Extend Podcast with Darshan Shah, MD

What if working out harder isn't actually making you healthier? And what if the secret to improving your fitness, recovery, and longevity is knowing when to push—and when to pull back?

In this episode, I'm joined by Joel Jamieson, performance coach, HRV expert, and creator of Morpheus, to explore the science of VO2 max, heart rate variability (HRV), Zone 2 training, and exercise recovery.

After decades of training elite athletes, Joel explains why the same principles that drive peak performance can help everyday people improve cardiovascular fitness, build strength, and age better. We discuss why more exercise isn't always better, how chronic stress and poor sleep affect your ability to recover, and how to use wearable data without becoming obsessed with every number.

In this episode, you'll learn:

• Why VO2 max is an important measure of cardiovascular fitness and longevity
• How to use HRV and resting heart rate to understand stress and recovery
• The difference between Zone 2 cardio and high-intensity interval training
• Why recovery is when your body actually adapts and gets stronger
• How to balance strength training, cardio, and rest for sustainable results
• Why sleep, stress, and lifestyle should influence how hard you train

The biggest takeaway? You don't need to train like an elite athlete to benefit from the science of performance. The key is finding the right balance between exercise and recovery—and building a fitness routine you can sustain for life.

Learn more about Dr. Shah:

Website: drshah.com

Clinic: next-health.com

Instagram: @darshanshahmd and @extend_podcast

Book Pre-Order: https://www.amazon.com/YourNewHealthOS

Learn more about Joel Jamieson:

Website: trainwithmorpheus.com

Instagram: @coachjoeljamieson

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What if menopause isn't the beginning of your decline—but the beginning of your most powerful chapter? And what if the reason fasting isn't working for you has more to do with stress than willpower?

In this episode, I welcome back Dr. Mindy Pelz, bestselling author of Fast Like a Girl and Age Like a Girl, to explore how menopause, hormones, and nervous system health influence the way women age.

Dr. Pelz challenges the traditional narrative around menopause, explaining how declining estrogen may affect the brain, behavior, and identity. We also discuss why intermittent fasting isn't one-size-fits-all, how chronic stress can affect metabolism and weight management, and why sometimes doing less is exactly what your body needs.

In this episode, you'll learn:

• How menopause and declining estrogen can influence brain health, mood, and behavior
• Why fasting strategies may need to change throughout a woman's menstrual cycle and menopause
• How chronic stress, cortisol, and nervous system regulation relate to metabolic health
• Why fasting harder and exercising more aren't always the best solutions for weight gain
• How sleep, breathwork, nutrition, and recovery can support your nervous system
• Why menopause can be an opportunity to rediscover your purpose and identity

The biggest takeaway? More isn't always better. Understanding what your body needs—and adjusting your approach as you age—may be one of the most powerful ways to support your long-term health.

Learn more about Dr. Darshan Shah:

Website: drshah.com

Clinic: next-health.com

Instagram: @DarshanShahMD and @extend_podcast

Learn more about Dr. Mindy Pelz:

Nervous System Questionnaire: NervousSystemQuestionnaire

Age Like a Girl Book: bit.ly/alagbook

Fast Like a Girl Book: bit.ly/fastlikeagirlbook

Resetter Collaborative Facebook Group: bit.ly/resettercollaborative

Reset Academy: bit.ly/resetacademymembership

Fast Like a Girl Certification Course: bit.ly/flagwaitlist

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What if your body is giving you clues about your health that you're overlooking? From changes in your tongue and skin to chronic tension, anxiety, and digestive issues, traditional Chinese medicine offers a different perspective on how seemingly unrelated symptoms may be connected.

In this episode, I'm joined by Dr. Chris Motley, a practitioner of traditional Chinese medicine and acupuncture, to explore how ancient healing practices can complement modern approaches to health and longevity.

We dive into the fascinating world of acupuncture, meridians, fascia, nervous system regulation, herbal medicine, and the mind-body connection, exploring how traditional Chinese medicine interprets patterns in the body and approaches chronic health concerns.

Dr. Motley explains why he believes symptoms shouldn't always be viewed in isolation, how emotional stress may influence physical health, and why understanding the body's interconnected systems is central to his practice.

In this episode, you'll learn:

• How traditional Chinese medicine approaches health, aging, and disease prevention
• What acupuncture is, how it's traditionally understood to work, and why people use it for more than pain relief
• Why Dr. Motley examines the tongue, skin, nails, and other physical characteristics when assessing health
• How traditional Chinese medicine connects different organs with emotional patterns, including stress, anxiety, anger, and fear
• The relationship between fascia, acupuncture meridians, and the body's nervous system
• How acupuncture, acupressure, and ear seeds are used in traditional approaches to relaxation and stress management
• Why practices like Tai Chi and Qigong may be valuable additions to a healthy aging routine
• How Chinese herbal medicine is used in approaches to infections, gut health, and inflammation
• What an integrative approach combining Eastern and Western medicine could look like

We also discuss the gut-brain connection, chronic infections, biofilms, applied kinesiology, and Dr. Motley's approach to identifying patterns that may contribute to persistent symptoms.

One of the most interesting parts of our conversation is how traditional Chinese medicine views the relationship between our emotional and physical health—and why managing stress may be an important part of supporting long-term well-being.

The biggest takeaway? Longevity isn't just about advanced diagnostics, supplements, and cutting-edge technology. It's also about paying attention to your body, understanding your patterns, and building habits that support your health over time.

As we continue exploring the science of healthy aging, there's value in understanding how ancient medical traditions approach the body—and where those perspectives may complement evidence-based modern care.

Learn more about Dr. Shah:

Website: drshah.com

Clinic: next-health.com

Instagram: @darshanshahmd and @extend_podcast

Learn more about Dr. Chris Motley:

Website: doctormotley.com

Instagram: @doctormotley

Youtube: youtube.com/@drmotley

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What if a negative Lyme disease test doesn't tell the whole story? And could an overlooked infection be contributing to symptoms like brain fog, chronic fatigue, or even cognitive decline?

When Nicole Bell's husband began experiencing personality changes, memory loss, and confusion, doctors diagnosed him with early-onset Alzheimer's disease. But Nicole, an engineer with a background in medical diagnostics, couldn't shake the feeling that something was being missed.

Despite initially testing negative for Lyme disease, her husband was later found to have evidence of Lyme and other infections, including Bartonella and Babesia. His decline and eventual passing transformed Nicole's life, inspiring her to become CEO of Galaxy Diagnostics and advocate for better testing for tick-borne diseases.

In this episode, Nicole joins me to explore the often-overlooked world of Lyme disease, chronic symptoms, tick-borne infections, and their potential connections to brain health and inflammation.

We discuss why Lyme disease can be difficult to diagnose, the limitations of traditional antibody testing, and emerging diagnostic approaches designed to detect infections more directly.

In this episode, you'll learn:

• Why Lyme disease can be difficult to diagnose, especially in its early stages
• How Lyme disease and other tick-borne infections may affect the brain, joints, heart, and nervous system
• What researchers are investigating about infections, neuroinflammation, and Alzheimer's disease
• Why a negative Lyme disease test doesn't always rule out an infection
• The differences between antibody testing, PCR testing, and emerging urine antigen tests
• What Bartonella and Babesia are, and why identifying co-infections matters
• Why Lyme disease doesn't always cause the classic bullseye rash
• What to know about tick bites, early symptoms, and seeking prompt medical evaluation
• How to advocate for yourself when you're experiencing unexplained or persistent symptoms

We also discuss the challenges of living with chronic illness, the importance of early detection, and Nicole's mission to make more accurate diagnostic tools accessible to patients and healthcare providers.

Nicole shares the deeply personal story behind her book, What Lurks in the Woods, and the lessons she learned navigating her husband's illness while raising a family and searching for answers.

The biggest takeaway? A negative test isn't always the end of the diagnostic process, especially when symptoms and exposure history suggest there's more to investigate.

Understanding your symptoms, asking better questions, and working with knowledgeable healthcare professionals can make an enormous difference in identifying health problems earlier.

Because longevity isn't just about treating disease once it appears. It's about recognizing warning signs, understanding potential causes, and giving ourselves the best opportunity to protect our long-term health.

Learn more about Dr. Shah:

Website: drshah.com

Clinic: next-health.com

Instagram: @darshanshahmd and @extend_podcast

Learn more about Nicole Bell:

Website: galaxydx.com

Instagram: @nicoledaniellebell and @galaxydiagnostics

Book - What Lurks in the Woods: amazon.com/What-Lurks-Woods

Thank You to Our Sponsors!

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What if the solution to your chronic back pain isn't another prescription, another injection, or even major spine surgery—but identifying exactly where your pain is coming from?

Back pain is one of the most common reasons people lose mobility, stop exercising, and experience a decline in their quality of life. Yet many patients spend years cycling through physical therapy, pain medications, and specialist appointments without ever getting a clear answer about what's actually causing their pain.

In this episode, I'm joined by Dr. Brad Goodman, a specialist in physical medicine, rehabilitation, and minimally invasive spinal interventions at OrthoAlabama Spine & Sports, to explore why chronic back pain can be so difficult to diagnose and the emerging treatments offering new possibilities for relief.

Dr. Goodman has dedicated his career to identifying the underlying sources of pain and developing targeted, minimally invasive approaches that may help patients avoid major surgery. Together, we break down the anatomy of the spine, why traditional treatments sometimes fail, and how new technologies are changing the way we approach chronic pain.

In this episode, you'll learn:

• Why chronic lower back pain can develop years before symptoms appear
• How herniated discs, degenerative disc disease, pinched nerves, and spinal stenosis cause different types of back pain
• Why identifying the actual source of pain is critical before choosing a treatment
• How MRIs and other imaging techniques help doctors investigate spinal inflammation and structural problems
• Why walking, movement, and physical therapy are essential for maintaining mobility and preventing further decline
• The minimally invasive alternatives to back surgery, including epidural injections, nerve ablation, and spinal stabilization procedures
• How emerging technologies like ReActiv8 muscle stimulation and SPRINT peripheral nerve stimulation are being used to treat certain types of chronic pain
• What the research currently suggests about PRP, stem cell injections, and regenerative treatments for spinal discs
• Why chronic pain, muscle loss, inactivity, and frailty are closely connected to healthy aging
• How to find the right spine specialist and explore your treatment options before considering major surgery

We also discuss the limitations of pain medications, the importance of spinal stability, and why some patients continue experiencing pain even after multiple procedures.

One of the most important ideas Dr. Goodman shares is that relieving pain isn't just about feeling better—it's about restoring your ability to move.

When chronic pain prevents you from exercising, maintaining muscle, and staying active, it can affect nearly every aspect of your long-term health.

The goal isn't simply to manage pain. It's to identify its source, restore function, and help you maintain the mobility and independence that make a longer, healthier life possible.

Because when it comes to longevity, movement is medicine—and protecting your ability to move is one of the most important investments you can make in your future.

Learn more about Dr. Shah:

• Website: drshah.com
• Clinic: next-health
• Instagram: @darshanshahmd and @extend_podcast

Learn more about Dr. Brad Goodman:

• Website: orthoalabama.com/doctors/bradly-s-goodman-md
• Clinic: orthoalabama.com
• YouTube: youtube.com/@doctalklive
• Facebook: facebook.com/doctalklivedrgoodman

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What if the brain fog, forgetfulness, poor sleep, and mood changes so many women experience in midlife aren't just signs of getting older—but signals that their brains need more support?

Women account for nearly two-thirds of Alzheimer's cases, yet women's brain health has historically been overlooked in medical research and conversations about prevention. And as estrogen levels begin to change during perimenopause and menopause, those changes can affect everything from memory and mental clarity to metabolism, sleep, and emotional well-being.

In this episode, I'm joined by Emma Heming Willis, co-founder of Make Time Wellness, and Dr. Nicole Beurkens a clinical psychologist with a background in nutrition science, for an important conversation about women's brain health, hormonal changes, and what we can do today to support cognitive health as we age.

Emma shares her personal experience with brain fog, feeling dismissed by her doctor, and the lifestyle changes that inspired her mission to make brain health a priority for women. Together, we explore the science behind cognitive aging and the everyday habits that can make a meaningful difference.

In this episode, you'll learn:

• Why women face a higher risk of Alzheimer's disease and dementia
• How declining estrogen during perimenopause and menopause can affect memory, focus, and brain energy
• Why brain fog, forgetfulness, and sleep disturbances deserve attention
• How chronic stress, trauma, and the demands of caregiving can affect brain health
• The connection between chronic inflammation, metabolic health, and cognitive function
• Why nutrition, protein, fiber, and reducing ultra-processed foods matter for brain health
• How sleep supports memory, cognitive performance, and long-term brain health
• What to know about brain health supplements, including rhodiola, curcumin, and other nutrients
• What the emerging research suggests about hormone replacement therapy and women's cognitive health

We also discuss practical ways to prioritize self-care, manage stress, improve sleep habits, and build sustainable routines without adding another overwhelming responsibility to an already busy life.

The biggest takeaway? Brain health shouldn't become a priority only when memory problems begin.

Protecting your brain is part of protecting your future. And the choices we make around sleep, nutrition, movement, stress, and hormonal health can help us take a more proactive approach to aging.

Because longevity isn't simply about living longer. It's about maintaining the clarity, independence, and quality of life that allow us to enjoy those extra years.

Learn more about Dr. Shah:

Website: drshah.com

Clinic: next-health.com

Instagram: @darshanshahmd and @extend_podcast

Learn more about Emma Heming Willis and Dr. Nicole Beurkens

Website: drbeurkens.com and emmahemingwillis.com

Instagram: @emmahemingwillis, @drnicolebeurkens and @maketimewellness

Try Make Time Wellness at maketimewellness.com, use code EXTEND20 at checkout for 20% off as a gift to our listeners! Also available at Target, Amazon, Ulta, The Vitamin Shoppe and Meijer.

Thank You to Our Sponsor!

Momentous: Head to livemomentous.com and use my code DRSHAH at checkout for up to 35% off.

What if problems in the bedroom were actually an early warning sign of something much bigger happening in your body?

Most people think of sexual health as separate from their overall health. But erectile dysfunction, low libido, and changes in sexual performance can reveal important clues about cardiovascular health, hormone levels, metabolic function, and even how we're aging.

In this episode, I'm joined by Dr. Rena Malik, a urologist and sexual health expert, to explore why sexual health deserves a much bigger place in the longevity conversation. We discuss her concept of "sex span"—how long we can maintain a healthy, satisfying sex life—and why protecting it may also mean protecting our long-term health.

One of the most eye-opening parts of our conversation is the connection between erectile dysfunction and heart disease. Because the blood vessels involved in erections are smaller than those supplying the heart, vascular problems can sometimes appear as sexual dysfunction years before more serious cardiovascular symptoms develop.

We also break down the truth about testosterone replacement therapy (TRT), Viagra, Cialis, nitric oxide supplements, pelvic floor health, and the psychological factors that influence sexual performance.

In this episode, you'll learn:

• Why erectile dysfunction can be an early warning sign of cardiovascular disease
• The five major causes of erectile dysfunction—and why low testosterone isn't always the answer
• How morning erections and nighttime erections can provide clues about sexual health
• The difference between Viagra and Cialis, and what these medications actually do
• What to know about testosterone replacement therapy, including its effects on fertility
• Whether supplements like L-citrulline and L-arginine can improve erectile function
• How pelvic floor health, exercise, sleep, and stress affect sexual performance
• How pornography, masturbation, and performance anxiety can influence arousal
• Why communication, intimacy, and relationship health matter for maintaining sexual wellness as we age

We also discuss emerging treatments for erectile dysfunction, the importance of identifying underlying health problems rather than simply treating symptoms, and the four pillars of sexual health Dr. Malik explores in her book, The Hard Truth.

The biggest takeaway? Sexual health isn't just about sex. It's another window into your overall health.

When we start treating sexual dysfunction as a potential signal of deeper metabolic, vascular, hormonal, or psychological issues, we create an opportunity to intervene earlier, improve quality of life, and potentially protect our long-term health.

Because longevity isn't just about adding years to your life. It's about preserving the health, connection, and vitality that make those years worth living.

Learn more about Dr. Shah:

Website: drshah.com

Clinic: next-health.com

Instagram: @darshanshahmd and @extend_podcast

Learn more about Dr. Rena Malik:

Webiste: renamalikmd.com

YouTube: youtube.com/@RenaMalikMD

Instagram: @renamalikmd

Book: renamalikmd.com/hardtruth

Thank You to Our Sponsors!

Next Health: Your destination for cutting-edge health optimization - from IV therapy to hormone balancing. Explore at next-health.com!

Momentous: Head to livemomentous.com and use my code DRSHAH at checkout for up to 35% off!

What if aging isn't just something that happens to us—but a biological process we can actually influence?

For decades, medicine has focused on treating diseases after they develop. But a growing field called geroscience is asking a much bigger question: What if we could target the underlying biology of aging itself, potentially delaying multiple age-related diseases before they begin?

In this episode, I'm joined by Dr. David Barzilai, MD, PhD, MBA, longevity medicine physician, Harvard Medical School lecturer, and medical editor of Harvard's Pathways to Longevity special report, to explore the science of biological aging and what it could mean for the future of human health.

We break down the 12 hallmarks of aging, why your biological age may be different from your chronological age, and how researchers are developing new ways to measure and potentially influence how quickly we age.

From epigenetic age testing and telomeres to senescent cells, autophagy, rapamycin, and cellular reprogramming, we separate promising longevity science from the hype.

In this episode, you'll learn:

• What the 12 hallmarks of aging reveal about why our bodies get older
• The difference between biological age and chronological age—and whether aging can be slowed
• How accurate biological age tests and epigenetic clocks really are
• Why VO2 max, muscle strength, sleep, and metabolic health are powerful indicators of longevity
• What telomeres reveal about cellular aging and why longer isn't always better
• How senescent "zombie cells" contribute to age-related inflammation
• What fasting, calorie restriction, and autophagy actually do inside your cells
• What the research says about rapamycin, senolytics, and emerging longevity treatments
• How cellular reprogramming and Yamanaka factors could change the future of regenerative medicine

We also discuss personalized longevity testing, the limitations of today's aging biomarkers, and emerging research exploring whether scientists could one day restore more youthful function to aging cells and tissues.

The most important takeaway? You don't have to wait for the next breakthrough to start improving how you age. Exercise, cardiovascular fitness, strength training, sleep, nutrition, and understanding your personal health risks remain some of the most powerful tools we have today.

The future of longevity medicine is incredibly exciting. But the real opportunity is combining what we already know works with the science that's still to come.

Learn more about Dr. Shah:

Website:drshah.com

Clinic: next-health.com

Instagram: @darshanshahmd and @extend_podcast

Learn more about Dr. David Barzilai:

Website: barzilaiconsulting.com LinkedIn: linkedin.com/in/agingdoc X (formerly Twitter): x.com/agingdoc1 Instagram: instagram.com/agingdoc1

Harvard Medical School's first Special Report on longevity, Pathways to Longevity, where I served as Medical Editor: https://www.linkedin.com/posts/agingdoc_harvard-medical-school-has-just-published-ugcPost-7465326141025775616-GOnh

For further reading on longevity science and its clinical application, I'm Co-Editor of Frontiers of Longevity Science, forthcoming from Springer Nature: https://www.barzilaiconsulting.com/fols

Thank You to Our Sponsors!

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What if the painful periods, irregular cycles, unexplained weight gain, acne, and fertility struggles so many women experience aren't something they should simply learn to live with?

Too often, women are told their symptoms are normal, their lab results look fine, or they're just stressed. But conditions like PCOS (polycystic ovary syndrome) and endometriosis can go unrecognized for years, leaving women without answers while their symptoms continue to affect their health and quality of life.

In this episode, I'm joined by Dr. Thais Aliabadi, her patients call her Dr. A, an OB-GYN with decades of experience in women's health, for an eye-opening conversation about two of the most commonly misunderstood conditions affecting women's hormones, metabolism, and reproductive health.

We break down the signs of PCOS and endometriosis, why these conditions are frequently overlooked, and how earlier recognition and individualized treatment can make a meaningful difference.

In this episode, you'll learn:

• The warning signs of PCOS, including irregular periods, acne, facial hair, and unexplained weight changes
• Why women can have PCOS even if they're lean or don't have ovarian cysts
• How insulin resistance, testosterone, and inflammation are connected to PCOS
• Why severe menstrual cramps and chronic pelvic pain deserve further investigation for endometriosis
• How PCOS and endometriosis can affect ovulation, fertility, and ovarian health
• What AMH testing can—and cannot—tell you about ovarian reserve
• The roles of birth control, metformin, GLP-1 medications, and lifestyle changes in PCOS management
• How endometriosis is evaluated and the treatment options available, from hormonal therapies to surgery

We also explore the connection between hormone health and mental well-being, the challenges women face when seeking a diagnosis, and why listening to patients is one of the most important parts of preventative medicine.

Your symptoms deserve to be taken seriously. Whether you're struggling with painful periods, irregular cycles, infertility, or unexplained hormonal changes, this conversation will help you better understand what may be happening in your body—and what questions to bring to your healthcare provider.

Learn more about Dr. Shah:

Website: drshah.com

Clinic: next-health.com

Instagram: @darshanshahmd and @extend_podcast

Learn more about Dr. Thais Aliabadi:

Website: draliabadi.com

Instagram: @drthaisaliabadi

Thank You to Our Sponsor!

Momentous: Head to livemomentous.com and use my code DRSHAH at checkout for up to 35% off.

We spend so much time thinking about exercise, nutrition, and performance—but I believe recovery may be one of the most overlooked pieces of longevity.

In this episode, I'm joined by Dr. Jason Wersland, chiropractor and founder of Therabody, whose own experience with debilitating pain after a motorcycle accident ultimately led him to invent the Theragun.

But this conversation goes far beyond muscle soreness.

Jason and I explore what recovery actually means, why it isn't just for athletes, and how the way we regulate our nervous system can influence pain, tension, sleep, performance, and how we feel every day. Whether you're training intensely, sitting at a desk for eight hours, standing all day at work, or simply dealing with chronic stress, your body still needs opportunities to recover.

In this episode, you'll learn:

• Why recovery should be part of your daily longevity routine—not just something you do after exercise

• How the "pain gate theory" helps explain why different forms of stimulation can temporarily change how we perceive pain

• Why sitting all day can contribute to hip, lower-back, neck, and shoulder tension

• How percussive therapy can affect pain, muscle tension, range of motion, and blood flow

• Why nervous system regulation matters for recovery and performance

• How shifting into a parasympathetic state may help you wind down before sleep

• Why HRV and heart rate can provide useful feedback about recovery

• How small "recovery snacks" throughout the day can help you take better care of your body

We also discuss massage, breathwork, movement, compression therapy, biofeedback, sleep, and practical ways to build short recovery "pit stops" into even the busiest schedule.

One of my biggest takeaways from this conversation is that recovery is not a luxury reserved for professional athletes. Your body is responding to physical, mental, and emotional stress every day. If we want to perform well—and stay healthy for decades—we have to give it opportunities to recover, too.

Learn more about Dr. Shah:

Website: drshah.com

Clinic: next-health.com

Instagram: @darshanshahmd and @extend_podcast

Learn more about Dr. Jason Wersland:

Website: therabody.com

Instagram: @drjasonwersland

Thank You to Our Sponsor:

IM8: Try IM8 with a 30 day money back guarantee. Get 10% off your first order with code DRSHAH at checkout im8health.com/drshah