, Biostrap, Garmin, and already have access to their data. [22:25]

How she’s looking for that number (HRV) to increase over time. Why the Oura ring is a great option for those wanting to track their raw data. What during the day happened for that person to have a higher HRV during the night? And over time, from Day 1 of their program to Week 12, is that raising the baseline. Why they use in their clinic the Garmin, which gives biofeedback during the day, looking at the “Body Battery.” (But it doesn’t give the raw HRV data, unfortunately, right now.). [24:15]

How looking at HRV helps people to build associations themselves, which may not have been there before, a huge part of the process, empowering people to reconnecting to signals in their own bodies that they may otherwise not notice. [25:42]

Why it’s also important to teach people to get comfortable with being in some stress, knowing they’re going to recover. How she looks at HRV, exercise, but also Deep Sleep. [25:54]

The biggest things Dr. Jessica Drummond looks for. Over time, is that baseline HRV increasing? And if there’s a great night of sleep, what contributed to that so we can replicate it more? How much time in Deep Sleep, especially between 10pm and 2am, when your brain is recovering. During the day, is someone recovering from exercise? What may they be stressing them out that they’re surprised about? And what can we dial-in when it comes to nutrition, personalized to that particular client (example about client who thought she was eating healthy by choosing organic sugar but was still pushing her “into the orange,” which prompted them to look more into that). [26:40]

Alcohol and its impact on HRV (hint: it can be disastrous). And how it can be an important KPI to notice. [28:37]

About how work and general life stress impacts many of their clients who are women, especially right now with many simultaneously working from home and home-schooling their kids, how that is all being reflected in their numbers while in quasi-lockdown related to the Covid pandemic. [28:37]

Why tracking can be helpful during stressful times. “The good news is that when you start to track, people are motivated to do the recovery.” Example of her assistant who wasn’t able to change everything about her busy week, but found her own outlet to recover, restore and rejuvenate. For her, taking a hike helped her, in less than 3 days, go from a ‘8’ to a ‘100’ (body battery from her Garmin). How Dr. Jessica’s mode of recovery is clocking out at 5pm every day and meditating with her paddle board. How important it is for people to find what recovery looks like for them. [29:09]

Use cases of HRV in the clinical setting, how it’s mostly used in health and wellness high performance, yet how Dr. Jessica Drummond is using HRV in her clinical practice related to inflammatory issues is important, helping to encourage clients and reinforce positive behaviors, watching the baseline increase, a win for everybody. [30:30]

How a lot of her women clients are high achieving. And when they see their numbers not looking so great, they don’t like to accept it. So she and her team of health coaches will coach them through that. It’s also validating. We remind them that they are doing great, are talented and smart, yet whether it’s postpartum, post-op surgery, that their bodies need recovery for longevity. “Using these numbers are helpful for showing us what our body has to go through to really recover.” [31:45]

How Dr Jessica Drummond is starting to use Heads Up to get some data on her clients remotely.  Dave and his team at Heads Up have started building customized dashboards for her and team of health coaches to collect those peripheral metrics. [33:17]

Why when it comes to chronic pelvic pain, it’s really important to collaborate with a skilled pelvic physical therapist as well. How important it is for people to really tune into the messages of their own bodies, to know when they’re physically relaxed, activated and strong, taking a holistic team approach, both conventional and integrative. [33:45]

How the Integrative Women’s Health Institute offers the only board certified health coaching program focused on women’s health. The program starts with the skillset of health coaching, helping people to have immediate buy-in, become excited about their plan to get healthy. Why this communication skill is new to most clinical professionals who are taught in their training to fix people as though they are mechanics. [34:27]

Why behavioral change is important; Dave mentioned other past podcast guests utilizing similar services in their clinics or programs, such as Brandy Wiltermuth of Three Health with medically supervised weight-loss and Dr. Sandi Scheinbaum who trains her health coaches to operate in that support role when it comes to lifestyle changes. [36:06]

How important it is for someone to want to take ownership of behavioral lifestyle changes and ask for help. While the nutrition and sleep plan is important, it won’t be executed without lot of support to making those lifestyle changes. Such as taking things off their plate and off their calendar. [38:05]

Ways to get in touch with Dr. Jessica Drummond and the Integrative Women’s Health Institute [40:30]

Integrative Women’s Health Institute (IWHI)

Where to contact Dr. Jessica Drummond on Instagram

Outsmartendo.com (If you struggle, or have patients who struggle, with endometriosis or other pelvic pain issues, this is a great place to get information)

Outsmart Endometriosis: Relieve Your Symptoms and Get Your Career Back On Track by Dr. Jessica Drummond 

Organic Acids Test (OATS) 

Dr. Jessica Drummond’s published study on vulvodynia (“Functional Nutrition Treatment of Vulvodynia, Irritable Bowel Syndrome, and Depression: A Case Report”)

Heads Up is a website designed to empower individuals who want to take a self-directed approach to managing their health AND we offer health professionals a way to centralize their clients’ health data and optimize their outcomes.

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The post Ep. 54 – How Dr. Jessica Drummond of Integrative Women’s Health Institute is Using HRV, Functional Nutrition and Health Coaching for Better Health Outcomes appeared first on Heads Up Health.