131. Dr. Elizabeth Yurth: The Science of Ketones, Hormones, and Faster Recovery

Most people assume joint pain, fatigue, and limited mobility are inevitable with age. But what if protecting your joints, optimizing recovery, and maintaining energy were about targeting the right systems early, rather than treating symptoms later? In this episode of Extend, we sit down with Dr. Elizabeth Yurth, co-founder and chief medical officer of the Boulder Longevity Institute and a Stanford-trained sports and spine physician. With over 30 years of experience merging orthopedic expertise with longevity science, Dr. Yurth brings a unique perspective on preventing joint degeneration, accelerating healing, and supporting long-term metabolic and musculoskeletal health. We talk about why most arthritis isn't caused by overuse, how the MEAT protocol replaces traditional approaches to injury, and why peptides, ketones, and regenerative therapies can dramatically improve recovery and joint function. We also explore strategies to protect joints before pain begins, maintain mobility over decades, and optimize overall energy and performance. What We Discuss: (00:00) Why Joint Pain, Fatigue, and Brain Fog Are Not Inevitable (05:38) How Ketones Optimize Mitochondrial Function and Energy Production (12:05) Hormone Balance for Joint, Bone, and Muscle Health (19:42) Reducing Inflammation and Activating Stem Cells Naturally (26:18) How Pentosan Polysulfate Can Regenerate Cartilage and Protect Joints (33:50) Blood Flow Restriction, Red Light Therapy, and Recovery Tools (40:27) Practical Strategies for Metabolic Flexibility and Long-Term Healing (48:15) Common Mistakes in Hormone Replacement and Nutritional Optimization Thank You to Our Sponsors: Function Health: Learn more and join using my link. Visit www.functionhealth.com/drshah http://www.functionhealth.com/drshah and use gift code DRSHAH25 for a $25 credit toward your membership. Vitaboom: Vitaboom: For supplements you can trust and wellness solutions tailored to your health, visit https://vitaboom.com/ Learn more about Dr. Shah: Website: https://www.drshah.com/ Clinic: https://www.next-health.com/ Instagram:@darshanshahmd https://www.instagram.com/darshanshahmd/ Learn more about Dr. Elizabeth Yurth:: Instagram: Dr. Elizabeth Yurth https://www.instagram.com/dryurth/ @boulderlongevity https://www.instagram.com/boulderlongevi Linkedin: Elizabeth Yurth, MD, ABAARM, FAARM, FAARFM https://www.linkedin.com/in/elizabeth-yurth-md-abaarm-faarm-faarfm-5745217a/ Boulder Longevity Institute: https://boulderlongevity.com/ Human Optimization Academy: https://bli.academy/ Youtube: https://www.youtube.com/@boulderlongevityinstitute https://www.youtube.com/@dryurth Facebook: https://www.facebook.com/BoulderLongevityInstitute https://www.facebook.com/elizabeth.yurth.3

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:03Dr. Darshan Shah?

  Welcome to Extend with me, Dr. Darshan Shah, a podcast dedicated to cutting-edge science, research, tools, and protocols designed to help you extend your health span. Having become one of the youngest doctors in the country at the age of 21 and trained and board certified at the Mayo Clinic, I've accumulated three decades of practice as a board-certified surgeon and longevity expert. Over that time, I've discovered that a mere 20% of health knowledge yields 80% of the results when it comes to your health span. We're living in a new era where we are creating a new healthcare system, no longer focused on disease management, but achieving optimal health and vitality. Join me as I interview world-renowned experts, offering you a step-by-step guide to proactively avoid disease and, most importantly, extend your health span.

• 0:49Dr. Darshan Shah?

  Today, we're going to be diving into one of the most overlooked pillars of longevity, your joint health. We talk so much about brain and heart health, but if you're living with chronic pain, it really doesn't matter how long you live. Life just won't feel good. Our guest today is one of my favorite people, Dr. Elizabeth Yurth. She's a leading expert in regenerative and cellular medicine. She's a co-founder and chief medical officer of the Boulder Longevity Institute and a Stanford-trained sports and spine physician, and she has spent over 30 years merging orthopedic experience with cutting-edge longevity science. In this episode, Dr. Yurth is going to break down why most arthritis isn't caused by overuse, and why N says after an injury can actually slow your healing, how her protocol, the meat protocol, is replacing the rice

• 1:34Dr. Darshan Shah?

  protocol, and the real science behind peptides, ketones, and early prevention. If you want to stay active and you want to stay pain-free and mobile for decades, this conversation is completely packed with tools that can truly change the way you age.

• 1:53Dr. Darshan Shah?

  Hey everyone. Before we dive into today's episode, I want to talk about something that you hear me talk a lot about, your biomarkers. And I want to tell you how I'm approaching this situation right now with all of the patients that are calling me from listening to this podcast. So what happens is every day, patients are writing to me saying they feel exhausted, they can't lose weight, they're having brain fog, and they see their doctor, and the doctor tells them all their blood work is normal. But the problem is this doctor usually is only checking about 10 to 15 biomarkers. It only tells you if you have a disease developing. Meanwhile, your body has 160 different systems that are running. Then all of these have blood tests that we can test on how effective they're working for you every single day. So if someone is not close to one of my clinics, one of my next self-clinics,

• 2:37Dr. Darshan Shah?

  then I tell them, go to their local laboratory and get on Function Health. Function Health gives you access to 160 different biomarkers, the same kind of comprehensive testing that we do at all of our next self-clinics. And if you try to get this on your own through your regular doctor, it can cost you thousands of dollars. Hormones, inflammation, toxins, nutrient levels, they're all tracked over time in this one platform called Function Health. They can even help you get an MRI scan or a CT scan if you want one. So what I love most about this company is that they don't have a crazy incentive to do this. Function doesn't push supplements, they don't have pharmaceuticals they're trying to get you to take. You're just getting the data, and you're getting insights from the data. And you can bring this data to a clinic like ours,

• 3:21Dr. Darshan Shah?

  and we then have the information that we need to tell you how to improve your health. Membership is now only $365 a year. Literally, it's just a dollar a day. And right now, if you're one of my listeners, you can get a $25 credit towards the membership. You just go to the link in the bio or go to functionhealth.com/DrShaw and use the code DRSHAW25 for a $25 credit towards your membership.

• 3:49Dr. Darshan Shah?

  Dr. Yerth, thanks so much for joining me today.

• 3:52Speaker 01

  Dr. Shahn, thank you for having me.

• 3:54Dr. Darshan Shah?

  Yeah, all the way from Boulder.

• 3:55Speaker 01

  All the way from Boulder, Colorado. Well, I have to say, I went from here to Buck Institute, Northern California, then Buck Institute to here. So I didn't have to, I only had a 55.

• 4:02Dr. Darshan Shah?

  I know. I'm just so excited that you're here because I've been trying to get you here in the studio for such a long time.

• 4:09Speaker 01

  You and I have known each other for a while now, so it's an honor, honestly, to be here.

• 4:12Dr. Darshan Shah?

  And I've learned so much from you. So for the listeners, we're on a WhatsApp group of longevity-focused doctors.

• 4:19Speaker 01

  Right.

• 4:19Dr. Darshan Shah?

  And I could tell you without a doubt, one of the top three smartest people in that group is Dr. Yerth, who's here with us today.

• 4:25Speaker 01

  You give me too much credit, but thank you.

• 4:27Dr. Darshan Shah?

  No, definitely. And what I'll say is, you know, you have such an incredible range of topics that you can talk about. So I initially had 100 different questions for you and 100 different topics. And I'm so glad I asked you. Like, I think we need to focus in on one thing today. And to me, which is something I've learned a lot from you actually about, is how we're completely rethinking the model around pain today, right? It is so different than what I learned in medical school.

• 4:54Speaker 01

  Yeah.

• 4:55Dr. Darshan Shah?

  It's mind-blowing to me.

• 4:56Speaker 01

  It's mind-blowing. And, you know, Dr. Shahn, well, one of the things that concerns me, and it was funny because I was just at this conference. It was all these researchers, right, doing all this very cool stuff in longevity. And I was sitting at breakfast with this guy who was actually developing some orthopedic stuff. And he said, you know, why is nobody at these conferences ever talking about orthopedic stuff and joints? Aside from you hear about stem cells and things like that, obviously. So that gets out there. People all know about stem cells and platelet cells for joints. But those are actually really not the answer to joint pain and chronic pain. So it's a really neglected area in our field. I mean, how many of these conferences do we go to, right? And how many do you see people talking about joints and how joints are going to impact our longevity?

• 5:39Dr. Darshan Shah?

  Right. I mean, it's a massive piece of our health span, of our longevity.

• 5:44Speaker 01

  And our happiness.

• 5:45Dr. Darshan Shah?

  Our happiness, right, being able to move.

• 5:47Speaker 01

  Right. No, I know, it's really, you know, honestly, until you're kind of, I tore my rotator cuff about two years ago. I had surgery, I was a full rotator cuff, I did a lifting, had surgery, but, you know, it was great for a little while. That just didn't do well.

• 5:59Dr. Darshan Shah?

  Right.

• 5:59Speaker 01

  I re-injured it and it didn't do well. And so I've had this chronic shoulder pain. And you know, you think, oh, it's just a little chronic shoulder pain, but it really has so impacted my life. I mean, everything is harder. Getting dressed is harder, right?

• 6:10Dr. Darshan Shah?

  Yeah.

• 6:11Speaker 01

  Putting on sports bras is like impossible.

• 6:13Dr. Darshan Shah?

  Right.

• 6:15Speaker 01

  Just putting on all these things. And so you start looking at people who are dealing with this stuff. You know, in much more severe natures lots of times and that they kind of lose the desire to want to live forever, even if they've got a great heart and a great brain and everything else, it becomes not very fun.

• 6:30Dr. Darshan Shah?

  Absolutely. You know, my story is very similar. Like I was doing surgery for 20 years. 20 years I was holding up retractors with my arms, right?

• 6:38Speaker 01

  Right.

• 6:38Dr. Darshan Shah?

  And it caused little micro tears in the tendons of my rotator cuff, which over time made my life miserable. I couldn't ski anymore. I didn't want to lift anymore in the gym.

• 6:48Speaker 01

  Stress to go, yeah.

• 6:51Speaker 01

  But it's really so hard.

• 6:52Dr. Darshan Shah?

  Right, right. And I think like with everything with Western medicine, we just kind of wait for things to really break down before we go in and do an intervention. So I had to have surgery, you know, and have my rotator cuff repaired. Was that?

• 7:03Speaker 01

  Did it fix it?

• 7:04Dr. Darshan Shah?

  It did fix it, yeah. But it was, you know, it was not an easy surgery. And I kept thinking to myself, like, why do we do this constantly? Especially like my mom has both of her knees replaced. She's going to get her hip replaced. And it's just like waiting and letting things progress to a bad place. And then, then we finally do an intervention.

• 7:21Speaker 01

  Right.

• 7:22Dr. Darshan Shah?

  And that intervention is usually surgical. It could be stem cells, but it's just really backwards, right?

• 7:26Speaker 01

  Right, exactly. So for your listeners' background, I came from background of orthopedics, right? So for, you know, 30 years practicing orthopedics and it really was, well, actually not 20 years ago. I started going, God, all I do is kind of patch people together and then they fall apart again. It was like, and you would do that over and over again. You stick a little steroid, you stick a little steroid in and finally you'd go, okay, well now we'll do a scope and okay, now we'll replace the joint. And that was everybody follow that path.

• 7:51Dr. Darshan Shah?

  Exactly.

• 7:52Speaker 01

  So I started to look at, can I do something different? Could I actually work with these people early on in the interview phase and impact their recovery much better? So I started thinking, okay, how can I use nutritions and hormones and other things that would benefit them? So I went back and started learning all this stuff, right? And I tried to incorporate that into my orthopedic practice where I, you know, in my 10 minute appointment, I try and go, oh, if we, you know, had you on the right hormones and the right nutrients. And that didn't go so well.

• 8:17Dr. Darshan Shah?

  I bet your ortho colleagues thought you were crazy.

• 8:19Speaker 01

  They did not like that at all. In fact, you know, at all. So, so I, I opened my longevity clinic 20 years ago now. You know, when you say I know a lot about everything, it's really simply time. I've been here so long.

• 8:28Dr. Darshan Shah?

  Right.

• 8:29Speaker 01

  So 20 years ago, but I did both. I had my orthopedic clinic because, you know, as you know, because I'm from the surgery world, it's a profitable world. I mean, you know, I, we had an MRI scan.

• 8:38Dr. Darshan Shah?

  Absolutely.

• 8:38Speaker 01

  Owned a surgery center. So you have all these things vested. So really, I kind of wore both hats for a long time. Where I was like, okay, I do orthopedics by day and I do along my longevity clinic by night.

• 8:48Dr. Darshan Shah?

  Right, right.

• 8:48Speaker 01

  And it really wasn't until about six years ago that I said, okay, I've got to coincide this all to one place. And so I left the orthopedic practice and, and, but as you said, my, the big sort of pushing point was when one of my orthopedic colleagues came to me and he goes, you know, you can't order labs anymore on people. Because we don't do medicine here. We do orthopedics.

• 9:07Dr. Darshan Shah?

  Oh, my gosh. You know, we followed the same journey. So, you know, 10 years ago is when I started learning about functional medicine, longevity medicine, and same thing. I was like telling my surgical patients what I'm doing to get healthy and they were cancelling their surgeries.

• 9:21Speaker 01

  Yeah.

• 9:21Dr. Darshan Shah?

  Everyone was like, what are you doing? You're getting them healthy? They're cancelling their surgery, not making any money off of this anymore.

• 9:26Speaker 01

  Right. It's not very, it's not, it's not profitable. Right, exactly. It's joint replacements, they're very profitable to replace a joint, right? Not so profitable to throw somebody out of your hormones and nutrients.

• 9:36Dr. Darshan Shah?

  Exactly, exactly. Yeah. So when you create a state of health, what happens is you avoid needing surgeries, prescription medications, et cetera. And it's not just for your joints, it's for every organ in your body.

• 9:47Speaker 01

  Right, exactly. So. But I think the joints get forgotten in this whole cascade, right? When we look at age-related diseases, they all, they all have similar mechanisms, right? They all are related to sort of a chronic inflammation mode, decline of immune function. So we, you know, lots of mitochondrial functions, the same things occurring in joints, but we forget that. So we're now, we're kind of treating, you know, somebody who has just had joint pain a little differently. And, you know, I think the big focus there is we need to catch people early on, right? You know, just like you're, once they've gotten to the point where they need surgery, yes, you can sometimes stop that. But if you could catch that person 10 years before when whatever started happening, the blood pressure started going, whatever, you know.

• 10:25Dr. Darshan Shah?

  Exactly.

• 10:26Speaker 01

  You know, and the same thing's true in, in the orthopedic world is we need to be addressing people day one of their injury. We need to be, you know, addressing people before the arthritis sets in or as soon as they start having joint problems and sort of intervening there and not waiting until the end game.

• 10:43Dr. Darshan Shah?

  Right, exactly. So on that topic. How does someone, when they're first noticing, like, maybe they're, for me, it was like a chronic injury over time, but some people, you know, a lot of people, they are skiing and they fall, they hurt themselves. What would you recommend people do instead of just like the traditional method of how we treat these injuries differently?

• 11:03Speaker 01

  So the first thing is, our bodies are actually designed to heal. We kind of, you know, orthopedic stuff, injuries are always concerned, you know, this kind of wear and tear. Oh, I just played too hard. I was a football player. And that actually is not, if you look at the people who really develop the worst arthritis, it's the most sedentary people. It's people who are not moving. It's not the football players. So even though you get these injuries, now, injuries certainly compound the problem because they create this big inflammatory state. But in the best of worlds, we resolve that inflammatory state, we go on to heal. So why don't we? I mean, why can, you know, one football player go on and, you know, get an injury and then come back and play and another football player is debilitated by it forever?

• 11:38Dr. Darshan Shah?

  Right.

• 11:39Speaker 01

  And they have to quit their, quit playing. So there's a big difference in healing and that has to do with what baseline levels you're at, right?

• 11:47Dr. Darshan Shah?

  Right.

• 11:47Speaker 01

  So like you, for your chronic micro tears in rotator cuff, and you were this busy surgeon, you're doing all this stuff and you look at, you know, what were your hormones doing? What kind of nutrient levels did you have? What were your vitamin D levels? Those are all things that need to be looked at very early on, as soon as somebody has a nagging injury, because there's a reason the nagging injury is not, your body's not recovering it. And it's because your body's not getting out of this inflammatory state.

• 12:12Dr. Darshan Shah?

  Right.

• 12:12Speaker 01

  There's a lot of reasons for that, right? Maybe you're eating a crappy diet, maybe you're not sleeping enough, maybe you have no hormones on board, or suboptimal hormones on board, maybe you're missing vitamin D or vitamin C, or, you know. So, so those are kind of the first things. But I think that, that there's sort of other simple things that when, you know, as soon as you, you notice an injury, we have to, what is our tendency to, as soon as we have an injury, our first tendency is we just pound a lot of ibuprofen.

• 12:37Dr. Darshan Shah?

  Yeah.

• 12:37Speaker 01

  Well, remember that that's, that first time, when we first get this injury, our body is designed to create this inflammatory response.

• 12:45Dr. Darshan Shah?

  Right.

• 12:45Speaker 01

  So there's all this data now, that if you take an anti-inflammatory drug when you first have an injury, that you actually markedly increase the likelihood that that injury is going to be chronic.

• 12:57Dr. Darshan Shah?

  Wow.

• 12:58Speaker 01

  Because you shut down that inflammatory response that we want. That's what brings in all these growth factors. That's what brings in all these things. They're gonna say, okay, let's start healing this joint. So for at least the first three days after you have an injury, you really need to try and stay away from anti-inflammatory drugs.

• 13:12Dr. Darshan Shah?

  Oh, man, that's such a game changing new thought. Like, everyone does that. The minute you're injured, you pop, you try to reduce the inflammation as much as possible.

• 13:21Speaker 01

  It's your natural, you know, it hurts. So you want to do that.

• 13:24Dr. Darshan Shah?

  Right.

• 13:24Speaker 01

  But it's the same thing. The reason we have a fever when we get sick. It's our body's inflammatory response. It's actually a good thing. Unless your fever goes super high, it's actually better to just let your fever run. It's your body's response to the illness. The same thing happens with this inflammatory state.

• 13:37Dr. Darshan Shah?

  Yes.

• 13:38Speaker 01

  So the goal is try and let that inflammation. So try and treat the, the, try and reduce the symptoms using other things, using red light, using other modalities, using peptides.

• 13:48Dr. Darshan Shah?

  Right, I mean, I think like, you know, people take the Advil because, I mean, some of it's to reduce pain, but also a lot of people just take it because they're been taught that the science tells us you want to reduce the inflammation.

• 13:58Speaker 01

  Yeah.

• 13:59Dr. Darshan Shah?

  And the reality is the exact opposite is what we need, right?

• 14:02Speaker 01

  Yeah, this whole concept, in fact, even the guy who came up that whole rice protocol.

• 14:05Dr. Darshan Shah?

  Yeah, like rice.

• 14:06Speaker 01

  Rest, ice, compression, elevation, right? And that's what we still all follow. Everybody's like, okay, rice, rest, ice, compression, elevation. Even the guy who first developed said, you know, I think I was wrong. And so now we actually advocate what's called the meat protocol.

• 14:17Dr. Darshan Shah?

  Uh huh, what's that?

• 14:18Speaker 01

  So that's motion. So you want to not stop moving.

• 14:21Dr. Darshan Shah?

  Okay.

• 14:21Speaker 01

  Right, so I hurt my ankle, I should keep passively moving it, right? I need to keep motion going. That's gonna get blood flow to the area. What does blood have? It has all of these healing elements to it, right? So, and then you actually want to keep exercising. So our tendency is you hurt yourself, you lay around for a few days, right? Really, you, and you know, you're not gonna go jump around and you're spraining ankle, but you're gonna get to the gym and work your upper body. You're going to get on the bike with one, your one leg, you're gonna keep moving. So with the motion and exercise are actually really key factors. And the people who do that, who keep moving and who exercise, who don't stop exercising, will heal about twice to three times as fast as someone who doesn't do that, who just goes to bed and sits up with their ankle up for three days, right?

• 15:02Dr. Darshan Shah?

  Right, that's just increasing blood flow.

• 15:04Speaker 01

  It's increasing blood flow, but it's also increasing. Think about the things when we're moving our muscles, we have these myokines, right? We have these really important factors that come out of contracting the muscle that actually have huge healing elements in them.

• 15:17Dr. Darshan Shah?

  Yes, myokines are so powerful.

• 15:19Speaker 01

  Myokines are so powerful, right? You know, if we could bottle myokines, you could hear a Z. So that's why exercise is the number one treatment for anything, right? It's really because our muscles have so much power to create these magical forces that heal us. So we stop doing that, right? So, you know, who exercises after you have, you just sprained your ankle? You don't. I could tell you, like, after my rotator cuff surgery, I was in the gym the next day and I was using my other arm. And, you know, you know, you're in a splint and everything else, right? You're using your other arm, you're moving. So it's motion, it's exercise, and then it's analgesics, but not anti-inflammatories, right? And I'm not a fan of Tylenol because Tylenol actually blocks our antioxidant system. So it blocks what's called glutathione, which is one of our antioxidants.

• 16:02Speaker 01

  So, you know, all this debate about Tylenol truly is true. Tylenol is not a good drug. So I'm not a big fan of Tylenol. So what do you do as analgesic therapy?

• 16:09Dr. Darshan Shah?

  And it's important to note that just real quick because when you're inflamed, you're making a lot of oxidants, right? And so you need, you need your antioxidant system.

• 16:17Speaker 01

  You need that antioxidant system powerful. So remember, what Tylenol does is it blocks glutathione. And glutathione is one of our big antioxidant systems. I mean, it's one, so Tylenol is very potent at blocking that. That's why you can chill yourself easily with Tylenol if you take much of it. So, you know, it's not the best choice. So, you know, so, and it's funny, like, whenever you have a procedure or a surgery, they always give you Tylenol to take before.

• 16:40Dr. Darshan Shah?

  They do, right?

• 16:41Speaker 01

  You know, and even like you're gonna have an anesthesia, worst thing you can do is block glutathione. Cause, you know, so, you know, I recently had to have a surgery and, you know, she's like, oh, here, take these. And I'm like, what are they? She's like, Tylenol. And I go, you know, there's Tylenol? I said, no, you know, I don't need those. What if I don't even have pain afterwards, which I didn't, you know? So why are they giving me Tylenol?

• 16:57Dr. Darshan Shah?

  You know, about 10 years ago, they, they came out, I think maybe more than 10 years ago with IV acetaminophen as well. We were using that before every surgery, whether people needed it or not. I mean, this could not be a good thing, you know?

• 17:09Speaker 01

  No, remember that that detox system is the main thing you need to detox from anesthesia.

• 17:13Dr. Darshan Shah?

  Exactly.

• 17:13Speaker 01

  Anesthesia is not so benign, right? So now we're blocked. Talking that so basically I don't recommend Tylenol. So what do I recommend? Well, there's so much you can do now with some of the modalities we have and peptides.

• 17:24Dr. Darshan Shah?

  Right, exactly.

• 17:25Speaker 01

  Yeah, that's where peptides become and you know peptides like BPC and Thymus and Beta 4 are so hugely beneficial in this realm. You know, and especially if you can take them a little higher dose, if you can take them subcutaneously, but even the orals will have some benefit there in helping with pain. The other big one that people have no idea about is exogenous ketones.

• 17:46Dr. Darshan Shah?

  Yeah.

• 17:47Speaker 01

  So exogenous ketones are huge here.

• 17:49Dr. Darshan Shah?

  Wow.

• 17:50Speaker 01

  So when you look at pain reduction with exogenous ketones, they actually block what's called NRRP3 and flamazone. So they actually stop the sort of pain at its root. They also increase blood flow to the area, they increase stem cell activation, they stop catablos and start break, stop breakdown of the joints. So basically, simply taking a high dose of exogenous ketones, you can actually significantly reduce pain in people.

• 18:14Dr. Darshan Shah?

  That's incredible.

• 18:15Speaker 01

  It's incredible. And if it kind of on that whole realm of ketones, we just had a meeting with with New York Giants about some of the players and stuff. And we're talking about using exogenous ketones because they're also super protective. So if you are taking ketones exogenuously.

• 18:30Dr. Darshan Shah?

  Right.

• 18:30Speaker 01

  And you get hit in the head or you get an injury, your likelihood of that becoming a problem is much lower. So we're a big advocate of these players should all be doing exogenous ketones before they play.

• 18:41Dr. Darshan Shah?

  Like prophylactically.

• 18:42Speaker 01

  Prophylactically.

• 18:43Dr. Darshan Shah?

  Exactly, because they're gonna get some level of injury.

• 18:45Speaker 01

  They're gonna get damaged, they're gonna get hurt, right? And so you can, you could actually, and plus you're gonna make, the quarterback's gonna perform better because they, they're gonna make you more mentally acute for being able to respond faster, your reflexes are faster. You know, we even talked to you, they brought, they said, well, how about the coaches? The coaches probably need them. And I said, yeah, that's probably a great idea. These coaches are deconditioned and they have to think fast and they're under a lot of stress. So if they were drinking ketones during the, so what I do is in that key phase is I put people on exogenous ketones, I put them on BPC, Thymus and Beta 4. I, you know, you can very inexpensively now purchase a small red light, right?

• 19:17Dr. Darshan Shah?

  Yes.

• 19:18Speaker 01

  I mean, you can get one for $300.

• 19:19Dr. Darshan Shah?

  Right.

• 19:19Speaker 01

  You know, just a small panel, which is great because you hurt your knee, you put on your knee, you hurt your shoulder, you put on your shoulder, you hurt your back, you put on your back. You don't need, you know. The massive panels that cost a lot of money.

• 19:28Dr. Darshan Shah?

  Right, right.

• 19:29Speaker 01

  You can do a lot with this small little panel. So I have people, you know, get a little red light. And I would tell people, just have a little red light because you're going to get hurt.

• 19:37Dr. Darshan Shah?

  Yeah, exactly.

• 19:38Speaker 01

  So have a little red light panel. Right. So now, you know, you use exogenous ketones, you use BPC, thymus and beta four. Now we've actually accelerated the healing process.

• 19:45Dr. Darshan Shah?

  Yes.

• 19:46Speaker 01

  We haven't blocked it. So that's kind of our analgesic thing. And then start therapeutic approaches, which are more things now, like maybe muscle stim, physical therapy, things to start really reactivating the joint.

• 19:58Dr. Darshan Shah?

  Got it.

• 19:59Speaker 01

  You know, and I love, you know, for that retraining phase, using things like blood flow restriction bands, right, where you can use a small load and still get huge benefit to the muscle. So we get people, you know, on BPC, blood flow restriction bands and doing things like, you know, there's some really good, you know, there's some really good muscle stimulants. You have to know the right muscle stimulants because they're

• 20:19Dr. Darshan Shah?

  Yes.

• 20:20Speaker 01

  to get, to get the right contraction muscles. So you can start using some muscle stimulants and things like that very early on.

• 20:25Dr. Darshan Shah?

  Okay.

• 20:25Speaker 01

  Do that approach, you're going to heal so much faster than if I just sat around, took Advil and said, you know, I sprained my ankle, I'm going to sit up with a weekend.

• 20:33Dr. Darshan Shah?

  Yeah.

• 20:33Speaker 01

  My ankle up.

• 20:34Dr. Darshan Shah?

  Yeah. Okay. So this is, this is an incredible new paradigm in how to deal with injuries. Instead of rice, we go meat.

• 20:41Speaker 01

  Meat, exactly. Which is, it's just like Dave Asprey with that, I say.

• 20:44Dr. Darshan Shah?

  Yeah.

• 20:44Speaker 01

  Meat over rice.

• 20:46Dr. Darshan Shah?

  Meat over rice, exactly.

• 20:47Speaker 01

  Get away from the carbs.

• 20:50Dr. Darshan Shah?

  So, and this is obviously not intuitive to people because we've grown up.

• 20:54Speaker 01

  We've grown up with it.

• 20:54Dr. Darshan Shah?

  Doing rice.

• 20:57Speaker 01

  That's, the trainers still practice it, right?

• 20:58Dr. Darshan Shah?

  Yes, absolutely. In gyms, every

• 21:00Speaker 01

  Gyms everywhere. That's, that's all you hear, right?

• 21:02Dr. Darshan Shah?

  And so this is like really updating our algorithm on how we treat pain and how we treat injury based on the modern science.

• 21:09Speaker 01

  Yeah.

• 21:10Dr. Darshan Shah?

  I want to do a little bit deeper dive into each one of the things you talked about, if you don't mind.

• 21:13Speaker 01

  Yeah.

• 21:13Dr. Darshan Shah?

  I think it's really important for people to understand the science of some of these because beyond just injury recovery, this can be very helpful in just day to day life, even prophylactively, like you said.

• 21:25Speaker 01

  Right.

• 21:25Dr. Darshan Shah?

  So let's talk about just quickly these peptides. So you mentioned two peptides, they're two of my favorite. They come together in a combo called Wolverine. And it's a really great combo. Of TB 500 and also thymus and beta.

• 21:40Speaker 01

  Thymus and beta 4.

• 21:41Dr. Darshan Shah?

  4 and BPC 157, sorry. And does it have TB 500 in it or is it?

• 21:45Speaker 01

  Well, TB 500 and TB 4, so there's a little bit of misnomer there. TB 500 is kind of a fragmentation of TB 4, which really came out when the peptide was designed in the horse population, actually, for treating horses.

• 21:56Dr. Darshan Shah?

  Okay.

• 21:56Speaker 01

  Thymus and beta 4 truly, and this is kind of a widely, you know, I've been unfortunately in the peptide world so long. Thymus and beta 500 really, or TB 500 was not really the real peptide. The real peptide is truly thymus and beta 4.

• 22:09Dr. Darshan Shah?

  Thymus and beta 4.

• 22:10Speaker 01

  But it's kind of transitioned into thymus. It's, it's, it's, thymus and beta 4 is a more complete chain.

• 22:14Dr. Darshan Shah?

  More complete chain, okay, got it. And how does thymus and beta 4 work?

• 22:17Speaker 01

  So basically, it's going to actually activate collagen actin. So it's actually going to sort of start stimulating collagen active function.

• 22:24Dr. Darshan Shah?

  Okay.

• 22:24Speaker 01

  It's also going to be, so it creates angiogenesis. It's why there's some debate about maybe if you have cancer, but it creates a lot of angiogenesis. Remember, if we have an injury, we want blood flow to the area.

• 22:35Dr. Darshan Shah?

  Right, angiogenesis is a formation of your blood vessels.

• 22:37Speaker 01

  Right, and to heal anything, so you tore your rotator cuff, you've got to get more blood flow to your, you know. So basically, and this one of the problems is that blood flow does get restricted when you have an injury. So basically, we've got to, we've got to help that. And so that's one of the places where thymus and beta 4 works so well. You know, and again, and it's kind of activating this bridging of collagen actin. So basically, it activates these factors. It also is a stem cell activator. So whenever we want to heal an injury, it's why we inject stem cells into a joint. You can activate some of your own stem cells. So thymus and beta 4 can do that very well.

• 23:09Dr. Darshan Shah?

  Interesting, and is, do you think it's also beneficial for people getting stem cells injections to also be on thymus and beta 4 at the same time?

• 23:15Speaker 01

  We do a lot of stem cell things. Everybody's followed up with BPC, thymus and beta 4 afterwards. So we use a combination approach of BPC, thymus and beta 4, GHK copper.

• 23:24Dr. Darshan Shah?

  Right.

• 23:25Speaker 01

  Post procedure, because you really want to accelerate the response of that.

• 23:28Dr. Darshan Shah?

  Right, right, it makes the stem cell injection that much more powerful.

• 23:31Speaker 01

  Exactly, much, much better.

• 23:32Dr. Darshan Shah?

  And then maybe you can tell us a little bit about BPC157 orgs as well.

• 23:35Speaker 01

  Yeah, so BPC is probably everybody's favorite peptide, right? Number one, it truly, you know, this question whether TB frag is, can be taken orally, there's some debate in the field about that, but maybe. But BPC definitely. One of the great things about both these peptides is they are made by our own bodies. I love things that our bodies make.

• 23:53Dr. Darshan Shah?

  They're natural biological signals.

• 23:55Speaker 01

  So we know that they're, they're likely safe, right? So thymus and beta four is a thymic peptide. So when we're babies, we have this giant gland in our chest, this thymus gland. It's huge. If you look at a baby's x-ray, it's got this massive mass in it. And until puberty, that thymus gland is really active and doing all this stuff and it's producing these thymic peptides. Thymus alpha one, which is really immune modulating, thymus beta four, which helps us to heal and grow and recover. So those are really active until puberty. And then that thymus gland starts atrophying. By the time you're old, it's nothing. So now you're not making these thymic peptides. So what we're doing to help you heal is giving you back what your body would have done when you were 13 to heal, right? When you could heal rapid, like, you know, you've got kids, they hurt themselves and they're better in a day.

• 24:40Speaker 01

  It's amazing. They break an arm and in two weeks it's healed. So that's one of the reasons is because they're making these thymic peptides. So BPC by the same, same notion is a gastric peptide. It's made by our gut. And it's in response to kind of protecting the gut, but also to circulate to areas of injury to try and promote healing. So basically, whenever we're injured, we activate this BPC. Now, the problem is as we age, or if we have bad guts, or if we have poor health, we just don't have as much BPC. So I'm going to give back more of it. The same concept of we're replacing hormones because they decline. Let's replace these things that are declining. So I kind of think everybody should sort of cycle these peptides periodically throughout life. Because I'm going to then hopefully be able to protect myself from injuries.

• 25:26Speaker 01

  The two synergistically with BPC being, being, you know, and we'll call it is modulating inflammation. It doesn't reduce or accelerate inflammation. It modulates inflammation. So it tries to keep inflammation just perfect for healing. So that's one of the things that's so beneficial about it is. We like, we don't want, as we talked about, completely blunt inflammation.

• 25:45Dr. Darshan Shah?

  Right.

• 25:46Speaker 01

  But we'd like to modulate, have it not escalate out of control.

• 25:49Dr. Darshan Shah?

  Exactly. Yeah, and I think that that's what these natural biological signals do when we're young, too. It doesn't overly suppress inflammation, doesn't overly promote inflammation, it just gets it at the right level. And our body's so smart, and then we'll never probably figure out exactly how these things work. We're gonna need AI to help us figure this out, but we know that these are natural biological signals.

• 26:09Speaker 01

  Right, and that we're very active when we were younger.

• 26:11Dr. Darshan Shah?

  Exactly.

• 26:12Speaker 01

  And are not when we're older. And so, and I think everything kind of goes back to that. Let's try and get back the system to where it was when we were, when we were able to repair and feel good.

• 26:23Dr. Darshan Shah?

  You mentioned GH, uh, copper peptide as well. Can you talk a little bit about that one and the mechanism of that one?

• 26:27Speaker 01

  So GHK copper is, so, so when you look at healing a wound, collagen needs copper, so it needs this combination of this GHK molecule combined to copper. And that actually is what, what lets collagen go to, from a stage of sort of disarray into nice, normal collagen. So without that onboard, you get this collagen that's very dysfunctional.

• 26:49Dr. Darshan Shah?

  Right.

• 26:49Speaker 01

  So that's why scar tissue forms. So if you look at an injury, like your rotator cuff or whatever you do, the big, the big complication that occurs with all these injuries is scar.

• 26:59Dr. Darshan Shah?

  Yeah.

• 26:59Speaker 01

  That's why you get a frozen shoulder after you have an injury, you can't move it, it's a scar tissue.

• 27:03Dr. Darshan Shah?

  Yeah.

• 27:04Speaker 01

  So if we can modulate the collagen production, GHK actually works on, it again is a natural peptide. Our body makes 500 different genes that modulates, so in a positive fashion. But its main effect is in regulating collagen synthesis.

• 27:17Dr. Darshan Shah?

  Got it.

• 27:17Speaker 01

  So we make normal collagen, not this scarred collagen.

• 27:22Dr. Darshan Shah?

  Yes.

• 27:22Speaker 01

  So it becomes a really important peptide to actually add on when you're trying to heal, also post-surgery.

• 27:27Dr. Darshan Shah?

  Right, absolutely.

• 27:28Speaker 01

  So it's a really important peptide. You can use GHK copper topically, it's great for skin.

• 27:33Dr. Darshan Shah?

  Right.

• 27:33Speaker 01

  Or if you have a topical wound.

• 27:35Dr. Darshan Shah?

  Yep.

• 27:35Speaker 01

  But if you're trying to heal something that's deeper, like an ACL tear or a rotator cuff or something like that, then you might inject it, inject it a small amount.

• 27:43Dr. Darshan Shah?

  Yeah.

• 27:43Speaker 01

  There are all these places now that are mixing GHK copper with BPC, with thymus and beta four. Really, you don't want to do that. Copper is, is actually a very volatile molecule. And when you start mixing with these other peptides, it creates actually problems with these other peptides. So really, people don't want to do that. We're seeing that more in the field now where these people are mixing these.

• 27:59Dr. Darshan Shah?

  Yeah.

• 28:00Speaker 01

  You really want to, you know, and in a perfect world, separate all of them.

• 28:03Dr. Darshan Shah?

  Got it.

• 28:04Speaker 01

  I know there are people who believe you can be inject BPC and thymus and beta four together. I'm not a big fan of that.

• 28:08Dr. Darshan Shah?

  Got it.

• 28:08Speaker 01

  I like to sep- separate them all out.

• 28:10Dr. Darshan Shah?

  Got it.

• 28:11Speaker 01

  I think it's just cleaner when you peptides are pretty unstable in general. And so when you start mixing them together, you can create things that, you know, bonds that you.

• 28:20Dr. Darshan Shah?

  Don't want.

• 28:20Speaker 01

  That you don't want.

• 28:21Dr. Darshan Shah?

  Right. Now it makes completes us. Yeah. So there's these combinations called Wolverine and Glow. And you're thinking that.

• 28:27Speaker 01

  So Glow is that combination of GHK, BPC and thymus and beta four. And I'm not a huge fan of it. You know, maybe it works. I'm not going to knock the maybe, you know, because anecdotally people say it works. And I think the problem is when you, when you're mixing these things together, you're creating immunogenic responses. Over time, you may create problems. And I think that that's where, you know, maybe you're doing it acutely. You're going to be okay. I don't know. I don't think there's a lot of proof that you can mix these peptides together and not create problems.

• 28:52Dr. Darshan Shah?

  Got it. Got it. So it's better to inject them in three separate injections.

• 28:55Speaker 01

  I mean, that's, if you want to be pristine, you know.

• 28:59Dr. Darshan Shah?

  Sure. Sure. Yeah. I have to show you one of the things that we're doing for peptides here now is we're actually doing peptide injectable pens and with the cartridges.

• 29:07Speaker 01

  Those are so nice.

• 29:08Dr. Darshan Shah?

  It's so much nicer. Yeah. It's a game changer in my mind.

• 29:11Speaker 01

  It's so much easier. I know. And there's a company out of Europe that's doing that. And, you know, and you look at them like, because it is a hassle, right? It's a hassle to drop your peptide, even though I like love peptides and I'll look at them and go, you know, it's just tedious.

• 29:25Dr. Darshan Shah?

  Yeah.

• 29:25Speaker 01

  You know, you're drying up. And so some of them will take a long time to draw up and you know, see yourself, you know, to have these, these pens are so incredibly.

• 29:32Dr. Darshan Shah?

  They're so incredibly more efficient. They're time-saving, but they're just cleaner. And then we get to mix the cartridges for the patients. So there's no dosing issues as well.

• 29:42Speaker 01

  Yeah, that's great.

• 29:43Dr. Darshan Shah?

  I'll, I'll show you, I'll show you downstairs in Next Health how we're doing that. But, um, you know, I think you're absolutely right. Like, I'm not a big fan of mixing peptides either. It's just people get fatigue with multiple injections, right?

• 29:53Speaker 01

  You're right. So the question is, you know, so is the convenience worth it? I don't know. Cause I don't know that we, I. They think there's a fair amount of evidence that you might be creating problematic things when you're doing it for long term.

• 30:07Dr. Darshan Shah?

  And these peptides, I mean, like during the acute healing phase from an injury, they're extremely valuable, but they're also valuable, like you said, just cycling these in normal life, especially as you age.

• 30:16Speaker 01

  Exactly.

• 30:17Dr. Darshan Shah?

  Our levels are decreasing.

• 30:18Speaker 01

  I mean, for me, talk about peptides, but one of the big things I say is, well, why are we so passionate about replacing hormones? Peptides decline in our bodies the same way. You know, the thymine peptides are almost nil.

• 30:29Dr. Darshan Shah?

  They're gone, right.

• 30:30Speaker 01

  They're gone, right? You know, growth hormone, the, you know, so using growth hormones of creatine to try and increase IGF levels because our IGF levels are dropping. My belief is let's try and sort of cycle things through time that we can actually keep everything at a nice level.

• 30:44Dr. Darshan Shah?

  Exactly.

• 30:45Speaker 01

  If we're going to replace estrogen, progesterone, testosterone, shouldn't we also be replacing BPC, enzymes N1, enzymes N beta 4, and maybe some of the thymine peptides? I mean, some of the mitochondrial peptides.

• 30:55Dr. Darshan Shah?

  Absolutely.

• 30:56Speaker 01

  So I think that that gets kind of forgotten.

• 30:59Dr. Darshan Shah?

  It does.

• 31:00Speaker 01

  You know, that we, these are declining, and if we can keep them higher, probably if we do get injured, we're going to recover faster just because those things are on board.

• 31:08Dr. Darshan Shah?

  Right, right. I think, the more I think about our overall biology is that we reach this kind of peak in our twenties probably, right? Even in adolescence to the thymus gland and

• 31:17Speaker 01

  Right.

• 31:18Dr. Darshan Shah?

  All these peaks occur between those ages of adolescence and our mid to late twenties, and then everything's on a decline. It's not just hormones.

• 31:25Speaker 01

  Right, I mean, you kind of realize that your decline starts much younger than we thought, right?

• 31:30Dr. Darshan Shah?

  Exactly.

• 31:31Speaker 01

  It's like, you know, people are like, oh, I'm 30, I'm fine. You have started your decline by then, right?

• 31:34Dr. Darshan Shah?

  Yes, yes.

• 31:35Speaker 01

  So when you look at these things, like even the thymine peptides, they're starting to decline in significant amounts. Hormones are starting to decline around 30, and sometimes earlier now in our world of toxins.

• 31:44Dr. Darshan Shah?

  Yeah.

• 31:45Speaker 01

  You know, and microplastics and all the things that are hormone disruptors.

• 31:47Dr. Darshan Shah?

  Yeah, and like to your point, like toxins, microplastics, all these things, they accelerate the decline even more than they used to be accelerating. And so really, to me, like this whole field of longevity medicine, people keep talking about living to 150, 200, to me, it's more about just how do we prevent the decline?

• 32:01Speaker 01

  The decline, right.

• 32:02Dr. Darshan Shah?

  And that's what's going to add 30 useful years to our life.

• 32:05Speaker 01

  And you feel good, right? So if we can actually, you know, sort of, I think there, we will come up with, I mean, it's just, we will come Up with some really good medications that that do.

• 32:15Dr. Darshan Shah?

  It's a matter of time.

• 32:16Speaker 01

  It's a matter of time. But for now, we have a law on hand that people will start sort of preventively doing an earlier stage, you know, it's a, you know, unfortunately, we didn't get into this world until, you know, later. I mean, I was older already by the time all this stuff started happening. But if you're now 30, you should be thinking about this stuff at 30.

• 32:35Dr. Darshan Shah?

  Exactly.

• 32:35Speaker 01

  You know, when your client's starting.

• 32:37Dr. Darshan Shah?

  Well, I think the other big problem here is that the traditional medical establishment is not accepting of peptides, is not accepting of ketones, is not accepting of even stem cells yet. And it's.

• 32:47Speaker 01

  Right. I know.

• 32:48Dr. Darshan Shah?

  We're moving way too slow in the traditional medical establishment for the things that you and I know already established. Like, this is safe, effective. Let's use this.

• 32:56Speaker 01

  That's what's so hard is we're fighting this paradigm of, you know, these things are not proven safe, they're not FDA approved. And yeah, you, you, you, we have these pharmaceutical compounds that have much more issues.

• 33:08Dr. Darshan Shah?

  Yeah, like Advil and Tylenol, like we talked about.

• 33:11Speaker 01

  Right. I mean, Tylenol should have never been approved as a drug. And people are popping it, you know, and, you know, all the time, you know. So I, I, I think that, that, that is, we have to sort of figure out how do we, you know, 17 years for the time of a drug discovery to get approval market. And we have to advance it or we'll all be dead.

• 33:28Dr. Darshan Shah?

  Absolutely.

• 33:29Speaker 01

  But this, taking the things that we know are safe because our body is already doing them. If you can take this more natural approach, this, it makes a lot of sense.

• 33:35Dr. Darshan Shah?

  Absolutely. Absolutely. It's, it's, once again, like I always say, peptides are not drugs. Drugs are chemical compounds like Advil and Tylenol. Peptides are natural biological signals.

• 33:43Speaker 01

  They're amino acids that our body, you know, makes. And then some of them are synthesized that our body are not natural to our body, but, but so many of them are, right?

• 33:51Dr. Darshan Shah?

  Yeah.

• 33:51Speaker 01

  You know, like mitochondrial peptides, like SS31, you know, so it is made by our mitochondria.

• 33:57Dr. Darshan Shah?

  Yeah.

• 33:57Speaker 01

  You know, so it is a natural compound that our mitochondria make that declines.

• 34:02Dr. Darshan Shah?

  Right.

• 34:02Speaker 01

  So I think that, that my goal is always replace all these things. And that's going to be your best bet.

• 34:06Dr. Darshan Shah?

  Exactly. And replace them prophylactically because they're declining anyway.

• 34:09Speaker 01

  Declining anyway. So and then if I get hurt, the hope is I heal better.

• 34:12Dr. Darshan Shah?

  Exactly.

• 34:13Speaker 01

  I suppose, oh, my God, I just got hurt. Now I'm gonna start taking all this stuff. You're trying to play catch up to damaged tissue already.

• 34:18Dr. Darshan Shah?

  Right, right.

• 34:22Dr. Darshan Shah?

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• 35:04Dr. Darshan Shah?

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• 35:15Dr. Darshan Shah?

  Can we dive into ketones a little bit? Because I don't think many people have heard about ketones either, except that, you know, the ketogenic diet is where people have probably heard about ketones. Let's talk about where do you get exogenous ketones from? And how do they work? And should you also be taking these profl actively? Can you take us through a little course on that?

• 35:32Speaker 01

  Honestly, Darshan, if I were to say, take one thing, if you said, you know, was the one thing, you know, you could only take one supplement?

• 35:41Dr. Darshan Shah?

  Yes.

• 35:41Speaker 01

  It would be ketones.

• 35:42Dr. Darshan Shah?

  Wow. Really?

• 35:44Speaker 01

  Yeah.

• 35:44Dr. Darshan Shah?

  That's mind blowing.

• 35:45Speaker 01

  They are incredibly powerful.

• 35:46Dr. Darshan Shah?

  Oh, my gosh.

• 35:47Speaker 01

  When you look at all the things that ketones can do.

• 35:49Dr. Darshan Shah?

  Right.

• 35:49Speaker 01

  So when you look at ketones, it's a combination. There's, you know, there's a lot out there. This ketone salts, ketone salts run into the problem that you actually can change, you know, disrupt some of your electrolyte levels with those. Those are, those can be problematic. Then we have ketone esters, which are the most common. My favorite is a company called Kinetic, which makes a ketone that they separated out the ketone esters. So they broke the ketone ester. So ketone esters is made up of beta-hydroxybutyrate and 1,3 butane nyl. And they both have kind of different effects. When you separate them out, you get this very nice rise in ketones from beta-hydroxybutyrate, but the 1,3 butane nyl kind of kicks in later. So by separating them out now, so instead of just gaining, like if you took a ketone ester, you would get this big bump for about 30 minutes and then would kind of fall back down, which can be useful.

• 36:32Speaker 01

  But our goal would be if we could keep ketone levels higher all the time.

• 36:37Dr. Darshan Shah?

  All the day.

• 36:38Speaker 01

  We would do better, right? Which is why a ketogenic diet, you're always having, making ketones.

• 36:42Dr. Darshan Shah?

  Got it.

• 36:43Speaker 01

  The problem with staying always in ketosis from a ketogenic diet is that you lose metabolic flexibility.

• 36:48Dr. Darshan Shah?

  Right.

• 36:48Speaker 01

  You actually don't get very tolerant of carbohydrates anymore and carbohydrates have some very good usefulness to our bodies overall.

• 36:54Dr. Darshan Shah?

  Right.

• 36:54Speaker 01

  And when you lose metabolic flexibility, you actually over time start to see disruptions in insulin, insulin resistance, things like that. So people who are constantly in ketosis are going to have problems over time.

• 37:04Dr. Darshan Shah?

  Right.

• 37:04Speaker 01

  It's a good thing to do, you know, acutely if you are trying to get through something, it's fine.

• 37:08Dr. Darshan Shah?

  Absolutely. I just want to highlight that for our listeners. So I use the ketosis diet on my patients in brief bursts.

• 37:15Speaker 01

  Right, right, right. You use it, yeah, because to get over something, like you have an autoimmune condition.

• 37:18Dr. Darshan Shah?

  Exactly.

• 37:19Speaker 01

  You know, you're really inflamed. It's a great way to kind of jumpstart.

• 37:22Dr. Darshan Shah?

  Traumatic head injury, maybe.

• 37:23Speaker 01

  Yeah, it's a great way to jumpstart.

• 37:24Dr. Darshan Shah?

  Right. Maybe you need to do a little bit of weight loss, but for the long term, I've personally seen almost, you know, maybe even close to like a few dozen patients now that have really got dysregulated insulin sensing.

• 37:35Speaker 01

  Right, no, you see it all the time.

• 37:37Dr. Darshan Shah?

  With being in ketosis for a long time.

• 37:38Speaker 01

  No, it's a huge issue.

• 37:39Dr. Darshan Shah?

  So as a long-term intervention, it can be a problem.

• 37:41Speaker 01

  So our goal would be to be able to eat regular diet, where, you know, eating high protein, lower carb, but getting carbs in there and then keeping ketones high. So if I take something like this kinetic ketone, which is, I'll get this nice little surge of beta hydroxybutyrate, and then the 13 butylenyl diol kicks in, and you know, it was funny, I was just at this conference and this guy was wearing, he had gotten a CGM, not a CGM, a ketone meter, a continuous ketone meter, which I didn't even think was available, but he got it from Sweden.

• 38:11Dr. Darshan Shah?

  Incredible.

• 38:12Speaker 01

  And yes, it was a continuous ketone meter, it was very cool. So Kinetic had a booth there, and so he wanted to see what happened, and so he took the ketones and it was exactly, you know, what we tell people all the time, is you get this, you got this really nice rise, and then it kind of dropped down a little bit, and then it kind of bumped up, and the 13 butylenyl diol stayed in, and he stayed in ketosis with pretty high ketone levels for four or five hours. I mean, so if we can do that, so what are ketones doing? Well, it is really our brain's best fuel, so it's going to make your brain, you know, you think much. Sharper. So remember ketones are a much cleaner way of making energy, of making ATP. So usually if you eat glucose, glucose, then it goes through oxidative phosphorylation.

• 38:54Speaker 01

  And you go through all these steps and you finally fit out ATP. And the problem with that is each of those steps is creating some reactive oxygen species. So you're creating more oxidative stress. Ketones don't have to do that. So they can feed directly in to ATP bypassing oxidative phosphorylation. So you don't create this oxidative stress. You also, you get much more bang for your buck. So for a molecule of oxygen, you make much more ATP. Using ketones. So it's a really efficient energy source. You have to think that's why it exists, right? If you were a caveman and you were starving, you needed just a really efficient energy source, right? And so that's what ketones evolved. So it really is the best energy source, both for our brain and really in general for our muscles.

• 39:40Speaker 01

  There's other pieces to that because lactate is important for muscles and so is carbohydrates and so. But so think about this as your cleanest, purest energy source. So this is like giving your car the best gas. You've got a sports car giving you the best.

• 39:53Dr. Darshan Shah?

  Hundred octane gas, right, exactly.

• 39:55Speaker 01

  And all the other things we just talked about for healing, they're always going to reduce these kind of high inflammatory states, markedly anti-inflammatory, markedly anti-inflammatory. They also, again, stem cell activation. So you're going to see much more stem cell activation. And people are taking ketones regularly. You're going to, you'll see much faster wound healing. So I take ketones all day long.

• 40:16Dr. Darshan Shah?

  Yep.

• 40:17Speaker 01

  I just sip them all day long.

• 40:19Dr. Darshan Shah?

  Exactly.

• 40:19Speaker 01

  So basically, you know, they make what's called Kinetic Pro, which is a very high dose in a few ounces. So I can drink my water with a little bit, just add it to it. So you add a couple of tablespoons to it, right? And now I'm keeping my ketone levels high all day long. It makes me sharper. I think faster. I recover better. And then you can use higher doses. For instance, when we're working with football players, we'll take them out, have them do a quite high dose right before they're playing, right? If they've just traveled or if they're, you know. So, so you can use the higher doses acutely and then lower doses kind of throughout the day. Got it. For our neurodegenerative people, people who have, who have cognitive issues or mild cognitive decline, we're going up to 20 grams three, four times a day of ketones.

• 41:01Speaker 01

  And so by doing this, this, this KETE PRO, actually, they made it for doctors to, to use because we realized we needed much higher dose ketones. Right. And we can really, you know, and we see significant improvements. If you look at just looking at EEG scans on people, within half an hour after taking ketones, you'll see improvement in cognitive. Incredible. So it's really, they're pretty incredible in terms of, you know, and just improvement in endurance. It's why athletes like them, right? You know, so they're the perfect fuel, they're anti-inflammatory, they're stem cell activating, they actually even have some genetic influences that are important. So if you look at kind of everything we want, this is going to be, I mean, the, the, by maintaining metabolic flexibility, but keeping myself in the perfect energy source, the

• 41:44Speaker 01

  last lock, last, lots of ATP is sort of the link to everything, right? Sure, that's absolutely. So, and now remember now, if I'm giving ketones, my mitochondria get out of this oxidative stress state. Sure. They're not spinning out. Right. Having to make all this ATP, so all these free radicals. So now my mitochondria should start to heal. Ah. So you'll see, you know, people with horrible mitochondrial dysfunction, now the mitochondria have sort of this rest state where they're like, okay, great, I don't have to work so hard, I don't have to make more reactive, reactive oxygen species. Uh huh. Just think of, one of the things that mitochondria are really smart. So if they're, they're trying to, you know, you, you need, you're in an injured state or you, you know, you just had a virus or you just ran a marathon, the mitochondria have worked really hard to make ATP.

• 42:27Speaker 01

  In response, they've made a lot of reactive oxygen species. They're gonna, there's a point where the reactive oxygen species start to go, okay, shut off, stop making ATP. Got it. That's why you finally get horribly exhausted. So there's like a feedback mechanism there, right? Reactive oxygen species are high, mitochondria are like, okay, I can't have any more reactive oxygen species, all stop making ATP. Uh huh. And that's why we see brain fog and fatigue in people with mitochondrial dysfunction. So basically, if we stop the reactive oxygen species, the mitochondria can start revving back up again.

• 42:53Dr. Darshan Shah?

  So interesting. Okay, so yeah, so basically the mitochondria are making energy from glucose, which is a really dirty way of making energy. Creates a lot of smoke.

• 43:01Speaker 01

  Right, exactly.

• 43:02Dr. Darshan Shah?

  And that smoke needs to be vented and your mitochondria, which is the engine, will just stop working when there's too much smoke. But ketones bypass that whole system.

• 43:09Speaker 01

  So now I can make energy, stop making smoke.

• 43:11Dr. Darshan Shah?

  Right.

• 43:12Speaker 01

  And now my mitochondria start to heal, so they actually start processing glucose better and, you know, and working better.

• 43:17Dr. Darshan Shah?

  So incredible. And so just practically, these, these drinks, these ketone drinks, the company's called Kinetic. They make the one that has kind of a higher plasma level. There's other ketone drinks out there, like Ketone IQ, I think is another one.

• 43:30Speaker 01

  Yes, Ketone IQ is, so those are ketone esters. And again, they're, they're fine. They work. But again, you're going to put yourself into a very rapid state of ketosis and very rapid state out. Our goal would be to try and maintain ketones in the blood, just like your, I would argue that you can do the same thing with your, your, you know, like your brain injury patients and things like that without putting them on a ketogenic diet. Because I can maintain ketones the same way I can with, with ketogenic diet.

• 43:52Dr. Darshan Shah?

  Yes.

• 43:53Speaker 01

  So, so, you know, I think that there, there's a place to say, when you look at, not everybody does well with ketogenic diet. It's just hard.

• 44:00Dr. Darshan Shah?

  Yeah.

• 44:01Speaker 01

  It's hard to follow.

• 44:02Dr. Darshan Shah?

  It's very, it's very difficult to maintain.

• 44:03Speaker 01

  So if I can use something now to substitute for that and get the same benefits. And you can't do that with a ketone ester.

• 44:09Dr. Darshan Shah?

  Right.

• 44:10Speaker 01

  Right. Now, again, I, I think as physicians, we're going to be going more to a higher dose product. But as, if you're just kind of a general person, they have, you know, just the little cans that are yummy. But the, the, or even from a cost perspective, the Pro level, so Kinetic Pro, so you go to Kinetic Pro, then it actually makes a much higher dose ketone.

• 44:30Dr. Darshan Shah?

  Got it. It saves money too.

• 44:32Speaker 01

  Saves a lot of money, right? Because you're using a much smaller concentration.

• 44:34Dr. Darshan Shah?

  Yep.

• 44:35Speaker 01

  I, you know.

• 44:36Dr. Darshan Shah?

  I didn't know that was available, so I'm really excited about that.

• 44:39Speaker 01

  That's what you should be using in your patients because it's, it's huge and it's much more cost effective for them. And you can actually just get much higher levels of ketones.

• 44:47Dr. Darshan Shah?

  And for the listeners, this is like spread through the longevity doctor community like wildfire. There's so many longevity doctors using this now. And to your point, it's just, it's just one of those supplements that are...

• 44:56Speaker 01

  If you gave me one thing. That's a hard question, right?

• 44:59Dr. Darshan Shah?

  That is really hard.

• 45:00Speaker 01

  K2 is a great thing. Magnesium is a great thing.

• 45:02Dr. Darshan Shah?

  I try not to ask out of this podcast because everyone's like, this is not one thing.

• 45:06Speaker 01

  Let's say one thing that would give me, because you know me, Darshan, I'm a huge mitochondria at the root of all.

• 45:12Dr. Darshan Shah?

  Absolutely, right.

• 45:13Speaker 01

  And so if I can preserve mitochondria, can I preserve everything else?

• 45:16Dr. Darshan Shah?

  Yes, yes.

• 45:17Speaker 01

  And so, you know, so, so, so, yeah, I mean, obviously, it's not going to be one thing. But if you, if you said, okay, you absolutely can have one thing. Absolutely, that's the only thing you can have, that would be K2.

• 45:27Dr. Darshan Shah?

  Wow. Okay, so that's another incredible new tool in the toolbox. And let's just briefly touch on red light therapy. So you have your patients buy red light panels. I think it's important to make sure you get a good quality one.

• 45:38Speaker 01

  A good quality red light panel, yeah.

• 45:39Dr. Darshan Shah?

  Yeah, because there's a very specific wavelength that you need to be at. And if you, a lot of red light panels now, they're just red lights and they're not the right light.

• 45:46Speaker 01

  Right, yeah. You're not going to get a cheap red light panel.

• 45:49Dr. Darshan Shah?

  Right, exactly.

• 45:50Speaker 01

  Let's put it that way.

• 45:50Dr. Darshan Shah?

  If it's cheap, it's not the right wavelength.

• 45:52Speaker 01

  If you're seeing an $80 red light panel, it's probably not, you know.

• 45:56Dr. Darshan Shah?

  Not the right one, right, exactly. And then you mentioned also, obviously, you want to keep moving. You want to keep promoting blood flow and BFR bands, blood flow restriction bands.

• 46:05Speaker 01

  Right, and there's some great now, like, you know, like, you know, I use, if you use BFR bands at all, but, you know. Like, it's great because you have something hooked up to your phone, you know, so it's super easy. You look stupid in the gym, but that's okay. Mostly, I do my BFR band stuff at home.

• 46:18Dr. Darshan Shah?

  Yes, yes.

• 46:20Speaker 01

  But, you know, but so there's much simpler to use now than the old ones. I don't know, you know, I've been in this for a long time. We used to like just wrap.

• 46:25Dr. Darshan Shah?

  Well, is that hard to put on?

• 46:26Speaker 01

  It's hard to put on, yeah. So these are much simpler, they're really nice.

• 46:30Dr. Darshan Shah?

  What's the brand that you like?

• 46:31Speaker 01

  I like Saga, Sutsuki is a good one, Saga is a good one. I think those are probably the two best on the market.

• 46:36Dr. Darshan Shah?

  Amazing. And then you also mentioned, what was the next, you mentioned one more tool that we can use for post-injury recovery. Let's talk about hyperbaric oxygen therapy. I have, I've had Scott on here.

• 46:47Speaker 01

  Love hyperbaric, right. Like, I mean, Scott's the pro one, I'm not going to, I'm not going to match anything, his knowledge about it. But hyperbaric post-injury is. Huge, right?

• 46:56Dr. Darshan Shah?

  There's no-

• 46:57Speaker 01

  Post-traumatic brain injury, post any kind of injury recovery. Because what is it, you know, same thing. We're actually reducing oxidative stress. We're increasing oxygen flow to the muscles and the tendon and all these places that have a hard time getting oxygen. I mean, tendon, one of those big problems is that why they're so hard to heal is they really aren't well-oxygenated tissues. They're not well vascularized tissues.

• 47:17Dr. Darshan Shah?

  Right.

• 47:17Speaker 01

  So you can do so much with hyperbaric.

• 47:19Dr. Darshan Shah?

  Right.

• 47:20Speaker 01

  I think hyperbaric is now kind of, you know, I, I think, rising in our longevity world, right? As a tool that probably everybody should do.

• 47:28Dr. Darshan Shah?

  Yeah.

• 47:28Speaker 01

  Even, even preventatively for longevity.

• 47:31Dr. Darshan Shah?

  Yeah, and that's a really good point because all of these things that we're talking about for injuries, they also work very well preventatively.

• 47:37Speaker 01

  Preventatively.

• 47:37Dr. Darshan Shah?

  And that tells you something about them. Like, you're not going to take Tylenol every day preventatively.

• 47:41Speaker 01

  Right, right.

• 47:41Dr. Darshan Shah?

  It's like, no one thinks that that's beneficial at all. Because you know you're going to get side effects and problems with it. But all of the stuff that we're talking about actually works preventative as well.

• 47:51Speaker 01

  Right.

• 47:52Dr. Darshan Shah?

  So, yeah. And then, um, what about, um, you know, you had mentioned earlier, and I want to make sure we touch on this too. We all kind of like expect this future where we're going to have degenerative joint disease, right? And the reality is that is not a future that everyone needs to head towards as though like that's our destiny no matter what, right? And so there's ways to prevent degenerative joint disease just starting in your 30s, 40s, 50s. And I, I would even say it's never too late to start, right?

• 48:18Speaker 01

  Exactly.

• 48:18Dr. Darshan Shah?

  Can we talk about some of those? Like, what's your checklist there?

• 48:21Speaker 01

  Well, I think first and foremost, hormones, right?

• 48:23Dr. Darshan Shah?

  Yes.

• 48:23Speaker 01

  You absolutely cannot, your, your muscles are not going to do well. Your tendons are not going to do well. Your collagen's not going to do well without hormones on board. And that's all of them for men and women. You need estrogen, testosterone, progesterone.

• 48:34Dr. Darshan Shah?

  Exactly.

• 48:35Speaker 01

  Progesterone is very forgotten in men.

• 48:36Dr. Darshan Shah?

  Yeah.

• 48:37Speaker 01

  And it's actually very critical to joint health.

• 48:39Dr. Darshan Shah?

  Ah, okay.

• 48:39Speaker 01

  One of the reasons you get stiffer as you age is there's actually progesterone receptors on joints. It helps synovial fluid to be thicker and more liquid. And so basically, if you don't have progesterone on board, and it doesn't get looked at in men.

• 48:50Dr. Darshan Shah?

  No.

• 48:51Speaker 01

  Um, you know, I have a lot of my men who have chronic back pain or chronic joint pain, or they just wake up horribly stiff and you put them on a little low dose progesterone at night. Obviously, you're using a much smaller dose than in women.

• 49:00Dr. Darshan Shah?

  Yes.

• 49:00Speaker 01

  Using like five, 10 milligrams, but a little trokey before they go to bed at night. And it markedly helps them this. They're not waking up so stiff. It's also really prostate protective. So progesterone gets very, very forgotten in men.

• 49:10Dr. Darshan Shah?

  Completely forgotten.

• 49:12Speaker 01

  Completely forgotten.

• 49:13Dr. Darshan Shah?

  Completely.

• 49:13Speaker 01

  And so it needs to be really looked at. Like, you know, if you look at progesterone deficiencies in men, it'll look a lot like testosterone deficiency. So it really has to be looked at and checked and utilized probably more than we do.

• 49:23Dr. Darshan Shah?

  And so you're saying men should even do a little trokey?

• 49:26Speaker 01

  Yeah, we do like a five, 10 milligram trokey. It helps us sleep. I mean, if you're not sleeping well, if you have anxiety, if you wake up stiff.

• 49:34Dr. Darshan Shah?

  So just like in women?

• 49:35Speaker 01

  It's like in women, you know, probably progesterone.

• 49:37Dr. Darshan Shah?

  So interesting. I did not know that. I learned something from you.

• 49:39Speaker 01

  It's majorly protective to the prostate, too.

• 49:41Dr. Darshan Shah?

  Ah.

• 49:41Speaker 01

  So, you know, so, you know, so we, it's hard to measure in serum because at a low level, you really need more urine metabolite testing to look at it.

• 49:50Dr. Darshan Shah?

  Like Dutch testing?

• 49:50Speaker 01

  Like Dutch testing, right, to really look at it in men. But you can see, and you know, so in men, you'll see the alpha and beta pregnenolone levels, and if those are low, you need to replace it because otherwise people are not going to do well. And it's probably, I don't know, 30% of men, you'll see that in. So it's not uncommon.

• 50:05Dr. Darshan Shah?

  You know, it's so incredible to learn this from you because I speak on stage a lot, just like you do, and one of the first things I always talk about when I talk about hormone replacement therapy is we've gone two, three generations now where people did not have the benefit of hormone replacement therapy. And now it's like you almost have to convince me, give me a reason why a person should not be on it, because this is...

• 50:24Speaker 01

  There's none. There's none, right. I mean, not even cancer, really. You know, I mean, you know, you look at the progesterone estrogen receptor positive cancers, even those people can probably benefit. You have to even, you know, have to sort of buck the system a little bit and watch how you're doing them. We know that, you know, and if you've ever talked, you should have Dr. Morgan Tolliver on your podcast.

• 50:44Dr. Darshan Shah?

  I would love to, yeah.

• 50:45Speaker 01

  Because listening to him talk about testosterone and prostate cancer, you're like, oh, my God, this is just asinine that we've ever thought testosterone was linked to prostate cancer. So really, I don't think there's anybody who should not be on hormones. And it's so hugely beneficial to joint health.

• 50:59Dr. Darshan Shah?

  Yeah.

• 50:59Speaker 01

  You know, it's, and estrogen for men, you know.

• 51:02Dr. Darshan Shah?

  As well.

• 51:03Speaker 01

  Yeah, as well for joint health. So I think that that kind of fits into, you know, the sort of the top line.

• 51:09Dr. Darshan Shah?

  And I don't think you can do hormone replacement therapy correctly without urine metabolites either. I think it's such a critical piece of the puzzle.

• 51:14Speaker 01

  Yeah, we have, you know, along with Dr. Smith, there's always some argument right in there. People are like, oh, you don't need urine metabolites. I'm a big believer, too. I really think urine metabolites are really useful. You need to see where the estrogen and testosterone are going.

• 51:25Dr. Darshan Shah?

  Yes.

• 51:25Speaker 01

  Right, you know. And even when you look at the testosterone metabolites into this, you know, androstenediol, there's, you know, there's...

• 51:33Speaker 01

  People who even have high levels of DHT, but they're not making testosterone dial. So those people are not going to get the anabolic effects. So you, you, you need those metabolites, I think, to really refine treatment.

• 51:42Dr. Darshan Shah?

  Right, to really dial it in.

• 51:43Speaker 01

  And to do it safely, to know that you're not making high levels of the bad estrogens that can cause, you know, cancerous things.

• 51:49Dr. Darshan Shah?

  Exactly. And there's different types of estrogens you can produce. And so, you know, it's not just about testosterone converting to estrogen. It's what direction is it converting, et cetera? And you get all that information with your metabolites.

• 51:59Speaker 01

  Yeah. So I, so I am a, a huge fan of your metabolite testing.

• 52:02Dr. Darshan Shah?

  Same. There's so much precision that we can have now with our therapy that, you know.

• 52:06Speaker 01

  So they're like, why not?

• 52:07Dr. Darshan Shah?

  Yeah, yeah, exactly. And, and you know, like, I feel that testosterone replacement therapy probably got a bad name for a while because it was done without precision. It was done, you know, people were just getting testosterone mail order and no one's even checking levels and it led to all sorts of problems. So.

• 52:21Speaker 01

  Yeah. It's funny. I mean, I, when I first got into the longevity world, which is now, you know, 20 plus years ago, you learn a lot from the bodybuilders, right?

• 52:28Dr. Darshan Shah?

  You do. I learned a lot from bodybuilders, right?

• 52:31Speaker 01

  They were like the people who actually got, were looking at the science of this replacement. It wasn't like, you know, it wasn't the reproductive endocrinologist. It was the bodybuilders, like, we, we know how to do this, you know, in a way. And then, and then they can do it in an unsafe way, but a lot of the really good bodybuilders have it, you know, really dialed in to the, okay, how can I do this healthfully, but still get the benefits? So you learned a lot from those people.

• 52:52Dr. Darshan Shah?

  Absolutely.

• 52:52Speaker 01

  But you're right. It did fall into a little bit of a, you know, bad hands, you know, and, and, and it's funny because I use in women, a fair amount with osteoporosis or with people with joint pain, Nangalong. So Nangalong is an anabolic steroid.

• 53:05Dr. Darshan Shah?

  Hmm, okay.

• 53:06Speaker 01

  Right? And if you look at Nangalong's history.

• 53:09Dr. Darshan Shah?

  That's FDA approved and anabolic.

• 53:10Speaker 01

  Yeah. History, it actually was the first treatment for osteoporosis.

• 53:15Dr. Darshan Shah?

  I didn't know that. Okay.

• 53:16Speaker 01

  It was like 1960s. It was, you know, and then it actually got sort of into the bodybuilder hands because it's very anabolic.

• 53:23Dr. Darshan Shah?

  Right.

• 53:23Speaker 01

  It's 50, if you look at testosterone, it's one to one anabolic to androgenic. Remember androgenics, all the other things you think about with men?

• 53:29Dr. Darshan Shah?

  Sure.

• 53:30Speaker 01

  Anabolic is just muscle bone building.

• 53:32Dr. Darshan Shah?

  Right.

• 53:32Speaker 01

  Right? So Nangalong is 15 to one anabolic to androgenic.

• 53:36Dr. Darshan Shah?

  15 to one.

• 53:37Speaker 01

  15 to one. So much more anabolic. But it fell into kind of the bodybuilder's hands. People stopped prescribing it because now the. All the doctors like, oh, okay, yeah, now I'm not doping people, right?

• 53:46Dr. Darshan Shah?

  Right, right.

• 53:47Speaker 01

  But we use it a lot by cycling it. So if you have a female with osteoporosis, I can tell you, I've had women improve from like a negative three, like a really bad osteoporotic score within, you know, a year, a couple of years of cycling nandrolone.

• 54:00Dr. Darshan Shah?

  Wow.

• 54:00Speaker 01

  Going into the positive states. You can't do that with any other drug.

• 54:03Dr. Darshan Shah?

  No.

• 54:04Speaker 01

  So nandrolone's a really, actually can be really beneficial. It's great for joint pain.

• 54:09Dr. Darshan Shah?

  Oh, okay.

• 54:10Speaker 01

  So my joint pain, people with chronic osteoarthritis, love it. It's hard to get them off of it. You gotta kind of cycle nandrolone. You don't want to do it continuously. So sometimes it's hard to get them off because they feel so much better on it.

• 54:19Dr. Darshan Shah?

  Yes.

• 54:20Speaker 01

  So even things like anabolic steroids, which have kind of gotten a bad rap in our field, like other than it's just a bodybuilder thing. Actually have some really huge benefits for us in terms of helping people to put on muscle or put on bone. So I use it a lot in helping fracture healing to my little old ladies who fracture something. Or my women with osteoporosis that, you know, are not doing, you know, you can stabilize things, but trying really rebuild bone to really be anabolic.

• 54:44Dr. Darshan Shah?

  Sure.

• 54:45Speaker 01

  It's hard. It's a really good thing for that.

• 54:47Dr. Darshan Shah?

  Absolutely. So nandrolone, estrogen replacement therapy for women.

• 54:50Speaker 01

  Right.

• 54:51Dr. Darshan Shah?

  Progesterone, testosterone for men, don't overlook that as well.

• 54:53Speaker 01

  Yeah.

• 54:54Dr. Darshan Shah?

  And then obviously stem cell injections as well.

• 54:57Speaker 01

  But remember the stem cells put into, so many clinics now, you pop in these people who are just stem cell clinics, right?

• 55:02Dr. Darshan Shah?

  Right.

• 55:02Speaker 01

  You have to get the garden all ready, right? You have to do everything else first, right? So we put everybody through a protocol before we do stem cells that, you know, that really, to try and optimize them. And then, you know, so you were talking about your surgery, about half people are like, I don't think I need this anymore. We also use a drug called pentecin polysulfate.

• 55:20Dr. Darshan Shah?

  Say that again?

• 55:21Speaker 01

  Pentecin polysulfate.

• 55:22Dr. Darshan Shah?

  Pentecin polysulfate, what is that?

• 55:24Speaker 01

  So pentecin polysulfate is approved in Australia. It's a drug called, and it's in phase three trials here in the US.

• 55:29Dr. Darshan Shah?

  Okay.

• 55:30Speaker 01

  It's called xylasol. And so xylasol's an injectable pentecin polysulfate. Pentecin polysulfate's been around since the eighties as a drug called Elmeron.

• 55:39Dr. Darshan Shah?

  Okay.

• 55:40Speaker 01

  Elmeron's for bladder inflammation, for bladder cystitis, so chronic bladder cystitis. And it came out in the eighties. It was a godsend to people who are suffering bladder inflammation. But it, like, when you look at the mechanism of drugs, there's a lot of very cool pharmaceuticals. Drugs out there.

• 55:54Dr. Darshan Shah?

  Sure.

• 55:54Speaker 01

  So if you look at what what Pentosan polysulfate does is it blocks inflammation, but it also blocks degradative enzymes.

• 56:02Dr. Darshan Shah?

  Okay.

• 56:03Speaker 01

  So there's these enzymes that get accelerated in people who have osteoarthritis.

• 56:06Dr. Darshan Shah?

  Okay.

• 56:07Speaker 01

  Something called Adam and Bim and M M P three.

• 56:09Dr. Darshan Shah?

  Yeah.

• 56:10Speaker 01

  And now we also see acceleration of interleukin one beta, interleukin six. So Pentosan actually works on all of those levels. It's because it's it's blocking this N L R P three inflammasome, which is kind of the key to starting everything. But it's working on improving blood flow. It's blocking the bad cytokines. It's blocking, there's nothing else that blocks these degradative enzymes.

• 56:31Dr. Darshan Shah?

  Oh, okay.

• 56:31Speaker 01

  There is, but not that it's as easy to do. And so this is like, so they they brought it out in Australia in twenty nineteen and and started working with this as an injectable. So orally, as Elmeron, it didn't work great for joints.

• 56:45Dr. Darshan Shah?

  Mm hmm.

• 56:46Speaker 01

  But as a low dose injection, it remarkably improved joint health. And within a year, we not only saw stabilization arthritis, but actually improvement in cartilage. So so in a year after being on this drug, we saw thirty percent improvement in cartilage.

• 57:01Dr. Darshan Shah?

  Wow.

• 57:01Speaker 01

  So it's a remarkable drug.

• 57:03Dr. Darshan Shah?

  That is thirty percent improvement in cartilage.

• 57:05Speaker 01

  Right, versus the placebo group who declined and lost six percent of cartilage.

• 57:08Dr. Darshan Shah?

  Oh, that's like we're headed towards a place where, you know, joint replacements might be a thing of the past.

• 57:13Speaker 01

  I think they will be. I mean, I think we'll, number one, we're going to get better and better at cartilage regeneration techniques, right? We're going to do more, but like this drug, I would say eighty percent. We have so many people who are headed to joint replacements who we put on this medication. It has to be, the reason we can get it, even though it's not approved here, is that Pentosan polysulfate is approved as an oral drug.

• 57:30Dr. Darshan Shah?

  Right.

• 57:31Speaker 01

  So it's great. We just have a compounding pharmacist turn it into an injectable drug and we follow the guidelines. It it will come to market in about two years because it's, but it's, I've been using it for about five years now. In my practice, game changer. I will tell you, people who have bad osteoarthritis, about eighty percent of them see significant.

• 57:48Dr. Darshan Shah?

  Incredible.

• 57:49Speaker 01

  And it's incredible.

• 57:50Dr. Darshan Shah?

  This is all such game changing stuff for osteoarthritis. And this, I mean, this podcast episode is, I think, is going to change people's lives because there's so many people out there suffering with joint aches and pains.

• 57:59Speaker 01

  Right, and there's so, there is so much you can do. You have to find a knowledgeable provider and I think it's a promise. Our field, there's not a lot of people focusing like even in all of our longevity docs group. If somebody came to you and tore their meniscus in their knee, you're gonna say, oh, go see your orthopedic surgeon. Really wrong thing to do.

• 58:14Dr. Darshan Shah?

  Right.

• 58:14Speaker 01

  We know that surgery for a torn meniscus in the knee doesn't work. I mean, if you're a young person, you can repair the meniscus, yes. But if you're our age and we tear our meniscus, don't go scope it. It's like the worst thing you can do. Ample studies now that show that markedly progresses the arthritis. That you may get a little temporary improvement, but over the next few months, you get marked worse in your arthritis. And in fact, in other countries, they don't let people do surgery anymore for torn meniscus because the results are catastrophic. They're horrible.

• 58:42Dr. Darshan Shah?

  Unfortunately, when all you have is a hammer, the whole world's a nail. And you stick a scope in everything, I think. And so it's, to your point, like the rate of arthritis after scoping is massive. And so you want to avoid it if at all possible now.

• 58:56Speaker 01

  Yeah. I'm gonna add one more when you add on your comprehensive thing. So the other really good thing to do is high dose omegas, which are good for everything. But here's the trick. Take a baby aspirin at night because there's this pathway people don't know about called the aspirin mediated pro resolving meteor pathway. So a lot of people have heard about pro resolving meteors. People even take them as a supplement. They take specialized pro resolving meteors. But there's this pathway that if you take baby aspirin with your omegas, they don't have to be taken at the same time. You actually accelerate this pathway to make these what are called resolvins and protectins that are these pro resolving meteors that turn off inflammation. So by doing omegas and a low dose aspirin, this is really important after you have an injury.

• 59:39Dr. Darshan Shah?

  Right.

• 59:39Speaker 01

  So about three days after an injury, low dose aspirin and omegas, you're gonna turn off the inflammation and start the healing process. But I do it ongoing, right? And you know, I take baby aspirin every night and I take my omegas every day. And you're keeping these pro resolving meteors at a much higher level. So you're just helping this process of healing and recovery.

• 59:59Dr. Darshan Shah?

  So interesting.

• 1:00:00Speaker 01

  And it's such an easy little thing to do.

• 1:00:01Dr. Darshan Shah?

  Yeah.

• 1:00:02Speaker 01

  Aspirin is maybe a baby aspirin, this aspirin mediated pro resolving meteor pathway is really cool. So just by taking a little bit of aspirin, you actually accelerate all these processes of making these omegas and turning them into these. Magical compounds.

• 1:00:14Dr. Darshan Shah?

  Another incredible tip from you. That's amazing. This has been such an incredible conversation. I've learned so much from you in just an hour. And like I said at the beginning of this podcast, I'm like, we have to have you on every, every few months because we talk about something else because I learned so much from you every time. You're on the pinnacle of knowledge with longevity science. And I really appreciate you bringing all this to us.

• 1:00:35Speaker 01

  I appreciate you giving me the time and being here.

• 1:00:38Dr. Darshan Shah?

  All right, so no more rice protocol. We're going to do the big protocol.

• 1:00:40Speaker 01

  Meat instead of rice. You got it.

• 1:00:42Dr. Darshan Shah?

  And we're going to work on.

• 1:00:42Speaker 01

  Nothing else home. Meat instead of rice. Take some baby aspirin. Keep your hormones up. Take a few peptides, you'll be good.

• 1:00:49Dr. Darshan Shah?

  Exactly. I love it. I love it. The protocol from Dr. Yurth. Where can people find you?

• 1:00:54Speaker 01

  So definitely our clinic where I'm licensed in 42 states. So we can see people from all over. So if you go to www.bodalongevity.com, that's our clinic and you can just sign up there to get information. And somebody will give you a call. Follow me on Instagram at Dr. Yurth. We actually have a training academy, just kind of train. It was developed kind of just for people to help them understand their own labs and things. Now we have a lot of physicians who do it, but it's called bli.academy. So if you go bli.academy, it's a training academy. We do monthly Q and As that are really fun. So you can, you can go there, follow my YouTube. I try and do a lot of educational stuff, so I try and try and throw up new stuff in the YouTube of, of stuff. But the, the academy is kind of fun because we get these questions from people that are just phenomenal. You know, so it's kind of fun.

• 1:01:39Dr. Darshan Shah?

  I love it. I love it. And you've been such an incredible monumental force with the longevity doctor community, educating all of us. So I thank you for that.

• 1:01:46Speaker 01

  I appreciate that.

• 1:01:47Dr. Darshan Shah?

  Thank you.

• 1:01:48Speaker 01

  Thanks, Dasha.

• 1:01:52Dr. Darshan Shah?

  Wow, that was such an information filled episode with Dr. Elizabeth Yurth. Here were my five top takeaways from that episode. Number one, joint pain is one of the biggest barriers to healthy aging and it's largely preventable. Longevity isn't just about organs and biomarkers. If you want to enjoy a long life, protecting your joints early, ideally in your 30s is going to be essential. Number two, most arthritis is not caused by overuse. Sedentary people often get the worst arthritis. The real driver is chronic. Body inflammation fueled by poor nutrition, hormonal imbalances and metabolic dysfunction. Number three, stop taking Tylenol after an injury. It will actually slow down your healing.

• 1:02:35Dr. Darshan Shah?

  Inflammation is the start of the healing process. Blocking it too early increases the risk of chronic pain and degeneration. Instead, follow the meat protocol you heard about with this episode. Motion, exercise, targeted anti-inflammatories like peptides and ketones, and appropriate therapies. Number four, peptides like BPC157, TB4, and GH Copper and hormones can actually dramatically improve your healing. BPC157 modulates inflammation. TB4 boosts blood flow and stem cell activity. And GH Copper helps collagen repair correctly to prevent scar tissue-driven chronic pain. And finally, number five, if you take only one supplement, it should be ketones.

• 1:03:20Dr. Darshan Shah?

  According to Dr. Yurth, ketones are the cleanest fuel for brain and muscles. It reduces inflammation, improves your endurance, enhances your healing, and helps regulate your metabolism without the downsides of the long-term keto diet.

• 1:03:37Dr. Darshan Shah?

  Thank you so much for listening to the podcast today. Please remember to subscribe if you like this episode and give us a good review and share a link with your friends. It really helps to support all of our efforts. I also want to remind you that the information shared on this podcast is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Please consult with your healthcare provider or physician before making any decisions or taking any action based on what you hear today, especially if you have any underlying health conditions or on any medications. Your doctor knows your personal health situation the best and it's always important to seek their guidance.