The Long Game | Dr Alex

You can throw out your salt shaker completely and your blood pressure can still barely move three months later. That is not you doing something wrong. It usually means something underneath your diet has been pushing that number up for years.

In this episode I go through five things that keep blood pressure high even when someone's diet already looks fairly sensible: where most of your salt actually comes from and the mineral that is missing alongside it, the hormone problem that runs quietly for years before anyone mentions diabetes, what ultraprocessed food does to your vessels beyond the salt it contains, the type of exercise that moves the number more than people expect, and the stress and sleep side of things, which I personally find hardest.

The full list of research references for this episode is in the description of the YouTube version.

Disclaimer: This is not personal medical advice and does not override what your doctor says.

#dralex #bloodpressure #preventativehealth

After my last video on B12 deficiency, thousands of you said you recognised the symptoms, and hundreds told me your test came back normal while you still felt unwell.

So this video is a proper follow up. I go through five things you can actually do if you think you might be deficient, starting with whether you have a genuine risk factor in the first place, such as age over 50, acid suppressing medication, metformin, nitrous oxide use, gut conditions like coeliac or Crohn's, or a diet with little or no animal products.

Then I walk through the handful of symptoms that matter most and explain what is actually happening in your body for each one, from fatigue and breathlessness to tingling in your hands and feet, balance problems, and changes to thinking or mood.

I also explain the testing pathway as it works in the UK and the US, why the standard blood test can miss a real deficiency, what the indeterminate zone means, and when tests like MMA or active B12 come into play.

Finally I cover tablets versus injections, what the evidence actually says about each, and what I would honestly do if I were in your position trying to get this taken seriously by a doctor on a busy Tuesday morning.

The full list of research references is in the description of the YouTube version.

Disclaimer: This is not personal medical advice and does not override what your doctor says.

#dralex #B12deficiency #preventativehealth

Your gut lining is rebuilt from scratch every few days, which means the food in your basket this week genuinely becomes the material your gut is made from next week.

In this episode I go through the 12 foods that make it into our shopping basket every single week, from tinned sardines and extra virgin olive oil to kefir, sauerkraut, oats, tinned pulses, frozen berries, leafy greens, broccoli, walnuts, garlic and onions, and ground flax seed.

I talk through what each one is actually doing once it reaches your gut, how that connects back to inflammation elsewhere in your body, and how we actually use these foods at home day to day.

The full list of research references is in the description of the YouTube version if you want to look into any of it further.

Disclaimer: This is not personal medical advice and does not override what your doctor says.

#dralex #guthealth #antiinflammatory

High cholesterol on a blood test and told to just cut back on fat and come back in six months? That advice misses almost everything that actually matters.

In this episode I walk through the one number on your blood test that really counts, LDL cholesterol, and why a high HDL does not cancel it out.

I also cover the portfolio diet, the combination of plant sterols, soluble fibre, plant protein and nuts that has been shown to bring LDL down by around 30 percent in research trials, plus the one simpler swap that does most of the work if that feels like too much all at once.

We get into the egg question properly, why your liver makes far more cholesterol than you could ever eat, and what is really happening inside your liver when you swap saturated fat for polyunsaturated fat.

I explain why going low fat often backfires when the fat gets replaced with refined carbs instead, and what a realistic two week plan looks like before you get retested.

The full list of research references is in the description of the YouTube version.

Disclaimer: This is not personal medical advice and does not override what your doctor says.

#dralex #cholesterol #nhs

A lot of you sent me the same podcast clip recently, where a well known nutrition professor says the protein guideline is plenty and the whole obsession with eating more is overblown. He is right about quite a bit of it. Protein deficiency barely exists in Britain or America. Protein shakes and bars are mostly just marketing. You can get everything you need from whole food, plants included.

Here is where I still disagree. The official number was built to stop an average, largely sedentary population from becoming deficient. It was never designed to be the amount you aim for if you actually want to stay strong as you get older.

Your body has nowhere to store spare protein. Eat more than you use and your liver just strips it down and either burns it or turns it into fat. So protein only does its job when there is somewhere for it to go, and that somewhere is exercise. Strength work at least twice a week, carrying your own shopping, getting off the floor without help well into your eighties. That is the target worth building towards.

If you are training regularly, somewhere around 1.2 to 1.6 grams per kilo of body weight, coming from eggs, beans, fish, nuts and a sensible amount of meat, is a reasonable thing to aim for. If you are not moving much at all, sort that out first before worrying about the number.

One caveat worth repeating here. If you have any degree of reduced kidney function, this is a conversation to have with your own doctor before changing anything, not something to do off the back of a podcast.

The full list of research references for this episode is in the description of the YouTube version.

Disclaimer: This is not personal medical advice and does not override what your doctor says.

#dralex #protein #health

Three minutes a day, split into three short bursts, is all it takes to work the muscles that quietly hold you upright every time you stand up, carry the shopping or reach into a cupboard.

A plank trains the deep muscles wrapping around your middle rather than the ones you see in the mirror, and that is exactly why it matters so much as you get older.

In this video I go through what a plank actually does to your blood pressure, your balance and your chances of a fall, what it does for a lower back that keeps aching, and how to build up to it if you cannot hold one for more than a few seconds right now.

I also show a simple variation at the end that turns this from a basic core hold into something much closer to a proper workout.

The full list of research references for this video is in the description of the YouTube version.

Disclaimer: This is not personal medical advice and does not override what your doctor says.

#dralex #planking #corestrength

Eight hours is probably the most repeated number in sleep health, yet so many people hit it every night and still wake up exhausted. That number was never a personal target. It is simply the middle of a range, and it only ever measures how long you lie in bed, not how much actual sleep your brain gets.

In this episode I break down what really determines sleep quality. Deep sleep is loaded into the first half of the night and handles physical repair, while REM sleep builds through the second half and processes emotion and memory. Losing time from either end costs you very different things, even if the hours lost look the same on paper.

I also talk through sleep efficiency, why sleep apnoea so often goes unnoticed, why alcohol wrecks the second half of your night, and why a large UK Biobank study found that sleep regularity predicted risk of death more strongly than sleep duration did. I cover caffeine timing, morning light, restless legs, and why cognitive behavioural therapy for insomnia is recommended ahead of sleeping tablets.

This episode is sponsored by Somnipods, the earbuds I have been using myself to deal with noise disruption overnight.

The full list of research references is in the description of the YouTube version of this video.

Disclaimer: This is not personal medical advice and does not override what your doctor says.

#dralex #sleephealth #nhsdoctor

Your leg muscles are often the first to weaken as you get older, usually because of years of sitting more and moving less. What you eat plays a direct role in how much of that muscle you keep.

In this episode I go through seven foods that help protect your leg muscles as you age, including eggs, oily fish, dairy, lean red meat, beetroot and leafy greens, pulses, and extra virgin olive oil, and why the timing and quality of your protein matters just as much as the amount.

The full list of research references for this episode is in the description of the YouTube version.

Disclaimer: This is not personal medical advice and does not override what your doctor says.

#dralex #muscle #nutrition

Here are seven foods I try to avoid as a doctor, and what I eat instead. Processed meat, sugary drinks, sweetened breakfast cereal, anything deep fried, alcohol, protein bars and sliced white bread all come up often in conversations with patients, so I wanted to explain what is actually happening in the body with each one and the swaps I make in my own kitchen.

This is not about judging the odd treat here and there. It is the pattern of the same choice repeated thousands of times over years that raises the risk of disease. Small daily swaps add up in the same way.

The full list of research references is in the description of the YouTube version.

Disclaimer: This is not personal medical advice and does not override what your doctor says.

#dralex #preventativehealth #nhsdoctor

Your thyroid gets blamed for a lot of stubborn weight gain, and sometimes that blame is fair. But very often someone is sent away with a normal blood test and told their thyroid is fine, with no explanation for how they actually feel.

In this episode I go through what your thyroid actually does, what changes when it runs slow or fast, what a normal result on your test really means, and what tends to be going on when your results are fine but the weight still will not shift.

A normal thyroid test is good news on its own, but it is only one piece of the picture. When it comes back clear, that should be the start of a proper conversation about what else might explain your symptoms, not the end of one.

I also talk through why a properly underactive thyroid usually explains a few kilos rather than several stone, and why so much of what people assume is fat is actually fluid building up under the skin. For a lot of people, the bigger drivers sit elsewhere, in food quality, movement, sleep and stress, and none of that is said to make anyone feel guilty.

The full list of research references for this episode is in the description of the YouTube version.

Disclaimer: This is not personal medical advice and does not override what your doctor says.

#dralex #thyroidhealth #weightloss