Longevity Now!

Muscle twitches are common and usually harmless. Dr. Zampino explains when that might not be the case. 

Where to find our guests:
https://www.uhhospitals.org/doctors/Z... 

Where to find us:
Website | https://vitaveda.health
Youtube |    / @vitavedahealth  
Twitter / X | https://x.com/drprilongevity
Newsletter | https://substack.com/@vitavedahealth
Instagram |   / drprilongevity   

Disclaimer: 
This audio and video podcast are for general informational purposes only and does not constitute a practice of medicine, nursing or other professional health care services including the giving of medical advice. It is not meant to be a substitute for professional medical advice, diagnosis, or treatment. No doctor patient relationship is formed. The use of this information and the materials linked to this podcast and video cast are at the user’s own risk.

In this clip, Dr. Anthony Zampino details the advanced equipment he uses for nerve health from diagnosing nerve damage to exploring emerging neural interface technologies.

Where to find us:
Website | https://vitaveda.health
Youtube | https://www.youtube.com/@Vitavedahealth
Twitter / X | https://x.com/drprilongevity
Newsletter | https://substack.com/@vitavedahealth
Instagram | https://www.instagram.com/drprilongevity/

Disclaimer: 
This audio and video podcast are for general informational purposes only and does not constitute a practice of medicine, nursing or other professional health care services including the giving of medical advice. It is not meant to be a substitute for professional medical advice, diagnosis, or treatment. No doctor patient relationship is formed. The use of this information and the materials linked to this podcast and video cast are at the user’s own risk.

Growth hormone causes potent insulin reisstance. In this clip we dicuss how to mitigate that effect, and who should stop the hormone completely.

Where to find our guests:
Website - https://proseek.org/
YouTube - https://www.youtube.com/@ProseekOfficial
Instagram - https://www.instagram.com/proseekofficial/

Where to find us:
Website | https://vitaveda.health
Youtube | https://www.youtube.com/@vitavedahealth
Twitter / X | https://x.com/drprilongevity
Newsletter | https://substack.com/@vitavedahealth
Instagram | https://www.instagram.com/drprilongevity/
Reddit | https://www.reddit.com/r/Vitaveda/ 

Timestamps:
00:00:00 – Growth Hormone and Insulin Resistance
00:01:52 – Managing Insulin Resistance with Medication
00:03:13 – Blood Sugar Targets and Exogenous Insulin
00:05:06 – Testing and Diagnosing Insulin Resistance
00:07:14 – Retatrutide and Tirzepatide for Sensitivity
00:08:54 – Monitoring Glucose Through Training Phases

Disclaimer
This audio and video podcast are for general informational purposes only and does not constitute a practice of medicine, nursing or other professional health care services including the giving of medical advice. No doctor patient relationship is formed. The use of this information and the materials linked to this podcast and video cast are at the user’s own risk. The content on this podcast and video cast are not intended to be a substitute for professional medical advice, diagnosis or treatment. Any listener or watcher of this information should not disregard or delay in obtaining medical advice from any medical condition they have and they should seek assistance of their healthcare professionals for any such conditions. We take all conflicts of interest very seriously. For all disclosures and companies we invest in or advise, please visit our website.

Dr. Anthony Zampino is a neurologist specializing in nerves and muscles. He explains which nerve problems are preventable, including those caused by diabetes, alcohol, vitamin deficiencies and over-supplementation, and which symptoms are worth taking seriously. Worth a listen if you take supplements or have wondered whether a recurring symptom needs a doctor.

Where to find our guests:

https://www.uhhospitals.org/doctors/Zampino-Anthony-1427518505 

Where to find us:

Website | https://vitaveda.health

Youtube | https://www.youtube.com/@vitavedahealth

Twitter / X | https://x.com/drprilongevity

Newsletter | https://substack.com/@vitavedahealth

Instagram | https://www.instagram.com/drprilongevity/ 

Timestamps

00:00 - Introduction and field overview 

03:25 - How EMG and nerve testing works 

07:49 - Electrical and magnetic therapies 

10:37 - The leading cause of nerve damage - diabetes

15:31 - Alcohol nerve damage

22:52 - Vitamin B12 deficiency 

31:11 - Vitamin B6 toxicity 

39:47 - Malabsorption, surgery and GLP-1s 

42:56 - Copper deficiency and excess zinc 

46:06 - Carpal tunnel and prevention 

52:34 - ALS

1:00:27 - Multiple sclerosis and myasthenia gravis 

1:10:21 - Twitching, cramps and stress

Diabetic peripheral neuropathy (10:37)

• What - Metabolic injury to the nerve endings, the farthest ends of the nerve degrade first.
• Who - Anyone with diabetes. The single most common cause of peripheral neuropathy in the US, and common within the diabetic population. Diabetics are also more prone to carpal tunnel and pinched nerves.
• Signs / symptoms - Numbness or tingling in the feet, slowly crawling up the legs and sometimes into the hands. Pain, sensory loss, balance problems, falls. In younger or earlier-stage patients the first sign is often autonomic instead: erectile dysfunction, lightheadedness on standing, or nausea and abdominal pain after eating from gastroparesis.
• Red flags - Dragging the feet, trouble lifting the legs, hand weakness. That is not typical diabetic neuropathy and points to a second problem.
• How it's diagnosed - People who have uncontrolled diabetes with signs / symptoms of nerve damage are suspected to have this. EMG/nerve conduction testing where the picture doesn't fit.
• How it's treated -  Blood sugar control. Which medication best treats the neuropathy itself, GLP-1 or otherwise,  is still an open question in the literature.
• Reversibility - Progression can be halted; existing damage often permanent. Some patients who truly reverse their metabolic health see the neuropathy improve, but many are left with residual deficit.
• What you can do about it - Manage blood sugar through diet and exercise. 
• Expert notes -  Two people with the same blood sugar can have completely different degrees of neuropathy. Susceptibility is genetic and metabolic, so "my numbers aren't that bad" is not reassurance.

EMG and nerve conduction studies (03:25)

• What - Two tests run together. Nerve conduction studies use sticker electrodes and a stimulator to send an artificial signal down the nerve and measure how it travels. Electromyography places a fine needle into the muscle and records the muscle's own electrical activity while the patient moves it. Nothing is ever inserted into the nerve itself, which is actively avoided.
• Who - Anyone with a suspected nerve or muscle problem, from carpal tunnel to muscular dystrophy.
• What it shows - Where a signal is blocked, whether nerve fibers are lost or slowed, and whether there is muscle inflammation. 
• Expert notes - This is the field's main diagnostic tool and it is interpretive work, reading voltages against the clinical picture rather than getting back a single number. 

Electrical and magnetic therapies (08:09)

• What - Devices that use electricity or magnetism to work around a damaged nerve. TENS units stimulate through the skin, physical therapists use the same principle to get a muscle to contract, spinal stimulators are implanted to change electrical activity in the spinal cord, and neural interface devices connect a nerve to a computer so a paralyzed patient can control a limb.
• Who - People with nerve pain that has not responded to other treatment, and patients in rehabilitation where the nerve-to-muscle signal is impaired.
• Expert notes - These work around the nerve's normal function rather than repairing it, so they offer real symptom relief but do not change the underlying disease. Neural interfaces are still at the research edge.

Diabetic peripheral neuropathy (10:37)

• What - Metabolic injury to the nerve endings, the farthest ends of the nerve degrade first.
• Who - Anyone with diabetes. The single most common cause of peripheral neuropathy in the US, and common within the diabetic population. Diabetics are also more prone to carpal tunnel and pinched nerves.
• Signs / symptoms - Numbness or tingling in the feet, slowly crawling up the legs and sometimes into the hands. Pain, sensory loss, balance problems, falls. In younger or earlier-stage patients the first sign is often autonomic instead: erectile dysfunction, lightheadedness on standing, or nausea and abdominal pain after eating from gastroparesis.
• Red flags - Dragging the feet, trouble lifting the legs, hand weakness. That is not typical diabetic neuropathy and points to a second problem.
• How it's diagnosed - People who have uncontrolled diabetes with signs / symptoms of nerve damage are suspected to have this. EMG/nerve conduction testing where the picture doesn't fit.
• How it's treated - Blood sugar control. Which medication best treats the neuropathy itself, GLP-1 or otherwise, is still an open question in the literature.
• Reversibility - Progression can be halted; existing damage often permanent. Some patients who truly reverse their metabolic health see the neuropathy improve, but many are left with residual deficit.
• What you can do about it - Manage blood sugar through diet and exercise.
• Expert notes - Two people with the same blood sugar can have completely different degrees of neuropathy. Susceptibility is genetic and metabolic, so "my numbers aren't that bad" is not reassurance.

Alcohol-related neuropathy (15:31)

• What - Toxic and metabolic injury to the nerve endings from alcohol.
• Who - Heavy drinkers. It often coexists with diabetes, and when both are present you usually cannot tell which one is doing the dama...

As testosterone therapy rises in popularity it's important to understand the risks, some of which can be life threatening. Dr. Pri and Sai discuss what to look out for and how to intervene early.

Where to find our guest:
Website - https://proseek.org/
YouTube - https://www.youtube.com/@ProseekOfficial
Instagram - https://www.instagram.com/proseekofficial/

Where to find us:
Website | https://vitaveda.health
Youtube | https://www.youtube.com/@vitavedahealth
Twitter / X | https://x.com/drprilongevity
Newsletter | https://substack.com/@vitavedahealth
Instagram | https://www.instagram.com/drprilongevity/
Reddit | https://www.reddit.com/r/Vitaveda/ 

Disclaimer: 
This audio and video podcast are for general informational purposes only and does not constitute a practice of medicine, nursing or other professional health care services including the giving of medical advice. It is not meant to be a substitute for professional medical advice, diagnosis, or treatment. No doctor patient relationship is formed. The use of this information and the materials linked to this podcast and video cast are at the user’s own risk.

Regular thyroid tests often miss abnormalities that explain symptoms like fatigue and depression. In this clip Dr. Gibbs explains the full set of tests you can get and the ratios that reveal abnormalities.

Where to find our guests:
Website - https://danagibbsmd.com/
YouTube - https://www.youtube.com/@danagibbsmd8190 
Podcast - https://podcasts.apple.com/us/podcast/beyond-the-thyroid/id1756413327 

Where to find us:
Website | https://vitaveda.health
Youtube | https://www.youtube.com/@vitavedahealth
Twitter / X | https://x.com/drprilongevity
Newsletter | https://substack.com/@vitavedahealth
Instagram | https://www.instagram.com/drprilongevity/

Timestamps:
0:00 — Thyroid symptoms
0:40 — Free T4 and free T3
2:43 — The three thyroid hormones
4:20 — The total-to-reverse T3 ratio
8:03 — Graves' disease and excess T4
9:18 — Best time to test
10:12 — Type 2 hypothyroidism

The Core Thyroid Lab Panel (5 Tests):
- Free T4
- Free T3
- Total T3
- Reverse T3
- TSH

References: 
Dr. Dana Gibbs’s education website - http://www.thyroidclarity.com 
Physician integrative hormone management class and discussion group - http://thyroidclarity.com/endo-optin 
https://wlwt.com/article/doctors-screenings-colorectal-cancer-young-adults/70320212 

Disclaimer
This audio and video podcast are for general informational purposes only and does not constitute a practice of medicine, nursing or other professional health care services including the giving of medical advice. No doctor patient relationship is formed. The use of this information and the materials linked to this podcast and video cast are at the user’s own risk. The content on this podcast and video cast are not intended to be a substitute for professional medical advice, diagnosis or treatment. Any listener or watcher of this information should not disregard or delay in obtaining medical advice from any medical condition they have and they should seek assistance of their healthcare professionals for any such conditions. We take all conflicts of interest very seriously. For all disclosures and companies we invest in or advise, please visit our website.

Dr. Pri sits down with Sai V, a bodybuilding professional and founder of Proseek to discuss the various peptides, meds, and supplements bodybuilders use to optimize human performance and increase longevity. We emphasize when to use these compounds and what blood work to monitor to make sure it's being done safely

Where to find our guests:

Website - https://proseek.org/

YouTube - https://www.youtube.com/@ProseekOfficial

Instagram - https://www.instagram.com/proseekofficial/

Where to find us:

Website | https://vitaveda.health

Youtube | https://www.youtube.com/@vitavedahealth

Twitter / X | https://x.com/drprilongevity

Newsletter | https://substack.com/@vitavedahealth

Instagram | https://www.instagram.com/drprilongevity/

Reddit | https://www.reddit.com/r/Vitaveda/ 

Timestamps: 

00:12 Introduction

06:38 Sai's Journey Into Bodybuilding

10:07 Building Proseek: From Idea to Launch

14:50 The Phases of Bodybuilding: Bulk, Cut, Recovery

17:41 When and Why to Get Blood Work Done

22:20 Testosterone Side Effects: The Cardiovascular Rundown

32:36 Managing Cholesterol: Ezetimibe, PCSK9 Inhibitors & More

38:19 Cardiac Imaging: Calcium Scores, CT Angiograms & Echocardiograms

50:01 Blood Clotting Risk: Nattokinase, Aspirin & Donating Blood

56:23 Protecting Your Liver: NAC, TUDCA & FibroScan

1:08:27 Mood, "Roid Rage" & Coming Off Compounds

1:21:56 Growth Hormone, Insulin Resistance & GLP-1 Drugs

1:36:12 Dementia Screening, BPC-157 & Emerging Peptides

Bodybuilding Competition Cycle

• Off-season / Bulking: Primary muscle-building phase. Can last several months to a full year or more depending on how much size the athlete needs to add.
• Health / Recovery phase: Back off compounds, lower training volume, get blood work done. Typically 4–16 weeks (average around 8 weeks).
• Prep / Cutting phase: Diet down to lose body fat while preserving muscle. Length varies by athlete.
• Competition → restart cycle

Recommended Blood Work Timing

• During or just after prep (peak stress) - see how much damage the compounds are doing
• End of recovery phase (8–10 weeks post-show) - confirm biomarkers are returning to baseline
• Ideally: test as often as practical. 
• More data points = better decision-making.

Cholesterol 

• Ezetimibe - first choice in bodybuilding. 
  • Generic, ~$10/month, virtually no side effects, no muscle issues. 
  • Blocks cholesterol absorption from the gut.
• Supplements - citrus bergamot, berberine (also helps blood sugar), garlic (may raise HDL), niacin, high-dose fish oil (caution: slight AFib risk)
• Statins - effective but potential muscle side effects make them a poor fit for athletes
• PCSK9 inhibitors (e.g., Repatha) - for people who can't tolerate statins. 
  • Reduces cholesterol up to ~70%. (~$500/month without insurance) but often covered after documented statin intolerance.
• Boston Heart test - determines if you're a hyper-absorber vs. hyper-synthesizer of cholesterol, helping guide whether ezetimibe or a statin is the better fit, as well as how much dietary cholesterol may be impacting levels

Liver 

• NAC (N-acetyl cysteine): 1.2–1.8 grams/day - shown anecdotally to reduce AST/ALT from the 200–300 range down to under 100 when using oral anabolics
• TUDCA: Supports bile flow, prevents biliary stasis
• Milk thistle: Commonly used, less evidence
• Injectable anabolics are far less hepatotoxic than oral compounds (orals pass through the liver twice due to first-pass metabolism)
• Oral anabolics (e.g., Winstrol, Halotestin) are typically limited to the last 4–8 weeks of prep
• Long-term athletes (5+ years): consider a FibroScan (liver ultrasound measuring stiffness/scarring) - liver fibrosis is irreversible

Blood Clot Prevention

• Nattokinase - breaks down fibrinogen (end of clotting cascade), mixed results
• Baby aspirin - prevents platelet clumping (separate mechanism), commonly used in patients with serious heart disease
• Donating blood every 8–12 weeks - directly lowers hematocrit, which can build up with anabolic steroids
• Watch for easy bleeding/bruising as a sign you've overdone blood thinners
• Be extra cautious with head trauma while on any blood-thinning protocol

Managing Estrogen Side Effects

• Don't take aromatase inhibitors (anastrozole) or tamoxifen preemptively - estrogen has neuroprotective and cardioprotective benefits
• Start only when symptoms appear: water retention, nipple sensitivity, acne, libido changes
• Some compounds (Masteron, Primobolan, Equipoise) naturally lower estrogen when stacked with testosterone, serving double duty as anabolics and estrogen managers
• Ideal approach: base decisions on blood work (E2 levels) rather than guessing

Growth Hormone Dosing & Insulin Resistance

• 1–2 IU/day: longevity-oriented dose, typically well tolerated
• 4–6 IU/day: muscle-building range, some athletes see insulin resistance
• 8–12+ IU/day: high performance range, insulin resistance is very likely
• Secretagogues (CJC-1295, Ipamorelin) raise IGF-1 only within natural limits - not comparable to exogenous GH for muscle growth
• Ways to manage insulin resistance for anyone (not just those on growth hormone)
  • Medications
    • Jardiance (empagliflozin
    • Pioglitazone
    • Metformin
    • Retatutride and other GLP1 agonists
  • Supplements
    • Berberine
  • Lifestyle
    • Zone 2 cardio

BPC-157 Caution

• Very effective for tendon/ligament healing and gut health
• Mechanism involves angiogenesis (new blood vessel growth) - continuous long-term use raises theoretical cancer risk
• Based on the mechanism of action it’s a lot more risky to use long term, so Dr. Pri recommends it as-needed for specific injuries in defined time windows (e.g., 4–6 weeks), not year-round, but there is limited data here
• Local injection near the injury site likely reduces systemic side effects vs. oral or distant injection - this is a general principle

Disclaimer

This audio and video podcast are for general informational purposes only and does not constitute a practice of medicine, nursing or other professional health care services including the giving of medical advice. No doctor patient relationship is formed. The use of this information and the materials linked to this podcast and video...

Most people only benchmark their strength, mobility, and other physical health once a year, but increasing it to quarterly results in better results. Tune in to find out why 

Where to find us:
Website | https://vitaveda.health
Youtube | https://www.youtube.com/@Vitavedahealth
Twitter / X | https://x.com/drprilongevity
Newsletter | https://substack.com/@vitavedahealth
Instagram | https://www.instagram.com/drprilongevity/

Disclaimer: 
This audio and video podcast are for general informational purposes only and does not constitute a practice of medicine, nursing or other professional health care services including the giving of medical advice. It is not meant to be a substitute for professional medical advice, diagnosis, or treatment. No doctor patient relationship is formed. The use of this information and the materials linked to this podcast and video cast are at the user’s own risk.

Are you checking the 6 domains of physical health that keep people stay strong, mobile, and independent for decades longer? Dr. Patrick Donovan breaks them down

Where to find our guest, Dr. Patrick Donovan, PT, DPT:
Website | https://www.heatherlanept.com/
Instagram | https://www.instagram.com/drdonovan_healthspan/
Facebook: | https://www.facebook.com/people/Heather-Lane-Physical-Therapy-and-Wellness/61561488149188/

Where to find us:
Website | https://vitaveda.health
Youtube | https://www.youtube.com/@vitavedahealth
Twitter / X | https://x.com/drprilongevity
Newsletter | https://substack.com/@vitavedahealth
Instagram | https://www.instagram.com/drprilongevity/ 

Timestamps:
00:00:00 — Introducing the Capacity Compass
00:01:00 — How the Assessment Works
00:02:05 — Strength
00:04:01 — Mobility 
00:07:35 — Balance 
00:10:15 — Cardiovascular Endurance
00:11:42 — Gait
00:14:15 — Chronic Conditions

Disclaimer
This audio and video podcast are for general informational purposes only and does not constitute a practice of medicine, nursing or other professional health care services including the giving of medical advice. No doctor patient relationship is formed. The use of this information and the materials linked to this podcast and video cast are at the user’s own risk. The content on this podcast and video cast are not intended to be a substitute for professional medical advice, diagnosis or treatment. Any listener or watcher of this information should not disregard or delay in obtaining medical advice from any medical condition they have and they should seek assistance of their healthcare professionals for any such conditions. We take all conflicts of interest very seriously. For all disclosures and companies we invest in or advise, please visit our website.

If you've never been to a gym and you're in your 60s, can you still improve? Dr. Donovan draws from his experience working with older adults to answer one of the most common questions in longevity.

Timestamps:
0:00 - Rethinking physical therapy as preventive care
1:46 - Aging role models shape our trajectory
3:11 - What older adults are actually capable of
4:07 - Meeting clients where they are
6:06 - Goal-driven programs
7:04 - Physical therapy as ongoing primary care for physical health

Where to find our guest, Dr. Patrick Donovan, PT, DPT:
Website | https://www.heatherlanept.com/
Instagram | https://www.instagram.com/drdonovan_healthspan/
Facebook: | https://www.facebook.com/people/Heather-Lane-Physical-Therapy-and-Wellness/61561488149188/

Where to find us:
Website | https://vitaveda.health
YouTube | https://www.youtube.com/@Vitavedahealth
Twitter / X | https://x.com/drprilongevity
Newsletter | https://substack.com/@vitavedahealth
Instagram | https://www.instagram.com/drprilongevity/

Disclaimer: 
This audio and video podcast are for general informational purposes only and does not constitute a practice of medicine, nursing or other professional health care services including the giving of medical advice. It is not meant to be a substitute for professional medical advice, diagnosis, or treatment. No doctor patient relationship is formed. The use of this information and the materials linked to this podcast and video cast are at the user’s own risk.