Biological aging is no longer just a concept tied to time. It is something we can now measure, track, and influence through data, lifestyle, and targeted interventions that directly impact how our cells function and age.

In this episode of Extend, we sit down with Dr. Kara Fitzgerald, functional medicine leader, researcher, and author, to unpack how diet and lifestyle can directly influence epigenetics and biological age. We break down the difference between chronological and biological aging, how epigenetic clocks work across organs and systems, and why aging may be driven by both environmental exposures and deeper programmed mechanisms.

We also explore how polyphenols, nutrient-dense diets, and emerging interventions like Yamanaka mimetics may begin to shift the trajectory of aging at the cellular level and open new pathways for extending healthspan and peak performance.

Dr. Kara Fitzgerald is a functional medicine physician, researcher, and author of Younger You, known for her pioneering clinical studies demonstrating how targeted nutrition and lifestyle interventions can reverse biological age and reshape long-term health outcomes.

What We Discuss:

• (01:36) Aging, performance, and menopause

• (05:01) Healthspan vs peak span

• (08:39) The dark matter of nutrition

• (11:36) Polyphenols and urolithin A

• (13:12) Biological age and epigenetics

• (15:41) Epigenetic clocks and measurement

• (21:02) Exposomic aging

• (25:03) Programmed aging

• (28:20) Yamanaka factors

• (33:24) Yamanaka mimetics

• (36:29) Polyphenols and caloric restriction

• (40:33) Nutrition and biological age reversal

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Pubmed: Potential reversal of epigenetic age using a diet and lifestyle intervention: a pilot randomized clinical trial

Pubmed: Potential reversal of biological age in women following an 8-week methylation-supportive diet and lifestyle program: a case series

Pubmed: Dietary associations with reduced epigenetic age: a secondary data analysis of the methylation diet and lifestyle study

Mitochondrial decline is one of the most overlooked drivers of aging, impacting energy, muscle function, cognitive performance, and immune resilience long before symptoms become obvious. Many of the changes we associate with aging may actually stem from a loss of cellular efficiency and the body's ability to renew itself.

In this episode of Extend, I sit down with Dr. Anurag Singh, Chief Medical Officer at Timeline, to unpack the science behind urolithin A and how mitochondrial health shapes longevity. We break down how the gut microbiome influences cellular function, why mitophagy declines with age, and what clinical research shows about improving muscle strength, recovery, metabolic health, and immune function.

We also explore how targeted supplementation and lifestyle strategies can help restore mitochondrial quality and support long-term performance and resilience.

Dr. Anurag Singh is a physician-scientist with an M.D. in internal medicine and a Ph.D. in immunology, currently serving as Chief Medical Officer at Timeline, where he leads the development of advanced nutritional and skincare products focused on mitochondrial and cellular health.

What We Discuss:

• (04:58) Drug vs nutraceutical and what urolithin A actually is

• (06:23) Gut microbiome differences and why most people don't produce it

• (08:11) How urolithin A is made from diet and polyphenols

• (10:25) Effective dosing and supplementation strategy

• (15:32) What mitochondria are and why they matter for aging

• (21:26) Mitophagy and how mitochondrial quality declines over time

• (23:43) Main drivers of mitochondrial damage

• (26:24) How urolithin A supports cellular renewal

• (28:55) Muscle aging, strength, and performance

• (33:07) Clinical trial results in older and sedentary adults

• (35:32) Effects on recovery in elite athletes

• (37:07) Brain health and neurodegeneration research

• (43:00) Immune system impact and inflammation

• (47:29) When to start and how to think about supplementation

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Modern life is quietly accelerating biological aging, from posture and movement patterns to sleep disruption, chronic stress, and constant digital stimulation. Many of the symptoms people experience daily, like pain, fatigue, brain fog, and disconnection, may reflect a deeper misalignment with how the human body was designed to function.

In this episode of Extend, I sit down with Dr. Kavin Mistry, board-certified neuroradiologist and author of Primal Health Design, to unpack how modern lifestyles are reshaping our biology and accelerating aging. We break down how posture, movement, circadian rhythm, nutrition, and environment influence brain and spine health, and why reconnecting with our primal design is essential for long-term resilience and performance.

We also explore how daily practices like morning sunlight, grounding, deep work, and intentional routines can help restore alignment with your biology and create more energy, clarity, and longevity in a fast-moving, AI-driven world.

Dr. Kavin Mistry is a board-certified neuroradiologist, author, and thought leader in longevity and human performance, known for developing the Primal Health Design framework to help individuals reconnect with their biology and reverse the hidden effects of modern living.

What We Discuss:

• (05:04) Seeing accelerated biological aging in brain and spine scans

• (06:02) Childhood exposure to primal tribes and longevity insights

• (10:19) Tech neck, posture, and modern spinal degeneration

• (12:09) Nerve compression, numbness, and daily symptoms

• (15:03) Primal posture and how alignment reduces aging

• (18:07) Strength training, hanging, and back development

• (21:17) Deep squat and reversing sedentary damage

• (24:14) Walking, movement, and daily activity patterns

• (25:01) Grounding, inflammation, and connection to earth

• (28:01) Morning sunlight and circadian rhythm optimization

• (31:27) Sleep, stress, and parasympathetic recovery

• (32:11) Nutrition, microbiome diversity, and prebiotics

• (36:44) Stillness, presence, and flow state

• (42:20) Tribe, relationships, and loneliness in modern life

• (48:44) Purpose, service, and greater cause

• (51:02) Finite life awareness and long-term decision making

• (56:07) AI, time leverage, and becoming more human

• (59:47) Morning and night routines as the foundation

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Allergies, chronic inflammation, and constant exposure to environmental toxins are reshaping how our immune system functions, often in ways that go unnoticed until symptoms appear. What many people see as isolated issues like gut problems, skin reactions, or fatigue may actually reflect a deeper immune imbalance.

In this episode of Extend, I sit down with Dr. Tania Elliott, double board-certified physician in internal medicine and allergy and immunology, to unpack how the immune system operates across infection defense, hypersensitivity, and autoimmunity, and how modern exposures like microplastics, synthetic chemicals, and ultra-processed products are disrupting this balance. We break down how chronic inflammation begins, why gut health is central to immune regulation, and how everyday products in your home may be silently driving immune dysfunction.

We also explore how simple, high-impact changes like reducing toxin exposure, improving indoor air quality, and retraining the immune system through targeted therapies can restore balance and reduce long-term disease risk.

Dr. Tania Elliott is a double board-certified physician in internal medicine and allergy and immunology, focused on helping patients understand immune health, reduce toxic exposures, and apply practical, science-backed strategies to improve resilience, longevity, and overall well-being.

What We Discuss:

• (09:07) Immune system explained in three core functions

• (10:42) How chronic inflammation begins

• (11:13) Gut health and microbiome disruption

• (12:50) Signs your immune system is out of balance

• (15:39) Environmental toxins and ultra-processed foods

• (17:39) Skincare, sunscreen, and endocrine disruptors

• (21:33) Microplastics and hidden daily exposure

• (24:00) Teflon, PFAS, and long-term health risks

• (30:01) Building a healthier home environment

• (40:07) Why allergies are increasing

• (41:40) Hygiene hypothesis and early exposure

• (45:10) Peanut allergy and early introduction

• (50:01) Recurrent infections and immune deficiency

• (51:21) Immune testing and biomarkers

• (52:30) IVIG therapy and immune support

• (57:11) Allergy immunotherapy and long-term solutions

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High-performing individuals often appear successful on the outside while quietly experiencing a loss of joy, emotional numbness, and chronic internal stress. This disconnect, often overlooked in traditional diagnostics, may signal a form of depression that goes unrecognized for years.

In this episode of Extend, we sit down with Dr. Judith Joseph, psychiatrist, researcher, and author of High Functioning, to unpack the science of high-functioning depression and how anhedonia can manifest even in highly productive individuals. We break down why traditional mental health models often miss these patients, how pathological productivity masks deeper issues, and how the biopsychosocial model helps identify where joy is being lost across biological, psychological, and social domains.

We also explore Dr. Judith Joseph's 5 Vs framework and how tools like validation, venting, values, vitals, and vision can help systematically restore daily points of joy and long-term emotional resilience.

Dr. Judith Joseph is a board-certified psychiatrist, researcher, and media educator specializing in high-functioning depression and the science of happiness, known for translating complex psychiatric concepts into practical, evidence-based tools that help individuals reclaim joy and optimize mental well-being.

What We Discuss:

• (06:03) High-functioning depression explained

• (08:50) Pathological productivity and busyness

• (10:07) Limits of traditional diagnosis

• (12:28) Anhedonia and loss of joy

• (14:00) Happiness vs joy

• (16:45) Biopsychosocial model

• (19:57) Biological drivers of mood

• (21:56) Metabolic health and inflammation

• (24:00) Social factors and relationships

• (26:09) Validation and venting

• (29:07) Values and meaning

• (31:39) Vitals and lifestyle factors

• (35:29) Technology and disconnection

• (37:18) Vision and planning joy

• (42:02) Psychoeducation and awareness

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Cognitive decline, mood disorders, and persistent neurological symptoms are often treated in isolation, even as underlying drivers like inflammation, infections, and blood flow dysfunction continue to go unaddressed. Emerging research suggests that brain health requires a root cause approach that integrates physiology, environment, and lifestyle over time.

In this episode of Extend, we sit down with Dr. Eboni Cornish, Associate Medical Director at Amen Clinics and President Elect of ILADS, to unpack the science of neural longevity and how brain imaging can reveal hidden drivers of mental health symptoms. We break down how SPECT scans uncover patterns of neuroinflammation, why conditions like ADHD and depression may stem from infections, toxins, or hormonal shifts, and how blood flow and cerebellar function play a central role in cognitive performance and emotional regulation.

We also explore how factors like sleep apnea, perimenopause, chronic infections, and metabolic dysfunction quietly reshape brain activity and how targeted interventions can restore function over time.

Dr. Eboni Cornish is a nationally recognized expert in neuroinflammation and complex chronic illness, integrating advanced biomarker testing with brain imaging to uncover root causes and translate cutting edge science into practical strategies for long term brain and body resilience.

What We Discuss:

• 04:17) Neural longevity and why brain health is missing from longevity conversations.

• (05:23) SPECT scan imaging and how it reveals brain activity and blood flow.

• (08:55) Neuroinflammation and root causes behind mental health symptoms.

• (14:13) The cerebellum as a central regulator of brain function.

• (17:06) Perimenopause, estrogen decline, and changes in brain perfusion.

• (23:22) Depression and mood disorders as physiological and blood flow issues.

• (25:56) Lyme disease, infections, and neuropsychiatric symptoms.

• (32:21) Brain scan patterns of inflammation and diagnostic insights.

• (36:05) Sleep apnea and its impact on brain function and cognition.

• (40:00) A systems approach to brain and body longevity.

• (45:43) What a healthy brain looks like on imaging.

• (48:01) Dementia risk, progression, and early detection.

• (52:09) Practical steps to assess and improve brain health.

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Mental health conditions like depression, PTSD, and trauma related disorders remain difficult to treat, especially when underlying cognitive and emotional patterns persist over time. Emerging research suggests psychedelic assisted therapies may work by temporarily changing how the brain processes information and the sense of self.

In this episode of Extend, we continue our conversation with Dr. Rick Doblin, founder of MAPS, to explore the mechanisms behind psychedelic therapy. We break down how compounds like LSD may reduce activity in the default mode network, how this shift affects perception and emotional processing, and why integration is essential for translating short term insights into lasting change.

We also explore how traditional practices like ayahuasca combine psychological and spiritual frameworks, and how these approaches are shaping new perspectives on trauma, behavior change, and mental health treatment.

Dr. Rick Doblin is the founder and executive director of MAPS (Multidisciplinary Association for Psychedelic Studies), the organization leading global research into psychedelic assisted therapies and working to develop evidence-based treatments for PTSD and other mental health conditions.

What We Discuss:

• (1:01:22) LSD therapy for trauma and addiction

• (1:10:10) Psilocybin, creativity, and cognition

• (1:12:05) DMT, ego dissolution, and consciousness

• (1:18:21) Ayahuasca traditions and addiction recovery

• (1:26:39) MDMA therapy and intergenerational trauma

• (1:31:36) Ketamine clinics and treatment resistant depression

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X: @RickDoblin

Depression, PTSD, and trauma related disorders continue to challenge modern medicine, even as our understanding of the brain and consciousness rapidly evolves. New research suggests that certain therapies may help unlock deeper healing by combining neuroscience, psychology, and carefully guided experiences.

In this episode of Extend, we sit down with Dr. Rick Doblin, founder of MAPS, to unpack the science and history behind psychedelic assisted therapy and its potential role in mental health treatment. We break down the research behind MDMA assisted therapy for PTSD, how psychedelics influence neuroplasticity and emotional processing, and why therapeutic context, preparation, and integration are essential for safe and meaningful outcomes.

We also explore how psychedelic research is reshaping conversations around trauma, healing, and the future of psychiatry.

Dr. Rick Doblin is the founder and executive director of MAPS (Multidisciplinary Association for Psychedelic Studies), the organization leading global research into psychedelic assisted therapies and working to develop evidence-based treatments for PTSD and other mental health conditions.

What We Discuss:

• (01:55) The political origins of psychedelic prohibition

• (04:40) Ancient psychedelic traditions and the Eleusinian Mysteries

• (08:01) Dr. Rick Doblin's path to founding MAPS

• (10:34) Science, policy, and the future of psychedelic medicine

• (11:00) Expanding research on MDMA therapy

• (12:21) Psychedelic churches and religious freedom laws

• (15:42) Why context and safety shape psychedelic outcomes

• (16:20) Neuroplasticity and emotional processing

• (17:36) Bromo-LSD and non-psychedelic therapeutic compounds

• (20:39) Psychedelics and rewriting personal narratives

• (23:22) The Good Friday Experiment and mystical experiences

• (25:23) MDMA therapy and trauma processing

• (27:47) Psychedelics and alternatives to alcohol

• (30:30) Ketamine therapy and pharmaceutical incentives

• (36:16) MAPS, MDMA development, and commercialization

• (41:56) The FDA pathway for MDMA therapy

• (47:00) Global psychedelic research initiatives

• (56:51) Early LSD research in psychology

• …to be continued

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Cholesterol remains one of the most debated biomarkers in cardiovascular medicine, yet many people still misunderstand what it actually tells us about metabolic health and disease risk. As research evolves, the conversation is shifting from simple cholesterol numbers toward deeper drivers of cardiometabolic dysfunction.

In this episode of Extend, we sit down with Nick Norwitz, metabolic health researcher and physician scientist, to unpack the science behind cholesterol, insulin resistance, and cardiovascular risk. We break down the difference between LDL and ApoB, why insulin resistance may be a stronger predictor of heart disease, how statins work beyond cholesterol lowering, and what emerging research reveals about metabolic health, biomarkers, and individualized risk.

We also explore how curiosity driven experimentation, data tracking, and deeper metabolic literacy can help people move beyond simplistic cholesterol narratives and better understand their own cardiometabolic health.

Nick Norwitz is a physician scientist and metabolic health researcher who graduated valedictorian from Dartmouth College before earning a PhD in Human Metabolism from the University of Oxford and an MD from Harvard Medical School. Following a personal battle with inflammatory bowel disease, he became a leading voice in metabolic health education and the author of the widely read newsletter StayCuriousMetabolism.com.

What We Discuss:

• (02:14) The biggest misconception about cholesterol, LDL, and cardiovascular risk

• (06:03) How sleep, inflammation, and plaque formation connect to heart disease

• (08:18) Why insulin resistance may predict cardiovascular risk more strongly than LDL

• (10:40) The atorvastatin study that showed suppressed GLP-1 levels

• (16:54) Statins, pleiotropy, and why lowering LDL is only part of the story

• (22:16) Coronary calcium scans and how imaging can change treatment decisions

• (24:48) The Lancet statin meta-analysis and how headlines distorted the findings

• (33:20) CoQ10, TUDCA, and supportive strategies for people taking statins

• (35:15) Ezetimibe, how it works, and why it may have neuroprotective potential

• (46:09) Bempedoic acid and how it compares with statins

• (51:47) PCSK9 inhibitors, pros and cons, and who may benefit most

• (54:20) ApoB versus LDL and why particle count matters

• (56:15) The Oreo experiment, lean mass hyper-responders, and individualized cholesterol responses

• (59:19) What to do after a high LDL result instead of automatically defaulting to a statin

• (1:02:00) Berberine, nattokinase, and other non-prescription options for cardiovascular support

• (1:06:03) The challenge of communicating nuance in health content online

• (1:10:18) Why personalized experimentation matters more than one-size-fits-all medicine

• (1:12:36) Lp(a), waist-to-hip ratio, and why cardiometabolic context changes risk

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Chronic stress, cognitive overload, and neurodegenerative disease are rising as modern life pushes the brain beyond what it was designed to handle. At the same time, most people still have almost no visibility into how their brain is actually performing day to day.

In this episode of Extend, we sit down with Ramses Alcaide, founder and CEO of Neurable, to unpack how brain computer interface technology is moving from research laboratories into everyday wearable devices. We break down how non-invasive EEG sensors built into headphones can track brain age, cognitive speed, mental recovery, focus, and stress, and how AI is making brain data accessible without the complex lab equipment historically required.

We also explore how continuous brain monitoring could transform prevention by identifying early patterns linked to burnout, ADHD, traumatic brain injury, and neurodegeneration years before symptoms appear.

Ramses Alcaide is the founder and CEO of Neurable, a neurotechnology company developing non-invasive brain computer interfaces built into everyday wearable devices. He earned a PhD in Electrical Engineering and Neuroscience from the University of Michigan, where his research on EEG biomarkers and brain computer interfaces laid the scientific foundation for Neurable's technology.

What We Discuss:

• (06:00) What brain computer interfaces are and how EEG measures brain activity

• (10:45) How Neurable uses AI to isolate and upscale brain signals

• (14:00) The limits of snapshot brain testing and the value of continuous brain data

• (18:00) ADHD, attention patterns, and biofeedback training for focus

• (22:00) Brain training through gaming and performance optimization

• (26:30) Why brain wearables may become the next generation of health trackers

• (28:00) The cognitive metrics Neurable measures including brain age and cognitive speed

• (30:00) Tracking brain age and how daily habits influence cognitive aging

• (35:00) Meditation training and future sleep optimization tools

• (39:00) How people can start using brain wearables in everyday life

• (40:00) Personal experiments to reduce brain age including sleep, exercise, and creatine

• (45:00) How clinics may use brain data to personalize treatments

• (50:00) Stress detection and the future of wearable brain monitoring

• (52:00) Barriers to adoption and the future of neurotechnology

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