For men, testosterone is important for mood, bone health, erectile function, libido, strength and muscle mass and is also associated with lower levels of inflammatory markers, better insulin sensitivity, and metabolic health. It also may even have some vasodilatory effects, and higher testosterone levels are also associated with better health outcomes in general and lower cardiovascular, cancer, and all-cause mortality. Unfortunately, It looks like testosterone levels in the population are dropping, although more isn’t necessarily better.

On this podcast, NBT Scientific Director Megan Hall and I are talking about testosterone: why we should care about it, how to test for it, and how to support healthy levels of this hormone. Megan discusses signs and symptoms of low testosterone and seven different lifestyle changes you can make to support optimal levels - before you even consider taking a supplement. We also talk about hormone replacement therapy, who might benefit, and some of the downsides to this strategy.

For all the references and a detailed roadmap of everything we discuss, be sure to follow along with Megan’s outline for this podcast. 

[00:00:24] Testosterone: Why you should care.

[00:01:49] Megan's outline for this podcast.

[00:02:46] Optimal reference range for Testosterone.

[00:03:51] Symptoms of low testosterone.

[00:04:25] Testing for testosterone.

[00:07:02] High testosterone is associated with violent crime. Study: Dabbs Jr, James M., et al. "Testosterone, crime, and misbehavior among 692 male prison inmates." Personality and individual Differences 18.5 (1995): 627-633.

[00:07:32] Book: Behave: The Biology of Humans at Our Best and Worst, by Robert Sapolsky.

[00:08:22] The testosterone suppression system.

[00:08:35] Book: The WEIRDest People in the World, by Joseph Henrich.

[00:10:13] Book: Mothers and Others: The Evolutionary Origins of Mutual Understanding, by Sarah Blaffer Hrdy.

[00:12:02] Testosterone physiology; troubleshooting by testing LS and FSH.

[00:14:38] Varicocele - the enlargement of veins within the testicles - common amongst athletes.

[00:16:31] Sex Hormone Binding Globulin (SHBG)

[00:19:44] How to support testosterone levels.

[00:20:41] 4-Quadrant Model; Josh Turknett's AHS talk: How To Win At Angry Birds: The Ancestral Therapeutic Paradigm - AHS19.

[00:20:55] Josh Turknett on the NBT podcast: How to Win at Angry Birds: The Ancestral Paradigm for a Therapeutic Revolution

[00:21:11] Sleep; Greg Potter on the podcast talking about sleep: Why Sleep Is Critical for Immune Health, How to Entrain Your Circadian Rhythm for Perfect Sleep and Metabolic Health, Better Sleep for Athletes, and What to Do When You Can’t Sleep.

[00:21:33] Sleep deprivation decreases testosterone; Study: Leproult, Rachel, and Eve Van Cauter. "Effect of 1 week of sleep restriction on testosterone levels in young healthy men." Jama 305.21 (2011): 2173-2174 and Gonzalez-Santos, M. R., et al. "Sleep deprivation and adaptive hormonal responses of healthy men." Archives of andrology 22.3 (1989): 203-207.

[00:22:26] Greg Potter's articles on sleep: 1. Having trouble sleeping? A primer on insomnia and how to sleep better 2. Sleep-maintenance insomnia: how to sleep through the night 3. Sleep-onset insomnia: how to get to sleep fast. 

[00:22:37] Stress; Chronic stress in particular, more so than acute stress.

[00:24:54] Podcast: How to Manage Stress, with Simon Marshall, PhD.

[00:25:09] Eating sufficient calories.

[00:26:13] Podcast with Herman Pontzer: How We Really Burn Calories, Lose Weight, and Stay Healthy.

[00:27:57] Nutrient deficiencies: zinc, magnesium, vitamin D.

[00:29:30] Cholesterol and dietary fat.

[00:30:51] Exercise.

[00:33:32] Within day energy availability can negatively impact the testosterone:cortisol ratio; Study: Torstveit, Monica Klungland, et al. "Within-day energy deficiency and metabolic perturbation in male endurance athletes." International Journal of Sport Nutrition and Exercise Metabolism 28.4 (2018): 419-427.

[00:34:59] Testosterone suppression - a dysfunction or a normal adaptation to training? Study: Sansone, Andrea, et al. "Sport, doping and male fertility." Reproductive Biology and Endocrinology 16.1 (2018): 1-12.

[00:37:02] Book: Move Your DNA: Restore Your Health Through Natural Movement, by Katy Bowman.

[00:39:00] Environmental toxins: estrogens, cigarette smoking and alcohol.

[00:40:16] Herbs and supplements to consider.

[00:43:40] Pituitary tumours, TBI and concussion.

[00:44:36] Testosterone Replacement Therapy.

[00:48:59] Join our group program to get a blood test, bloodsmart.ai report, and 4 group coaching sessions.

If you’ve followed the NBT podcast for a while you probably heard Dr. Malcolm Kendrick talking about the tenuous connection between cholesterol levels and cardiovascular disease. Malcolm has published with The International Network of Cholesterol Skeptics on this topic, including a recent review paper entitled LDL-C does not cause cardiovascular disease. In the paper, they include both total cholesterol and LDL-C in their discussions, and if you look at epidemiological data, I think they make a good point. For instance, total cholesterol had almost no effect on mortality in the HUNT-2 study in Norway, and higher levels were associated with lower mortality risk in women. Or the ESCARVAL-RISK study, where higher LDL-C is associated with lower all-cause mortality until it’s well above 200 mg/dl. Or the In-Chianti study, where people over 64 had the lowest mortality rates if they had an LDL-C greater than 130mg/dl.

The question then becomes, if not cholesterol, then what? To answer that we must resist monomania and acknowledge the very notion of causation in a complex system is suspicious. Ask not what but how. Malcolm argues in his new book The Clot Thickens that if you maintain metabolic health, manage stress, and mind your endothelial function, cholesterol levels become largely irrelevant. Simple enough, but as you’ll discover in this interview, the devil is in the details.

[00:00:24] Previous NBT podcasts with Malcolm Kendrick: Why Cholesterol Levels Have No Effect on Cardiovascular Disease (And Things to Think About Instead) and A Statin Nation: Damaging Millions in a Brave New Post-health World.

[00:00:42] Book: The Clot Thickens: The enduring mystery of heart disease, by Malcolm Kendrick.

[00:03:04] 5-part series with lipidologist Thomas Dayspring (Part 1, 2, 3, 4, 5);  2-hour interview with Ron Krauss on The Drive Podcast.

[00:04:23] Book: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine.

[00:06:12] LDL Cholesterol - challenging mainstream thought.

[00:17:16] Fatty streaks never become atherosclerotic plaques; Review: Velican, C., M. Anghelescu, and D. Velican. "Preliminary study on the natural history of cerebral atherosclerosis." Medicine interne 19.2 (1981): 137-145.

[00:18:54] Genetic influences; familial hypercholesterolemia (FH) and high clotting factors; Case study of patient with untreated FH but no presence of atherosclerosis: Johnson, Kipp W., Joel T. Dudley, and Jason R. Bobe. "A 72-year-old patient with longstanding, untreated familial hypercholesterolemia but no coronary artery calcification: a case report." Cureus 10.4 (2018).

[00:21:22] Clotting factors more important than high LDL; Paper: Ravnskov, Uffe, et al. "Inborn coagulation factors are more important cardiovascular risk factors than high LDL-cholesterol in familial hypercholesterolemia." Medical hypotheses 121 (2018): 60-63.

[00:25:03] UK Biobank Study: Mora, Samia, Seth S. Martin, and Salim S. Virani. "Cholesterol Insights and Controversies From the UK Biobank Study: Three Take-Home Messages for the Busy Clinician." (2019): 553-555.

[00:25:51] Machine learning used to predict cardiovascular disease; Study: Weng, Stephen F., et al. "Can machine-learning improve cardiovascular risk prediction using routine clinical data?." PloS one 12.4 (2017): e0174944.

[00:30:54] FOURIER PCSK9-inhibitor study: More deaths in the treatment group; Study: Sabatine, Marc S., et al. "Evolocumab and clinical outcomes in patients with cardiovascular disease." New England Journal of Medicine 376.18 (2017): 1713-1722.

[00:31:26] Evolocumab also reduces Lp(a); Study: O’Donoghue, Michelle L., et al. "Lipoprotein (a), PCSK9 inhibition, and cardiovascular risk: insights from the FOURIER trial." Circulation 139.12 (2019): 1483-1492.

[00:34:02] APOA-1 Milano and HDL cholesterol.

[00:38:45] Lp(a) and Vitamin C, plasminogen and clotting.

[00:47:02] Rudolf Virchow, the father of the cholesterol hypothesis.

[00:48:42] So what causes CVD?

[00:49:53] Biomechanical stress; High blood pressure.

[00:52:16] Endothelial and glycocalyx damage.

[01:02:19] Steroids, immunosuppressants.

[01:03:52] Avastin (bevacizumab) increases the risk of CVD; Study: Totzeck, Matthias, Raluca Ileana Mincu, and Tienush Rassaf. "Cardiovascular adverse events in patients with cancer treated with bevacizumab: a meta‐analysis of more than 20 000 patients." Journal of the American Heart Association 6.8 (2017): e006278.

[01:06:07] Clotting disorders.

[01:10:41] Sickle cell anemia - 50,000% increased risk of CVD.

[01:11:36] Case study of 14-year old boy: Study: Elsharawy, M. A., and K. M. Moghazy. "Peripheral arterial lesions in patient with sickle cell disease." EJVES Extra 14.2 (2007): 15-18.

[01:13:25] Air pollution, smoking, lead.

[01:15:57] Biggest risk factors for CVD.

[01:20:09] Supplements that strengthen the glycocalyx; Chondroitin Sulfate.

[01:22:12] Malcolm's blog.

Each month for the past year we’ve offered our bloodsmart.ai group program. It’s an opportunity to use machine learning to predict—from a pretty simple blood test—what is likely happening inside your body (and what might be going wrong) along with expert feedback on the results from NBT Scientific Director and Coach, Megan Hall and me. The program has been very popular, not to mention a lot of fun, and people are going through more than once to measure their ongoing progress.

On this podcast, Megan provides detailed feedback on the bloodsmart.ai report belonging to NBT Coach Clay Higgins. What you’ll hear is very similar to what goes on during our group coaching sessions. It’s a review of exactly what’s going well and where there’s opportunity for improvement - along with specific steps to take right now to improve overall health, based on the data, symptoms, and personal history.

If you’d like to participate in a group program please email NBT support for details and be sure to let us know where in the world you live so we can tailor our response to your needs.

[00:00:33] Clay's combined bloodsmart.ai report.

[00:05:13] Overall wellness score and PhenoAge.

[00:07:30] Marker Detail View Page.

[00:08:12] NutriSense continuous glucose monitoring.

[00:12:03] Calculated red blood cell survival and HbA1C.

[00:13:52] Eight Sleep.

[00:16:33] Uric acid.

[00:25:10] Potential oxidative stress: N. Acetyl Cysteine (NAC) may help.

[00:26:58] Calcium a bit low; consider following up with a blood parathyroid test and/or supplement with magnesium.

[00:32:56] HDL Cholesterol a little high and what that might mean.

[00:34:26] Red blood cell indices and low oxygen deliverability suggest possible nutrient deficiencies.

[00:35:53] Digestive enzymes: Thorne Biogest or Betaine HCl.

[00:38:05] HomocysteX Plus.

[00:40:33] Reticulocyte production index and RDW.

[00:43:44] Low neutrophils (neutropenia) could suggest low copper level.

[00:46:36] Nose to Tail.

[00:48:00] Bloodsmart.ai forecasts.

[00:48:32] Environmental toxin exposure; Quicksilver Blood Metals Testing.

[00:51:53] Supporting detoxification: sauna, binders, supporting detox pathways.

[00:53:45] Mitigating toxins in the environment. Skin Deep app; Think Dirty Shop Clean app.

[00:55:59] Forecasted iodine deficiency; sea vegetables are a good source.

[00:57:06] Forecasted issues with immune system/gut.

[00:58:28] Designs for Health GI Revive.

[00:59:35] Lucy Mailing, PhD; Lucy on previous NBT podcasts: 1, 2, 3.

[01:01:49] Homocysteine forecasted to be high - B vitamins are important, as well as glycine, creatine.

[01:01:50] Join our bloodsmart.ai group program to get Megan’s feedback on your blood chemistry.  In the US, click here to get started. $198 includes blood testing, a bloodsmart.ai report, and access to 4 group coaching sessions with Megan. (Note: Residents of NY, NJ, RI and those living outside the US - pricing and availability varies. Please contact us for assistance.)

The vaginal microbiome is often mentioned in passing - sort of as an afterthought - usually when we’re really talking about the gut microbiome. We’ve decided to give the vaginal microbiome centre stage today, and with good reason - it’s a huge factor when it comes to the quality of a woman’s life and health, and has implications for fertility, pregnancy and childbirth, and risks associated with sexually transmitted infections. 

On this podcast, NBT Scientific Director and Coach Megan Hall and I are discussing the vaginal microbiome: what it is, how to assess for problems, and how to maintain a state of good health. Megan talks about the effects of vaginal dysbiosis on pregnancy and fertility, and how to create the best possible outcome for childbirth. She explains what causes disruption to the vaginal microbiome in the first place, and how ancestral health principles can keep you on track. She also outlines how to rebalance the vaginal microbiome when there’s dysbiosis, along with practical steps to take before resorting to antibiotics and antifungals.

[00:02:30] Why care about the vaginal microbiota?

[00:03:55] Megan's outline for this podcast.

[00:04:50] What is the vaginal microbiome (VM)?

[00:05:52] 5 core vaginal microbiome community state types (CSTs).

[00:07:40] Why lactobacilli are beneficial.

[00:10:52] Lucy Mailing, PhD; Podcasts: 1, 2, 3.

[00:12:06] Diagnoses associated with vaginal dysbiosis.

[00:13:47] Direct to consumer VM testing.

[00:15:48] Changes throughout a woman's lifespan.

[00:18:02] Podcast: You Are Not Broken: A Modern Approach to Women’s Sexual Health and Desire, with Kelly Casperson, MD.

[00:18:38] Common vaginal microbiome dysbiosis pathologies: Bacterial Vaginosis (BV), Vulvovaginal Candidiasis (VVC), and Group B Strep (GBS).

[00:26:16] Pregnancy: protection from preterm labor, preeclampsia, and infertility.

[00:29:44] Studies on the effects of the microbiota and success with infertility treatment: 1. Moreno, Inmaculada, et al. "Evidence that the endometrial microbiota has an effect on implantation success or failure." American journal of obstetrics and gynecology 215.6 (2016): 684-703. and 2. Moore, Donald E., et al. "Bacteria in the transfer catheter tip influence the live-birth rate after in vitro fertilization." Fertility and sterility 74.6 (2000): 1118-1124.

[00:31:06] NBT Podcasts with Dr. Malcolm Kendrick: 1, 2.

[00:32:15] Causes of disruption to the vaginal microbiome: menses, gut dysbiosis, diet, smoking, contraceptives, antibiotics, general hygiene, stress, tampons, lubricants, hygiene products.

[00:35:49] Women who eat a vegetarian diet have higher vaginal microbial diversity (which is unfavorable); Study: Song, Stephanie D., et al. "Daily vaginal microbiota fluctuations associated with natural hormonal cycle, contraceptives, diet, and exercise." Msphere 5.4 (2020): e00593-20.

[00:37:05] Compounds from cigarette smoke can be found in cervical mucus; Study: Prokopczyk, Bogdan, et al. "Identification of tobacco-specific carcinogen in the cervical mucus of smokers and nonsmokers." Journal of the National Cancer Institute 89.12 (1997): 868-873.

[00:37:24] Microbial composition of man's penis can predict BV incidence in female sex partner: Study: Mehta, Supriya D., et al. "The Microbiome Composition of a Man's Penis Predicts Incident Bacterial Vaginosis in His Female Sex Partner With High Accuracy." Frontiers in cellular and infection microbiology 10 (2020): 433.

[00:38:53] Maternal stress alters proteins related to vaginal immunity and abundance of lactobacilli; Study: Jašarević, Eldin, et al. "Alterations in the vaginal microbiome by maternal stress are associated with metabolic reprogramming of the offspring gut and brain." Endocrinology 156.9 (2015): 3265-3276.

[00:39:34] Maternal vaginal microbiome mediates responses to prenatal stress; Study: Jašarević, Eldin, et al. "The maternal vaginal microbiome partially mediates the effects of prenatal stress on offspring gut and hypothalamus." Nature neuroscience 21.8 (2018): 1061-1071.

[00:42:44] Summarizing lifestyle practices that most affect the vaginal microbiome.

[00:43:07] The BBC More or Less Podcast: Has the number of periods a woman has in her lifetime quadrupled? 

[00:43:49] Best options for contraceptives; Fertility Awareness Method. Podcast: The Truth About Fertility and the Fertility Awareness Method, with Torea Rodriguez.

[00:45:08] Personal hygiene products - be wary.

[00:46:49] Podcast: How to Manage Stress, with Simon Marshall, PhD.

[00:47:22] How to rebalance the vaginal ecosystem (before resorting to antibiotics and antifungals).

[00:48:19] Vaginal pH test strips.

[00:48:33] Probiotics: Jarrow Fem-Dophilus has two good strains.

[00:52:34] Intervaginal vitamin C can help treat BV; Study: Petersen, E. Eiko, and Paola Magnani. "Efficacy and safety of Vitamin C vaginal tablets in the treatment of non-specific vaginitis: A randomised, double blind, placebo-controlled study." European Journal of Obstetrics & Gynecology and Reproductive Biology 117.1 (2004): 70-75.

[00:52:46] Medical grade honey, thyme and garlic.

[00:55:13] The next frontier in VM study.

[00:57:02] Seeding with fecal microbiota transplantation in C-section infants; Study: Korpela, Katri, et al. "Maternal fecal microbiota transplantation in cesarean-born infants rapidly restores normal gut microbial development: a proof-of-concept study." Cell 183.2 (2020): 324-334.

[00:58:30] Microbiome-based biologic drug being studied (L crispatus probiotic); Study: Lagenaur, Laurel A., et al. "Connecting the dots: Translating the vaginal microbiome into a drug." The Journal of Infectious Diseases 223.Supplement_3 (2021): S296-S306.

[01:00:09] 4-quadrant model.

One of the best things about doing this podcast for the past seven years has been how our guests have shaped nearly every aspect of my life and the lives of my family. Over the years my wife Julie and I have built an ancestral lifestyle we believe to be most conducive to health, connection, and longevity, largely influenced by the brilliant guests we’ve interviewed right here. The process has been nothing short of an adventure, and it continues to unfold.

On this podcast, I’m joined by my wife, food scientist Julie Kelly to talk about how we’ve taken everything we’ve learned about health, wellness, and ancestral living to create a home life that truly supports and sustains our family. We talk about how we eat, prepare meals, and educate our kids and changes we’ve made over the years. Julie shares the immense value she’s derived from a very specific type of psychotherapy, and we discuss how our practice of managing stress has evolved. We also give an update on our adventures in cohousing, and the number one factor that we’ve learned will make or break cohousing relationships.

​​[00:00:17] Ayla is 6 months old; the birth experience.

[00:02:21] Podcasts with Lily Nichols, RDN: How to Optimise Nutrition for Pregnancy and Real Food for Gestational Diabetes with Lily Nichols.

[00:03:13] How our eating has evolved over time.

[00:04:04] Podcast: How We Really Burn Calories, Lose Weight, and Stay Healthy, with Herman Pontzer, PhD.

[00:04:22] Meal prep and shopping. Our eBook: What We Eat.

[00:07:14] Justin Sonnenberg.

[00:07:37] Lucy Mailing, PhD; Podcasts: 1. How to Optimise Your Gut Microbiome, 2. Microbiome Myths and Misconceptions, 3. Rewilding the Gut: Restoring Ancestral Diversity to the Microbiome.

[00:09:17] Simon Marshall's Stress Audit; Podcast: How to Manage Stress.

[00:11:31] Accelerated Experiential Dynamic Psychotherapy (AEDP); Podcast: Healing and Transformation with Accelerated Experiential Dynamic Psychotherapy (AEDP), with Jason Connell. Learn more about working with Jason.

[00:16:27] Book: It's Not Always Depression: Working the Change Triangle to Listen to the Body, Discover Core Emotions, and Connect to Your Authentic Self, by Hilary Jacobs Hendel.

[00:18:33] Forest School.

[00:21:58] Book: Free to Learn: Why Unleashing the Instinct to Play Will Make Our Children Happier, More Self-Reliant, and Better Students for Life, by Peter Gray; Podcast: Free to Learn: Unleashing the Instinct to Play, with Peter Gray, PhD.

[00:22:36] Books: The Gardener and the Carpenter: What the New Science of Child Development Tells Us About the Relationship Between Parents and Children, and The Scientist In The Crib: Minds, Brains, And How Children Learn, by Alison Gopnik, PhD.

[00:24:54] Book: Range: Why Generalists Triumph in a Specialized World, by David Epstein.

[00:25:00] Cohousing; Podcast: Contemplating Cohousing: A Paradigm for Modern Day Tribal Living.

[00:25:07] Book: Mothers and Others: The Evolutionary Origins of Mutual Understanding, by Sarah Blaffer Hrdy.

[00:26:13] Article: The Nuclear Family Was a Mistake, by David Brooks.

[00:26:25] Podcast: The Postmenopausal Longevity Paradox and the Evolutionary Advantage of Our Grandmothering Life History, with Kristin Hawkes, PhD.

[00:29:54] Our experience with Workaway.info. 

[00:38:38] Our Workaway profile.

Dr Gabriel Niles, MD has travelled many roads in his search for the ideal model of healing and flourishing. Prior to his training as a Medical Doctor at USC School of Medicine, he studied Traditional Chinese Medicine in Shanghai, China. He has organized and led multiple Circle of Healers retreats with the American Medical Student Association as a medical student, seeking to integrate the wisdom of healing traditions with modern medical science. In recent years, Dr Niles has been integrating the insights and benefits of Functional Medicine into his medical practice while remaining committed to keeping medical care affordable for his patients. 

For this podcast, I caught up with Gabe after the Ancestral Health Symposium in Los Angeles to discuss his integration of Functional Medicine into a mainstream bill-to-insurance medical practice. We talk about areas where his approach differs from that of other family physicians, including his favouring of lifestyle changes over-reliance on pharmaceuticals. He also explains why he has continued working within the conventional medical system, despite rejecting the big-pharma controlled dis-ease model of medical “care”.

[00:00:27] Gabriel's background and interest in medicine and health.

[00:02:33] Evan Hirsch, MD; Podcast: How to Fix Your Fatigue.

[00:03:01] Institute for Functional Medicine's AFMCP Training.

[00:03:15] Studying Chinese medicine.

[00:09:58] Service in the US Navy.

[00:13:30] Dr. Kirk Parsley; Podcasts: 1. How to Get Perfect Sleep with Dr. Kirk Parsley, MD; 2. Sleep To Win: How Navy SEALs and Other High Performers Stay on Top.

[00:14:27] Saying no to Big Pharma; The problem with statins.

[00:17:14] Ancestral Health Symposium.

[00:20:20] James Nestor; Book: Breath: The New Science of a Lost Art; Podcast: How to Fix Your Breathing to Improve Your Health.

[00:21:06] Todd Becker; Podcast: Getting Stronger; AHS Talk: Desirable Difficulties: Using Hormesis to Learn More Effectively - Todd Becker (AHS21).

[00:23:20] Mickey Trescott; Podcast: Autoimmune recovery with Mickey Trescott.

[00:26:22] Book: The End of Alzheimer's, by Dale Bredesen.

[00:28:41] Medical problems faced by knowledge workers.

[00:31:13] International Society for Environmentally Acquired Illness (ISEAI).

[00:34:37] Books: It Starts with Food and The Whole30, by Melissa Hartwig Urban and Dallas Hartwig.

[00:36:39] Paul Saladino: The Carnivore Code; Podcast: Fundamental Health Podcast.

[00:40:23] Book: Natural Causes by Barbara Ehrenreich.

[00:42:56] Why Gabriel continues to bill insurance.

[00:44:34] Podcast: The Community Cure: Transforming Health Outcomes Together, with James Maskell. Book: The Community Cure.

[00:45:31] Evan Hirsch's Virtual MD course.

[00:47:48] Work with Gabriel Niles in Los Angeles, CA.

Evan Hirsch, MD, is a world-renowned fatigue expert and the Founder & CEO of the International Center for Fatigue. Through his best-selling book, podcast, and online programs, he has helped thousands of people around the world boost their energy naturally, and is on a mission to help a million more. He has been featured widely on television, podcasts, and summits.

On this podcast, Evan discusses the many different causes of fatigue and his 4-step process for treating it. He shares details about his Fix Your Fatigue program, which has identified 10 different causes of fatigue - and Evan notes that everyone has multiple causes. To complicate things further, everyone has different multiple causes, so no one treatment works for everyone. Evan shares resources for identifying the causes of your fatigue and simple steps you can take to improve your energy levels today.

[00:00:20] Gabriel Niles, MD introduced us at the Ancestral Health Symposium.

[00:00:41] How Evan became interested in medicine and fatigue.

[00:02:28] Book: Fix Your Fatigue: The four step process to resolving chronic fatigue, achieving abundant energy and reclaiming your life!, by Evan H. Hirsch MD.

[00:04:29] Viruses that can be transmitted that can end up triggering fatigue.

[00:06:21] How to know if you have an abnormal level of fatigue.

[00:08:16] Book: This Is Your Mind on Plants, by Michael Pollan.

[00:08:41] Surviving on caffeine.

[00:09:48] Different levels of fatigue (levels based on treatment needed).

[00:11:22] Toxicities that we're exposed to that need to be removed to alleviate fatigue.

[00:11:54] 4-Quadrant Model.

[00:12:58] Best diets for fixing fatigue.

[00:14:14] Mike T. Nelson; Course: Flex Diet Foundations.

[00:14:53] 4-step process: 1. assess causes 2. replace deficiencies 3. opening detox pathways 4. remove toxicities.

[00:17:19] Adrenals, mitochondria, thyroid - the "Big 3" factors that help restore energy.

[00:21:42] "Detox"; Herbal products + external therapies.

[00:24:42] Mold exposure and toxicity.

[00:28:51] Article: Your building might be making you sick. Joe Allen can help., by Colleen Walsh.

[00:30:12] Great Plains Urine MycoTOX Profile to evaluate for mold exposure/toxicity.

[00:31:16] Environmental Relative Moldiness Index (ERMI) test - evaluates mold in the environment. Find a professional.

[00:31:46] What to do if you have mold exposure: binders, supplements to remove toxins.

[00:32:54] Heavy Metals and infections.

[00:33:37] COVID long-haulers or post-acute syndromes.

[00:35:24] Using symptoms to diagnose conditions.

[00:36:01] Bartonella quiz on the www.FixYourFatigue.com website.

[00:37:49] Podcast: How to Prevent and Heal Lyme and Its Co-Infections, with Sunjya Schweig, MD.

[00:38:13] Herbal antimicrobials vs antibiotics.

[00:38:33] Results page of Evan's website.

[00:42:30] Book: Cure: A Journey into the Science of Mind Over Body by Jo Marchant.

[00:47:18] Electromagnetic Fields; Previous podcasts on EMF: Electromagnetic Fields (EMFs): The Controversy, the Science, and How to Protect Yourself, with Joseph Mercola, DO; EMFs: Why You Should Care and What to Do, with Nick Pineault.

[00:51:52] Safe Sleeve cases and other ways to mitigate EMFs.

[00:52:41] LessEMF.com.

[00:54:05] How to know if your fatigue can be helped.

[00:55:38] Find Evan at www.FixYourFatigue.com; Facebook group; Schedule a free discovery call.

Jim Stray-Gundersen, MD is a world-renowned expert in Sports Medicine, Exercise Physiology and Training for Sport Performance. Drawing from his lifetime of experience with elite level athletes and clinical populations, Jim developed and co-founded the B Strong Training System using Blood Flow Restriction (BFR). The system works by applying cuffs to the arms and legs to temporarily restrict venous return without occluding arterial inflow. Put simply, blood flow restriction prompts an outsize response from the brain to speed up the normal process of repairing and rebuilding damaged tissue with lighter weight and a reduced risk of injury compared to traditional weight lifting. Jim predicts the B Strong Training System will change how the world gains the benefits of exercise, improving longevity and quality of life.

On this podcast, Jim discusses the important difference between the B Strong system and other BFR devices on the market, and answers questions about application and safety when training with blood flow restriction. He talks about how athletes and like-minded people are using BFR and shares some common user errors and ways to avoid them. Jim also describes his new professional training course available to anyone interested in learning more about the theory and application of BFR. Or - even better - for the next 14 days you can get the B Strong BFR Training System for 20% off using the code Kelly20. 

[00:00:10] Jim's previous appearance on the NBT podcast: Blood Flow Restriction Training for Improved Strength, Performance, and Healthspan.

[00:00:28] B Strong Blood Flow Restriction (BFR) training system.

[00:00:41] Dr. Steven Patterson; Podcast: Blood Flow Restriction Training: Science and Application.

[00:01:08] Blood flow restriction: elastic vs. rigid devices.

[00:05:04] Study: Patterson, Stephen D., et al. "Blood flow restriction exercise: considerations of methodology, application, and safety." Frontiers in physiology 10 (2019): 533.

[00:05:09] Johnny Owens, founder of Owens Recovery Science.

[00:09:19] Question regarding the potential for endothelial damage; Study: Credeur, Daniel P., Brandon C. Hollis, and Michael A. Welsch. "Effects of handgrip training with venous restriction on brachial artery vasodilation." Medicine and science in sports and exercise 42.7 (2010): 1296.

[00:13:10] Olympic athletes using BFR training: Sifan Hassan (Netherlands), Galen Rupp (USA), Kate Grace (USA), Mikaela Shiffrin (USA).

[00:14:52] How athletes are using the BFR system.

[00:17:24] B Strong BFR training course for both BFR users and professionals.

[00:21:37] Common errors and things to avoid with BFR.

[00:25:17] Delayed onset muscle soreness.

[00:27:38] Frequency of workouts and habit building.

[00:31:40] Get the B Strong system using the 20% off discount code Kelly20, good for 2 weeks after podcast airs.

Ben Greenfield is a human performance consultant, speaker, and New York Times bestselling author of 13 books, including the popular titles “Beyond Training”, “Boundless” and “Fit Soul”. Former collegiate tennis, water polo, and volleyball player, bodybuilder, 13-time Ironman triathlete, and professional obstacle course racer, Ben has been voted by the NSCA as America’s top Personal Trainer and by Greatist as one of the top 100 Most Influential People In Health And Fitness. In 2014, my NBT co-founder and medical doctor Jamie Kendall-Weed and I appeared on the Ben Greenfield podcast, and to this day people tell me that’s how they learned about Nourish Balance Thrive. 

​For this podcast, Ben and I met up on the UCLA campus during the Ancestral Health Symposium in August to walk and talk about the harmful effects of loneliness and the importance of social connection. Ben shares some of the innovative ways he’s increased connection with others, despite being a self-proclaimed introvert. We talk about some of the downsides of social isolation and the best reasons for opening yourself up to the “messiness” of others. 

[00:01:48] Previous podcasts with Ben Greenfield featuring Christopher Kelly: Why Is My Cortisol High Even Though I’m Doing Everything Right? Hidden Causes Of High Cortisol, The DUTCH Test & More!, The Little-Known Test That Tells You Everything You Need To Know About Your Metabolism, and 7 Signs Your Cortisol And Adrenals Are Broken.

[00:03:21] James Nestor; Podcast: How to Fix Your Breathing to Improve Your Health.

[00:03:27] Diana Rodgers; Podcast: Kale vs Cow: The Case for Better Meat.

[00:03:50] All the 2021 AHS videos are on YouTube.

[00:06:52] Book: Loneliness: Human Nature and the Need for Social Connection, by John T. Cacioppo.

[00:07:01] Book: Why Zebras Don't Get Ulcers: The Acclaimed Guide to Stress, Stress-Related Diseases, and Coping (Third Edition), by Robert M. Sapolsky.

[00:09:56] Book: The Martian, by Andy Weir.

[00:11:47] Introversion.

[00:12:00] Book: The WEIRDest People in the World: How the West Became Psychologically Peculiar and Particularly Prosperous, by Joseph Henrich.

[00:12:25] Recent podcast with Lucy Mailing, PhD: Rewilding the Gut: Restoring Ancestral Diversity to the Microbiome.

[00:13:53] Book: Quiet: The Power of Introverts in a World That Can't Stop Talking, by Susan Cain

[00:18:21] Loneliness is as bad for you as smoking; Study: ​​Dyal, Stephanie R., and Thomas W. Valente. "A systematic review of loneliness and smoking: small effects, big implications." Substance use & misuse 50.13 (2015): 1697-1716.

[00:18:49] Loneliness vs. social isolation.

[00:25:20] Book: Never Eat Alone, Expanded and Updated: And Other Secrets to Success, One Relationship at a Time, by Keith Ferrazzi.

[00:26:39] Mastermind Talks, created by Jayson Gaignard.

[00:27:34] Ben's dinner parties.

[00:33:04] Julian Abel, MD; Book: The Compassion Project: A case for hope and humankindness from the town that beat loneliness; Julian's Podcast: Survival of the Kindest.  Listen to Julian's most recent interview on the NBT Podcast.

[00:35:40] Opening yourself up to the messiness of other people.

[00:38:38] Ben’s article on the dopaminergic response while experiencing pain or pleasure with others.

[00:39:40] Book: Friendship in the age of loneliness: An Optimist's Guide to Connection, by Adam Smiley Poswolsky.

[00:40:40] Contacts+.

[00:42:26] Community events; Realm Church Management Software.

[00:48:23] Ben's expanded spiritual practice.

[00:52:34] Books by Jamie Wheal: Stealing Fire and Recapture the Rapture.

[00:53:13] Book: The Immortality Key: The Secret History of the Religion with No Name, by Brian C. Muraresku.

[01:01:59] Church and the monogamous nuclear family.

[01:11:05] Eye gazing.

[01:14:44] See Ben’s show notes for this recording.

[01:15:52] Join the NBT Elite Performance Club Forum by supporting NBT on Patreon.

Throughout 2021 we’ve had hundreds of people try out our bloodsmart.ai software within the format of our monthly group program. We’ve met clients from all walks of life – some athletes, some not – but most want the same things: to feel better now and to preserve healthspan later. Over the years – and especially more recently after racing was cancelled – my own goals have also shifted from athletic performance, instead landing on what needs to be done to maximise healthspan – that is the period of life spent in good health, free from the chronic diseases and disabilities of ageing. Talking each week to others with the same goals has become a highlight of my work week...

On this podcast, NBT Scientific Director and coach Megan Hall and I are discussing my latest blood chemistry results and bloodsmart.ai report. I was pleased with my results a couple of years ago when my Overall Wellness Score reached a perfect 100. This time around, however, there’s room for improvement, and Megan offers her usual excellent advice.

If you’d like to get a blood test + a bloodsmart.ai report along with a series of group coaching sessions with Megan and me, we can arrange that for you. The coaching sessions take on a format much like this podcast, with individual reports reviewed and advice for a path forward described in detail. Be sure to follow along with this episode with Megan’s detailed outline.

[00:00:25] Podcasts featuring Brianna Stubbs, PhD: 1, 2, 3, 4.

[00:02:29] Christopher Kelly’s combined bloodsmart.ai report. 

[00:02:58] Overall Wellness Score; Horne paper: Anderson, Jeffrey L., et al. "Usefulness of a complete blood count-derived risk score to predict incident mortality in patients with suspected cardiovascular disease." The American journal of cardiology 99.2 (2007): 169-174.

[00:03:25] Health Assessment Questionnaire.

[00:04:36] Why to get a blood test when you're feeling good.

[00:12:21] Wellness Score and PhenoAge; Podcast: How to Measure Your Biological Age, with Megan Hall.

[00:13:54] Individual input markers.

[00:14:42] Podcasts: Why You’re Probably Not Eating Enough Protein (How to Know for Sure), with Megan Hall; Protein vs. Energy for Improved Body Composition and Healthspan, with Ted Naiman, MD; Why We Get Sick: The Hidden Epidemic at the Root of Most Chronic Disease and How to Fight It, with Ben Bikman, PhD.

[00:15:55] Protein requirements: 1.6g protein per Kg of body weight.

[00:17:12] Rhonda Patrick’s podcast with Ashley Mason: Dr. Ashley Mason On Drug-Free Approaches For Treating Depression, Insomnia, And Overeating | Found My Fitness With Dr. Rhonda Patrick.

[00:19:44] Podcast: Blood Chemistry in Athletes, with Tommy Wood, MD, PhD.

[00:21:02] Thorne Multi-Vitamin Elite.

[00:21:54] Supplements Megan is most likely to take: Magnesium and creatine (with Creapure).

[00:24:45] Iron panel and blood donation; DIY therapeutic phlebotomy.

[00:27:17] Podcast on iron overload:  Iron overload and the impact it can have on performance and health, with Dr. Tommy Wood; “Bronze Diabetes” paper: ROOT, HOWARD F. "Insulin resistance and bronze diabetes." New England Journal of Medicine 201.5 (1929): 201-206.

[00:28:46] Protein:Energy (PE) Ratio; Book: The PE Diet: Leverage your biology to achieve optimal health, by Ted Naiman.

[00:38:04] Podcast: How to Go Faster and Feel More Energetic By Addressing Anaemia and Increasing Oxygen Deliverability.

[00:43:25] Zinc deficiency makes RBC membranes more fragile; Study: O'Dell, Boyd L., Jimmy D. Browning, and Philip G. Reeves. "Zinc deficiency increases the osmotic fragility of rat erythrocytes." The Journal of nutrition 117.11 (1987): 1883-1889.

[00:45:06] bloodsmart.ai forecasts.

[00:45:45] Previous podcast talking about bloodsmart.ai and forecasts: You Literally Bled for That Data. Now What? and How to Use Biomedical Testing to Find Problems Inside Your Body.

[00:50:28] Lead and toxic metals overload.

[00:51:23] The negative impacts of lead on both nervous and renal systems are obvious at a blood lead concentration of 2 μg/dL; Study: Shefa, Syeda T., and Paul Héroux. "Both physiology and epidemiology support zero tolerable blood lead levels." Toxicology letters 280 (2017): 232-237.

[00:53:19] Supporting detoxification.

[00:55:00] Iodine and sea vegetables; Maine Coast granulated sea vegetables.

[00:57:29] Summarizing action items.

[00:58:01] Eat more food!  RED-S; Podcast: How to Identify and Treat Relative Energy Deficiency in Sport (RED-S), with Nicky Keay.

[01:02:08] Vitamin D; Chris Masterjohn's Presentation on COVID-19 at AHS and article on Vitamin D and COVID-19: The Current State of the Evidence.

[01:04:55] Megan's outline for this podcast 

[01:05:11] Join a bloodsmart.ai group program to get a blood test, bloodsmart.ai report, and group coaching sessions with Megan Hall.