In part 2 of this 2 part episode Buck discusses male sexual health with Justin Houman, MD from Tower Urology in Los Angeles. Over half of American men over the age of 40 suffer from erectile dysfunction and other sexual disorders.

• 00:00:42 - Male Refractory Period
• 00:01:44 - Erections are going to be weaker as you age
• 00:02:15 - Medication like Phosphodiesterase that help lower one's refractory period
• 00:02:50 - Hormone called Prolactin that can cause increased refractory time
• 00:07:36 - Dealing with Premature Ejaculation
• 00:10:24 - Paxil and Tramadol For Premature Ejaculation
• 00:12:10 - Prostate issues
• 00:12:37 - Benefits of Cialis and Flomax
• 00:14:49 - Testosterone Replacement
• 00:16:17 - Clomid for Hypogonadism and Low Testosterone
• 00:18:31 - Human Chorionic Gonadotropin (hCG)
• 00:24:08 - Preserving Fertility
• 00:26:39 - Testosterone Blood Testing
• 00:27:44 - Masturbation Effects on Testosterone Levels
• 00:30:30 - Supplements like Tongkat Ali and Fadogia Agrestis

In this two part episode Buck discusses male sexual health with Justin Houman, MD from Tower Urology in Los Angeles. Over half of American men over the age of 40 suffer from erectile dysfunction and other sexual disorders. Buck asks the questions many men are uncomfortable asking.

00:01:44 - The concept of Erectile Dysfunction

• 00:06:22 - Diagnosing Erectile Dysfunction
• 00:09:33 - What is sex therapy?
• 00:10:56 - Main causes of Erectile Dysfunction
• 00:12:02 - Testosterone Levels
• 00:15:48 - Venous Leak
• 00:17:32 - Erectile Dysfunction Treatment
• 00:20:54 - PDE5 inhibitors
• 00:26:14 - Erectile Dysfunction and Cardiovascular Disease?
• 00:31:38 - Intracavernosal injections
• 00:37:13 - GAINSWave Procedure
• 00:42:53 - Platelet-Rich Plasma (PRP) Injection

Buck discusses Yamanaka Factors and recent experiments where a team led by David Sinclair was successful in reversing cellular age applying the concepts in an experiment.

• 00:00:02 - Is it possible to stop or even reverse the aging process?
• 00:01:48 - 2012 research by Shinya Yamanaka - Yamanaka Factors
• 00:02:50 - Pluripotent stem cells
• 00:03:08 - Revolutionary discovery for the world of regenerative medicine
• 00:03:28 - Salk Institute study using mice with progeria
• 00:03:55 - Doxycycline and improvements in signs of aging
• 00:04:26 - David Sinclair's research to regenerate optic nerves in mice to restore vision
• 00:04:49 - David Sinclair's book on aging research called Lifespan
• 00:05:20 - Epigenome and the aging process
• 00:06:15 - Horvath lab and using Yamanaka factors to reset epigenetic clocks in rats

In this edition of Ask The Doctor Executive Producer asks Buck viewer questions and some of his own. Discussed is continuous glucose monitoring for non-diabetics, cardiac arrest in young athletes, effectiveness of vibrating plates, human growth hormones, jet lag and melatonin. This is Part 2. Listen to episode 24 to hear part 1.

• 00:01:31 - Question about taking naps to make up for not enough sleep
• 00:03:06 - REM Sleep and Deep Non-REM Sleep
• 00:11:54 - Shift work is very detrimental to to health
• 00:13:11 - Question about reversing aging in cells
• 00:13:29 - David Sinclair's book Lifespan
• 00:15:30 - Stem cells and aging
• 00:17:22 - Genetically mutated rodents with Progeria and the Yamanaka Factor
• 00:21:59 - Methylation and the Epigenome
• 00:22:37 - Biological clocks and changes in the Epigenome
• 00:23:20 - Sinclair's study on using a drug cocktail to reverse the cellular aging patterns in aged human cells

Buck discusses Heart Rate Variability (HRV). What is it? Why does it matter and how can it effect your overall health in this mini Sapio with Buck Joffrey episode.

• 00:00:31 - Medicine 3.0: Taking medicine into your own hands
• 00:01:15 - What is Heart Rate Variability (HRV) anyway?
• 00:02:16 - The Autonomic Nervous System
• 00:02:37 - The Parasympathetic Nervous System
• 00:03:32 - Lower Hrv Has Been Linked To An Increased Risk Of Cardiovascular Diseases
• 00:04:18 - Ways To Increase Your HRV

In this edition of Ask The Doctor Executive Producer asks Buck viewer questions and some of his own. Discussed is continuous glucose monitoring for non-diabetics, cardiac arrest in young athletes, effectiveness of vibrating plates, human growth hormones, jet lag and melatonin. Part 2 will drop next week as episode 26.

• 0:01:11 - Question about Continuous Glucose Monitoring and Repatha®
• 0:04:34 - Where is the glucose coming from in the morning?
• 0:07:07 - Blood Glucose Spike in the sauna
• 0:09:43 - Impact on blood sugar of the order of eating food
• 0:12:18 - Continuous Glucose Monitor App
• 0:13:29 - A question about avoiding jet lag
• 0:13:26 - Minimizing Jet Lag and Melatonin
• 0:16:15 - Adjust your watch to the timezone you are going to be at
• 0:19:29 - Getting your brain acclimated to the new time
• 0:22:30 - Warning about taking Melatonin
• 0:26:59 - A question about Vibration Plates and their benefits
• 0:27:23 - Vibration Plates and the claim of increasing Growth Hormones
• 0:32:39 - Back Pain and Vibrating Plates
• 0:33:47 - What happened to Bronny James?
• 0:34:27 - Hypertrophic Cardiomyopathy
• 0:40:54 - Athletes and Heart Disorders

Planning a trip? Jet lag can be a serious impediment to making the most of it. Buck discusses jet lag; what it is and strategies to beat it including the use of Melatonin.

• 00:00:25 - Desynchronosis - Disruption To Your Circadian Rhythm
• 00:01:05 - Melatonin
• 00:02:39 - Bright Light Exposure Is Really Important To Resetting Your Circadian Clock
• 00:04:48 - Some Negative Effects Of Chronic Melatonin Use

Buck and Alan Viglione, MD discuss the Cardio IQ® report in detail and battle it out to see has the best numbers in this 2 part episode. This is Part 2. If you missed Part 1, check out episode 20.

• 0:01:16 - Metabolic Markers and Cardiovascular Risk
• 0:01:55 - Framingham Risk
• 0:06:08 - Hemoglobin A1C
• 0:08:00 - C-peptide
• 0:09:07 - Homocysteine and the methylation cycle
• 0:11:50 - Methyl Protect®
• 0:13:46 - Why is Vitamin D important?
• 0:21:34 - APOE Genotype
• 0:24:35 - Alzheimer's Disease Risk
• 0:28:57 - Colchicine Study

Scary news last week when Bronny James, the 18 year old son of Lebron and Savannah James collapsed during a workout at USC. It has been reported that James suffered a cardiac arrest. In September 2022 another seemingly healthy and fit USC basketball player, Vince Iwuchukwu also suffered cardiac arrest.

Thankfully USC was prepared and in both cases they were able to get these young athlete's hearts beating again. Buck discusses why and how it happens.

• 0:00:11 - Bronny James' cardiac arrest
• 0:00:53 - What is cardiac arrest?
• 0:01:23 - Arrhythmias or abnormal beating of the heart
• 0:01:48 - Myocardial Infarction or heart attack
• 0:02:42 - Hypertrophic Cardiomyopathy
• 0:04:11 - Early detection is key

Buck and Alan Viglione, MD discuss the Cardio IQ® report in detail and battle it out to see has the best numbers in this 2 part episode. Part 2 will drop as Episode 22.

• 0:01:31 - What exactly is a Cardio IQ?
• 0:03:15 - the cost of Cardio IQ
• 0:05:18 -Lipid panel, Total Cholesterol, HDL, Triglycerides, LDL Cholesterol
• 0:08:29 - HDL the so-called good cholesterol
• 0:13:55 - Lipoproteins
• 0:15:42 - LDL Particle Number
• 0:22:46 - Apolipoproteins
• 0:25:40 - Apolyte protein tag
• 0:27:48 - Apolipoprotein B or apoB
• 0:28:31 - Lipoprotein(a) or Lp(a)
• 0:31:41 - Statins: Crestor and Livalo
• 0:32:41 - How do Statins work?
• 0:33:11 - Repatha
• 0:36:58 - Inflammation and Atherogenesis
• 0:39:39 - High-sensitivity C-reactive protein (hsCRP)
• 0:40:43 - Lp-PLA2 activity
• 0:41:43 - Oxidative LDL
• 0:42:04 - Myeloperoxidase enzyme
• 0:45:07 - F2-isoprostanes as a marker of risk