Why You Hate Uncertainty & The New Science of Living Longer

Have you ever struggled with a problem—only to have the answer suddenly appear when you stopped trying? It feels almost like magic, but it’s actually your brain working in a very specific way when you step back. https://drexel.edu/now/archive/2016/March/Insight_Correctness/ We all want to know what’s going to happen next. But life doesn’t work that way. In fact, the real challenge may not be uncertainty itself—but our growing discomfort with it. Simone Stolzoff, journalist and author of How to Not Know: The Value of Uncertainty in a World that Demands Answers (https://amzn.to/428rpWb), explains why we crave certainty, why that craving can make life harder, and how learning to tolerate—and even embrace—uncertainty can change the way you experience the world. You’ve probably heard that your health is shaped by both your genes and your lifestyle. But how much control do you really have? Are some outcomes unavoidable—or can your daily choices actually override genetic risk? Dr. Florence Comite, endocrinologist and expert in longevity and precision medicine, has spent decades studying how to optimize health at the individual level. In our conversation, she explains how genes influence your future, where they don’t, and how understanding your personal biology can help you make smarter decisions to improve health and extend lifespan. She is author of Invincible: Defy Your Genetic Destiny to Live Better, Longer (https://amzn.to/3Pir404). In the middle of a tense conversation, it’s easy for things to escalate quickly. But there’s a simple three-word phrase that can instantly shift the tone—turning conflict into something more productive and less combative. Source: Bill Jensen author of The Simplicity Survival Handbook (https://amzn.to/4thwWEX) PLEASE SUPPORT OUR SPONSORS AQUA TRU: Take the guesswork out of pure, great-tasting water. Head to ⁠⁠https://AquaTru.com⁠⁠ now and get 20% off your purifier using promo code SYSK. AquaTru even comes with a 30-day best-tasting water guarantee or your money back. RULA: This Mental Health Awareness Month, don’t just think about your mental health - actually take the step to take care of it. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://Rula.com/sysk⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ to get started. QUINCE: Refresh your everyday with luxury you will actual use! Go to ⁠⁠⁠⁠https://Quince.com/sysk⁠⁠⁠⁠ for free shipping on your order and 365-day returns. Now available in Canada, too! SHOPIFY: It's time to turn those "what ifs" into CHA CHING with Shopify Today! Sign up for your $1 per month trail and start selling today at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://Shopify.com/sysk⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

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

• 0:00Mike Carruthers?

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• 1:23Mike Carruthers?

  Just go to indeed.com/podcast right now and support our show by saying you heard about Indeed on this podcast. Indeed.com/podcast. Terms and conditions apply. Need the right hire fast? Then this is a job for Indeed Sponsored Jobs. Today, on Something You Should Know. Have you ever had the solution to a problem just pop in your head? I'll explain why that happens. And uncertainty. Humans have never handled uncertainty very well.

• 1:59Speaker 01

  You pair that with a more modern phenomenon, the decrease in our tolerance of uncertainty. With the rise of the internet, we have this increasing expectation that answers should be readily available, and an increasing discomfort with not knowing.

• 2:14Mike Carruthers?

  Also, a simple phrase that will ease the tension in any conversation. And a leading endocrinologist on the good news about living longer.

• 2:25Speaker 02

  There are more and more people we know for a fact that are living beyond 100. I do think 120 is possible in our lifetime. And the way to do that is not how to worry about longevity, but rather the quality of your life.

• 2:40Mike Carruthers?

  All this today on Something You Should Know. Now here's something that might be worth a minute of your time. How would you like $1,000 to spend on shopping, especially with the holidays coming? Well, the people behind Shopify have a shopping site called shop.com. And to celebrate the new shop.com, they're giving away $1 million in Shop Cash, but not to one person. A thousand people will each win $1,000 in Shop Cash. And shop.com is actually a really clever idea. It brings lots of different stores together in one place.

• 3:22Mike Carruthers?

  So instead of bouncing around from website to website, you can search across stores, find what you're looking for, and track your orders all in one place. Clothes, electronics, gifts, things for the house, all kinds of stuff. And whether you win or not, it's worth knowing, but with 1,000 chances to win $1,000, I'd certainly take a look. Enter to win the $1 million Shop Cash giveaway from now until November 1st. Just go to shop.com. There are so many ways to win. That's shop.com. Shopping designed around you. No purchase necessary. Restrictions apply. Official rules available at shop.com.

• 4:23Mike Carruthers?

  Have you ever had an answer to a problem or a solution to something you've been thinking about? It just pops in your head out of nowhere. No thinking, no effort, just there it is. It happens to almost everyone, and it's why it's a great topic to begin this episode with. I'm Mike Herrothers, this is something you should know. So when an answer just pops in your head, research shows that those aha moments often come after your brain has been quietly working on the problem in the background, connecting dots you weren't even aware of. And here's the surprising part: when people solve certain problems with this sudden insight,

• 5:06Mike Carruthers?

  they're more likely to be right than when they grind through it step by step. Why? Because analytical thinking can get stuck in the obvious. Insight just skips over that. It jumps to patterns and connections you didn't see consciously. But you can't force it. In fact, the harder you push, the less likely it is to happen. So when you're stuck, the best move might not be to think harder, it might be to step away and just let your brain catch up. And that is something you should know. Nobody likes uncertainty, not knowing what's gonna happen about your job, your health, your relationships.

• 5:51Mike Carruthers?

  It can feel very uncomfortable, even stressful. And these days, it seems like we're surrounded by more uncertainty than ever. So what do we do? We try to eliminate it. We check our phone, we research, we scroll, we refresh, looking for answers, looking for certainty. But what if that instinct is actually making things worse? Because life isn't something you can fully predict or control. And the more you try to force certainty, the more anxious, stuck, and frustrated you can become. In fact, there's growing evidence that people who are better at tolerating uncertainty tend to be more resilient, more creative, and better at navigating change.

• 6:36Mike Carruthers?

  So how do you get more comfortable with not knowing? My guest says it's a skill and one that's becoming more valuable than ever. Simone Stolzoff is a journalist and author, whose work has appeared in The New York Times, The Atlantic, The Wall Street Journal, and more. His book is How to Not Know: The Value of Uncertainty in a World That Demands Answers. Simone, welcome.

• 7:05Speaker 01

  Thanks for having me, Mike.

• 7:07Mike Carruthers?

  So uncertainty seems as if it has been a constant throughout time. So why is it so important right now? Why is it any more important now than ever before?

• 7:19Speaker 01

  There are two things going on. The first is that uncertainty has actually ticked up in the last few years. So there's this great study that has tracked global uncertainty over time since the 80s, and it's found that the five highest measurements since the study began have all occurred in the last five years. So you think about COVID, wars overseas, shifting tariff policies. The world is incredibly uncertain right now. But you pair that with a more modern phenomenon, which is the decrease in our tolerance of uncertainty. With the rise of the internet and mobile phones, we have this increasing expectation that answers should be readily available and an increasing discomfort with not knowing.

• 8:03Speaker 01

  So I think phones do sort of two things. One is they rob us of the practice of sitting with what we don't know. And two, they bring all of the uncertainties around us into our pockets. So the world is more uncertain than ever, our tolerance for uncertainty is in decline, and that's what leaves so many people feeling anxious and unmoored.

• 8:22Mike Carruthers?

  And that is the symptom, then, anxious and worried.

• 8:27Speaker 01

  Yeah, I think we can all feel that on a personal level, you know, even on a more trivial example, whereas 10 years ago, I might have been okay not knowing the name of a given actor. Now I feel an almost involuntary need to reach into my pocket. We're just not as comfortable with sitting with what we don't know as we used to be.

• 8:45Mike Carruthers?

  Yeah, well, that's a that's actually, although a seemingly insignificant example. It's an interesting example because I justify that. Like, if I want to know, how how old is Harrison Ford? I have no idea. It's not that it's it's it doesn't feel like it's uncertainty because I because I don't know, but I don't really need to know. But because I can know, I'll look. It's not because I must know or that I feel anxious for not knowing. But since I can know, I'll look and say, oh, okay, well, that's his age and life goes on.

• 9:26Speaker 01

  Yeah, I mean, there's two problems that arise as an extension from this phenomenon. The first is that sometimes we expect to have definitive answers about things that aren't as knowable as Harrison Ford's age. So, for example, I do a lot of work with people trying to figure out what they want to do for their jobs. And I see a lot of young people in particular looking towards a question like, what will my career look like in 10 years? Or should I take job A or job B as a job that can just be answered by a Google search or a ChatGPT query? The second thing that I think happens is when we are increasingly dependent

• 10:05Speaker 01

  on knowing all the time, it makes us less able to sit with uncertainties in other facets of our life. So there's a distinction I make in the book between acute uncertainty, which is something that is knowable. Will I pass the bar exam? What will be the results of this medical test? Versus the more ambient uncertainty that so many of us live with. When will I die? What will climate change do to our planet, et cetera? And the problem is when we aren't comfortable sitting in that uncertainty, sitting in that state of unknowing, we get less able to deal with that uncertainty in other facets of our life as well.

• 10:44Mike Carruthers?

  Uncertainty, although you say there's more of it, but uncertainty is at some level a constant, right? We don't know what's going to happen five minutes from now. We just don't know. I mean, we have a pretty good idea, but we just don't know. And you would think that we would get comfortable with that, that since the beginning of time, we haven't known. And that rather than get more uncomfortable with it, you would think that would just become life.

• 11:15Speaker 01

  Yeah, I mean, we have so much exposure to uncertainty. I like thinking back to it from a more sort of developmental, biological perspective. If you think about our ancestors in the jungle, per se, imagine they hear a rustling in the bushes. If they don't know the source of that noise, it could potentially be lethal. And so our bodies have trained to try and get out of uncertain situations as quickly as possible. The problem is that we see a lot of false positives, which is to say that we treat uncertainty as if it's always a problem to be solved, even when it can't necessarily be solved. So one study that I thought was fascinating

• 11:58Speaker 01

  was that research participants were given either a 50% chance of receiving a painful electric shock or an 100% chance of receiving a painful electric shock. And those with the 50% chance felt far more stressed and anxious than those with the 100% chance. You'd think those with the 50% chance would feel less stressed because they have a chance of getting off shock-free. But we would somehow rather a certain bad thing happen than have to deal with the ambiguity of not being sure.

• 12:31Mike Carruthers?

  Isn't that interesting? That you would think, I mean, I would think that if you were going to have a 50% chance of getting a shock versus 100% chance, I don't know that I would feel less stressed, but I don't think I would feel more stressed because there's still a chance you're going to get a shock. So I would think the stress levels would be pretty equal, but apparently not.

• 12:54Speaker 01

  Yeah, and this is a finding that's been replicated in other contexts as well. So for example, professional uncertainty has been found to have a similar toll on our health as actually losing our job. Just having that cloud of not knowing hanging above us can be equally as taxing as actually getting laid off. And so part of my goal is to help people get more comfortable with uncertainty, to not look for false senses of certainty that so many pundits and people on social media and people on the television are peddling today, and be okay staying in that state of not knowing until clarity or truth emerges.

• 13:33Mike Carruthers?

  Is there a connection here with patience?

• 13:37Speaker 01

  Very much so. I think when we are certain, it closes our minds. You think about it from the perspective of polarization in politics, or from the perspective of career professional uncertainty. If we think we know exactly how the world is going to look in five years, or exactly who someone is based on who they voted for in the last election, it closes our minds. Whereas if we are uncertain, if we're able to be patient enough to wait, it allows us to see truth as it emerges. There's this great parable that I love that is illustrative of this phenomenon, which is called the Chinese farmer parable.

• 14:19Speaker 01

  And how it goes is there's a farmer whose horse runs away from his small village. The next day, his neighbors come to his door and they say, "We're so sorry to hear about your horse." And the farmer says, "You know, maybe yes, maybe no." The next day, the horse comes back and there are seven other wild horses that have followed it in tow. And the neighbors come to the door and they say, "You are so lucky, what great fortune." And the farmer says, "Maybe yes, maybe no." The following day, the farmer's son is riding one of the wild horses and falls off and breaks his leg. And again, the neighbors return and they say, "What a tragedy, we're so sorry to hear about your son." And the farmer says, "Maybe yes, maybe no."

• 15:02Speaker 01

  And the day after that, generals from the military come to the small village to draft people into the war. And because the son has broken his leg, he's able to skip the draft. Again, the neighbors say, "You're so lucky." And the farmer says, "Maybe yes, maybe no."

• 15:19Speaker 01

  I think that is the value of uncertainty and how it intersects with patience. When we are willing to be patient enough to see what actually transpires, as opposed to making assumptions about what the future will hold, we can see the world more accurately and not rush to judgment about what is to come.

• 15:37Mike Carruthers?

  But there are different levels of uncertainty, and I want to ask you about that in just a moment.

• 15:43Speaker 03

  At Edward Jones, we believe rich is about taking care of what gives your life meaning. That's why your financial advisor personalizes your plan to help you preserve your progress and create something that lasts. Let's find your rich. Edward Jones. Member SIPC.

• 16:01Speaker 04

  In deepest jungle, Cartier's panther spies a wandering bird that circles the skies. A lovebird, lost and missing his mate, is far from his path in lonely state. Dry your tears now, there's a start. Follow my steps to heal your heart. Panther stalks through the leaves with silent grace. Through the power of scent, she finds the trace. Behold, two lovers reunite in the skies. A most precious thrill sparkling in their eyes. Together forever, they shine each day, bound by the beauty of Cartier.

• 16:44Mike Carruthers?

  I'm speaking with Simone Stolzoff about uncertainty. He's author of a book called How to Not Know: The Value of Uncertainty in a World That Demands Answers. So Simone, it feels like there are two different kinds of uncertainty. There is uncertainty that is completely beyond your control and uncertainty, because I could get in my car and drive and there's a possibility. I'm not sure. I'm uncertain if I'll get into an accident. But there are things I can do, like put on my seatbelt and that at least I'm doing something to protect myself so that the uncertainty of imminent death, anyway,

• 17:28Mike Carruthers?

  is reduced because I'm taking action. I'm doing something proactive to mitigate the uncertainty.

• 17:37Speaker 01

  Yeah, I think you hit the nail on the head. You know, I think the first thing that I often tell people is when you're feeling the anxiety of uncertainty, the first thing to do is separate what you can and can't control. So many of us worry about things that are fundamentally out of our control. And then when you think about the realm of what you can control, if you can take steps to get your desired outcome, do that. So put on your seatbelt. If you're worried about where you're going to go to college, you know, try to put in the best application as possible. And if you go down the decision tree one layer deeper, plan for different potential contingencies. So rather than just have one fixed idea of how you think the future will go, try to

• 18:19Speaker 01

  think about how you might be able to plan for different potential futures. And the last thing I say is to try and find your anchors. When we are certain about some elements of our life, it makes it easier to hold uncertainty in others. So in your personal life, maybe that's a commitment to living in a particular place or a commitment to a particular person or a commitment to a set of values. But finding those anchors, finding those boulders that will remain steady amidst all of the changing winds, makes it easier to handle some of those inevitable uncertainties that will come your way.

• 18:56Mike Carruthers?

  It's interesting that it seems that a lot of uncertainty that we have is unwarranted in the sense that most of, most of the things that I look back on, that I was stressed about and anxious about, uncertain about, things worked out. You know, things have a tendency to work out. We have what it takes to get through difficult times and come out the other end. It may not be exactly what we wanted, but it was never as bad as we felt when we were uncertain about it.

• 19:34Speaker 01

  Yeah, I'm sure we all have a friend who maybe went through a breakup or got laid off from a job. And the immediate aftermath said something like, oh, my gosh, my life is over. This is the worst thing that's ever happened to me. And then you go back and talk to them six months or a year later. And they say, oh, my gosh, it was the best thing that ever happened to me. It was this blessing in disguise. It's a case of what psychologists tend to call effective forecasting. So our ability to predict how we will feel about future events. And we are really bad at it. There's been some canonical findings from Daniel Gilbert and others who show that we aren't very good forecasters about both what will happen in the future

• 20:19Speaker 01

  and how those future events will make us feel. And so I think that's a great case for reserving judgment about how those future events might go. If you're able to heed some of the wisdom of the farmer and maintain a level of equanimity about how a given event might affect your life long term, you'll be able to maintain a little bit more of the peace of your mind and adapt more gracefully to whatever comes your way.

• 20:46Mike Carruthers?

  There is, it seems like, a mismatch between when you're uncertain about something, even something horrific. You know, if you're a parent of a child who's very sick and you start to imagine, you know, if he dies or she dies, what would happen? And it's always catastrophe. And it is a catastrophe. It's like the worst thing in the world. But people manage somehow, for the most part, to redo their lives or reorganize things or somehow in their mind, get on with their lives, even though it happened. But when they were predicting what would happen, it was far worse. Even in something horrific like that,

• 21:29Mike Carruthers?

  people do manage to get on with their lives.

• 21:33Speaker 01

  I profiled a friend of mine named Emily Anhalt. And she is a therapist. She works with leaders navigating uncertainty and change in their work. But before she became a professional, mental health... Practitioner, in her early twenties, her mom was diagnosed with a potentially terminal illness. And so Emily spent weeks by her mom's bedside at the hospital. And she was really struggling to cope. She was riding this roller coaster of anticipatory grief and fear. And one day, one of their family friends, this guy named Bill, who's an oncology doctor and has lots of experience dealing with people at the end of their lives, came to visit Emily. And he said, Emily, how are you doing? And Emily said, honestly,

• 22:18Speaker 01

  not very well. I don't know how I'll be able to handle it if my mom were to pass away. And Bill said, Emily, the version of you that will deal with that tragic event, if or when it ever occurs, will be born into existence in that moment. And that version of you will have more context, more information, and be better equipped to handle it than you are today. You have to trust in your future self to be able to handle your future problems. And I love that phrase, trust in your future self to handle your future problems, for that exact reason that you just mentioned, Mike, which is that

• 23:00Speaker 01

  our brains have this natural tendency to spiral, to catastrophize, to think about all of the worst case scenarios. We often rush out to meet our suffering. And Emily is so glad that she didn't prematurely grieve before she had to, because her mom ended up recovering and was okay in the hospital. But even if that weren't the case, I think that wisdom of our ability to adapt to our new situations is one of the most important human skills that we all have. And if we're able to heed Bill's advice, to trust in our future self, to be able to cultivate a sense of faith and hope, even in dark times, that is the skill that will help us.

• 23:47Speaker 01

  Handle any sort of sling or arrow the future brings us.

• 23:50Mike Carruthers?

  I love that. That's just such a great, that's such a great line.

• 23:54Speaker 01

  Yeah, and the other side of it is that uncertainty need not be the cause of inevitable pain. I think the other side of uncertainty is possibility. Often, we frame any sort of uncertain situation as a threat, and rightfully so. You know, our bodies are predisposed to be incredibly uncomfortable in uncertainty. But if you think about, say, a revolutionary artist, or a research scientist, or even a visionary entrepreneur, no one is able to create truly original work without their willingness to get to a point of uncertainty and to persist.

• 24:36Speaker 01

  This idea of uncertainty tolerance, the idea that you can get to the precipice of what you know and continue to move forward, not in the absence of uncertainty, but in spite of the uncertainty that you feel. And that is the way that you create truly original breakthrough work.

• 24:56Mike Carruthers?

  So I'm certain there are people in the world who this isn't a problem for. Somehow, they, this is water off a duck's back. It just, they're fine with it. And I wonder, what's the difference between those people and the people who struggle with this?

• 25:13Speaker 01

  I can't be too prescriptive, but I think one commonality that I think a lot of these people might share is the ability to choose curiosity over fear. To see an uncertain situation with that lens of what might it teach me? How might I grow? Who might I become on the other side of this uncertainty? Often, when faced with uncertainty, we don't have a choice. And I think a lot of the dissonance comes from people who resist the uncertainty that they feel. So in the book, for example, I quote people who are really susceptible to conspiracy theories. And one of the main explanations is People's intolerance of uncertainty.

• 25:58Speaker 01

  They reach for this false sense of certainty that maybe a guru or an online pundit provides because it simplifies their understanding of the world. It's why it's so easy to fall for the allure of a cult-like leader who tells you if you just do one, two, three steps, then you'll get your desired outcome. But a more adaptive way to live is to acknowledge the uncertainty that we all face and to develop the ability to adapt. That is the way that we are able to handle the inevitable uncertainties that we'll face in our own life.

• 26:38Mike Carruthers?

  Isn't there some old saying about the only thing you can be certain of is that you can't be certain of anything? And the trick, as you point out, is to learn to live with that uncertainty. I've been talking with Simone Stolzoff. He is a journalist and author, and the name of his book is How to Not Know: The Value of Uncertainty in a World That Demands Answers. And there's a link to his book in the show notes. Thanks for coming on.

• 27:05Speaker 01

  Thanks, Mike. This is great.

• 27:07Speaker 03

  At Edward Jones, we believe rich is about taking care of what gives your life meaning. That's why your financial advisor personalizes your plan to help you preserve your progress and create something that lasts. Let's find your rich. Edward Jones. Member SIPC.

• 27:22Speaker 04

  In deepest jungle, Cartier's panther spies a wandering bird that circles the skies. A lovebird, lost and missing his mate, is far from his path in lonely state. Dry your tears, now bears a start. Follow my steps to heal your heart. Panther stalks through the leaves with silent grace. Through the power of scent, she finds the trace. Behold, two lovers reunite in the skies, a most precious thrill sparkling in their eyes. Together forever, they shine each day, bound by the beauty of Cartier.

• 28:11Mike Carruthers?

  How much control do you really have over your health? We're often told it's a mix of lifestyle and genetics. Eat well, exercise, and hope you got lucky with your DNA. But what if that's not the whole story? What if your genes don't determine your future nearly as much as you think? Because new research suggests that many of the diseases and declines we associate with aging may not be inevitable at all, and that with the right information, you can actually change the trajectory of your health. My guest says your body leaves clues, measurable signals that can predict where your health is headed and what you can do about it.

• 28:55Mike Carruthers?

  Dr. Florence Comiteé is an endocrinologist and a leading expert in longevity and precision medicine. She's treated thousands of patients and has spent decades studying how to optimize health and extend lifespan. Her book is Invincible: Defy Your Genetic Destiny to Live Better Longer. Hi, doctor, welcome to Something You Should Know.

• 29:18Speaker 02

  I'm delighted to be here, Mike.

• 29:21Mike Carruthers?

  So if our health and longevity is determined by a mix of genetics and lifestyle, what does that mix look like?

• 29:29Speaker 02

  Think of it as genetics and what you've inherited in your DNA, which doesn't change. Your DNA doesn't change. But there's also a field of how your DNA interacts with the way you live life, and I think of it as your health story, meaning the way you sleep, or don't eat, exercise, do anything restorative like maybe yoga or qigong. Any of that affects the way your genes express themselves. So there's an interplay between genetic makeup and how you choose to live life. That's why even identical twins are different. So my twin and I like different things. We have different taste buds. I can live on sushi. She doesn't like fish. She's an amazing gardener. I murder plants, not people, but plants.

• 30:14Speaker 02

  And so, and all along, there are other differences in the way... Our bodies express health and disease that we take care of in different ways. There are certain medications she can take that I can't. And all of us are made in that fashion. So the real strength in understanding the path we're on is to look, if we can, to our parents and grandparents, aunts and uncles, because they have expressed diseases that are written into their DNA. But by living and making certain choices in life, you can stop that expression of disease. You can actually turn a switch and change the way your body operates so that you don't have to get, it's not inevitable. You don't have to get chronic disease as you age.

• 30:56Mike Carruthers?

  So when you go to the doctor, when I go to the doctor, you know, one of the first things they'll ask you is, you know, is there a history of this disease in your family? And they ask that question because why?

• 31:10Speaker 02

  They ask that question because in the old days, it was an important piece of what we did. And asking about the family is important if you can implement what it tells you. So if you hear that someone's mother just got diagnosed with diabetes or a grandfather fell and broke his hip, you should be looking for those signs and symptoms deep within the patient's body, the person that's facing you, because it's already brewing under the surface. And that's why family history is important. But far too often, it doesn't really get addressed in depth.

• 31:44Mike Carruthers?

  What are these five biomarkers of health? What does that mean and what are they?

• 31:50Speaker 02

  Over the years, what I designed, you know, over 20 years ago, before I came to New York, was looking at people through the lens of N of one, meaning each of us is unique. And again, that speaks to my innate knowledge of epigenetics, that my twin and I have the exact same genes, but we express them differently. And as a result, I studied people in depth. I would get 100 to 150 lab tests. Today, we call them biomarkers. And I was able to tell if people were on a track to get a heart attack, to get dementia, to get osteoporosis or cancer. And so what I learned from that test, which I think of as Real world research is that there are five key biomarkers that everyone should request

• 32:34Speaker 02

  in their visit with a doctor, or even try to do it online through a telemedicine company. And basically, it's looking at fasting sugar, fasting insulin, hemoglobin A1C, a cholesterol test called cholesterol risk ratio. And the final one is a little less often, and most doctors don't do this, would be a free testosterone. Because the combination of those tests in all the thousands of patients I've seen have never been optimal. They've always shown me, and can show your doctor and you, what is brewing in your body and what you might want to think about so that you can keep your health for life,

• 33:16Speaker 02

  and it's not inevitable to get sick or to get a chronic disease.

• 33:21Mike Carruthers?

  Well, it's inevitable at some point, right? I mean, you can't live forever.

• 33:26Speaker 02

  Right. Well, I don't think I'm a proponent of living forever, but I do think there are more and more people we know for a fact that are living beyond 100, even 110. I do think 120 is possible in our lifetime. And the way to do that, what I think about, is not how to worry about longevity, but rather the quality of your life. Like, I personally wouldn't want to live with diabetes or a stroke until even 90. Why would I want? I want to enjoy life to the fullest. I want to dance at my great, great, great children's wedding. But I want to feel great, too. I want to have that vitality and that joie de vie. So the five key markers of true health tell us exactly how your body is aging

• 34:09Speaker 02

  and what your predilection is for disease as you age. And if you're at risk, and which diseases you're at risk for developing. And of course, there's deeper tests. For example, if dementia runs in your family, and people have developed Alzheimer's, then you might want to know even at an earlier age, although not everybody does, so there's a caveat in there. You might want to know, what do I put into play so I never get dementia? I have many of those patients. I can tell you genetically, they are It dictates, their genetic genes dictate that they are at risk, high risk for dementia. Because we do even deeper testing, looking at thousands of genetic markers to tell us what

• 34:51Speaker 02

  these variants look like and how they impact your life. And yet, we've reversed loss of memory and cognition issues, energy issues. And it starts with these five key biomarkers, so that you can then decide how to dig in further and what needs to be done.

• 35:08Mike Carruthers?

  So, just if we can use that example, if you're somebody who has a high risk of developing dementia, and you do these five tests, then what could you possibly do different in your life if you're genetically inclined to get that? How do you prevent that?

• 35:27Speaker 02

  Well, that's a great question. So, there's a whole slew of supplements that have been shown by evidence-based medicine to have an impact on reversing the abnormal protein particles that develop in our, in our system. In fact, you can actually measure them today. So, there are studies that have come out. One of them is, for example, tau 217. There's also amyloid. And the combination of those, you'd want to start clearing them. You'd want to start deciding, the basics are, if you smoke, try to stop smoking. If you don't exercise, try to start exercising. If you don't get quality sleep, which actually washes your brain at night when you sleep,

• 36:07Speaker 02

  deep sleep leads to cleaning and cleansing your brain in a way that means you're reducing your risk of Alzheimer's. In fact, if I'm going to point to one factor, it's quality sleep. Quantity is important, at least six hours a night, and eight is even better. Some of us need more, some of us need less, but six is the minimum. You're getting quality sleep in that, which means you need deep sleep. So, one of the other factors that leads to is wearables. Consider an Apple Watch, or an Oura, or a Whoop. And those will tell you exactly what's going on during the night when you sleep. Some people wake up after 10, 15 hours of sleep even, and don't feel rested. And that's because they're Quality of sleep is compromised.

• 36:50Speaker 02

  A final one that affects all of us. And I actually wrote an op ed piece in the New York Post on this at the end of last year is sugar. We all have, and this is something that's probably not well known. We all have a propensity for abnormal carbohydrate metabolism, which many of us think of as diabetes type two. So they've come to the market, and you've probably seen this, with something called a continuous glucose monitor. They do a lot of commercials, particularly for diabetics who had to be used to pricking their finger to measure their sugar. And this little device is a wearable that sits on your tricep and can read your sugar minute to minute.

• 37:35Speaker 02

  The sugar that's circulating around your muscle. And that can tell you if the food you eat, the workout you have, the stress you're under, the sleep you're getting or not getting, is affecting your sugar dynamics. Because sugar dynamics affects every single organ in our body, every cell. I'm a little biased because I'm an endocrinologist. And I know that this is what happens in all of us. It's in fact why women who are pregnant, and when you're pregnant, your body is handling a newborn inside internally. You're living life with at least one other person that you have to feed and take care of in utero. They get oral glucose tolerance tests, short ones, to say, is your sugar behaving? Because that's a stressor.

• 38:21Speaker 02

  Birth control pills in young women also change the way your body handles sugar because you suppress testosterone. And testosterone's key for all of us. We lose it as we age, beginning in our 30s and 40s. So these are factors that would prevent Alzheimer's, dementia. And all sorts of dementia is actually also preventable. There's tons of kinds of dementias, not, I can't say every single one or 100%. The type of dementia that Bruce Willis is dealing with, there really isn't as much insight as we would like. But sometimes people have difficulty with cognition and memory.

• 38:59Speaker 02

  Because they're high blood, they have high blood pressure for years and they've stopped good blood flow with oxygenated blood to their brain. Because it's like the pipes are pushed, are, you know, under strain. They can't allow blood flow when your blood pressure is high. You may not feel anything, but the blood isn't circulating the way you want it to. And all of these factors are not just good to prevent dementia, if that runs in your family, but also diabetes, cancer, high insulin, for example, one of the biomarkers I mentioned, can tell us decades before you get diabetes, that you're at risk for diabetes.

• 39:37Speaker 02

  And because insulin is a, is an inflammatory factor, it also causes and is related to cancers.

• 39:46Mike Carruthers?

  So it seems like what you're saying is there's, there's these tools to use, but essentially you're recommending what we have all been told is a healthy lifestyle. Sleep, eat better, exercise, do the things that we've all been told since we were little.

• 40:06Speaker 02

  Yes, and that's a great fact. I will say, however, that there be, there are people who have done bad stuff, like they've smoked three packs a day, but because they have a certain body makeup, they're blowing out all the candles on their cake at a hundred and three. And there are others who look like they're in phenomenal shape. And I have those patients that I take care of. They look like they're great. They have less than 10% body fat. Their, their VO2, which is their performance in terms of their hearts and lungs are at a level of a 25 to 30 year old, yet they still develop disease. So it's not the same stroke for everybody. Each one of us is unique and being able to use a wearable can tell us how we're changing

• 40:51Speaker 02

  and what we could do. For example, me. Their studies done out of Israel that show they measured a thousand people and they looked at their sugars and for some people having a banana causes your sugar to go as high as a diabetic and for other people it doesn't even budge but having a cookie does the same thing. So for me, a banana causes my sugar to go up. So I have bananas in a limited way and when I do, I make sure that I have a handful of nuts or nut butter with it because it's a little more finely tuned, the nuances are there. It's not just eat well. What do you mean by eating well?

• 41:32Speaker 02

  Eating well means trying to stay away from processed and ultra-processed food, starting with protein before you have a carbohydrate that causes your sugar to go up like a pasta or any kind of bread or, you know, potato or rice. But it doesn't mean giving up on foods that we think are unhealthy. It means looking at the way you can live with balance in your diet. So it has more specifics. You can dig even deeper.

• 41:58Mike Carruthers?

  So here's a question that I think people want, or I've certainly wondered about. So if you don't have a history in your family of diabetes or any other illness, you pick the illness, and then you get it, you get it anyway, even though there's no family history, do you now, do your descendants now have a higher risk because you got it? Or this is a one-off, you got it because you didn't eat well or whatever, and it doesn't, it doesn't enter it into the family story?

• 42:37Speaker 02

  That's a great question and it's complex. So it can go one of two ways. You can have mutated a gene. And or lived life in a certain way. Let's say you're under tremendous stress and you're constantly, you know, your cortisol, which is the stress hormone, is high. That can lead to issues that affect your body in such a way that diabetes can be turned on. For example, there's a famous scientist who's actually my patient and I am allowed to talk about him. He runs a personalized and precision medicine program at Stanford, Mike Snyder, he's very well published.

• 43:19Speaker 02

  And he diagnosed his own diabetes from being under stress and having the flu. So twice in one year that happened to him. And he showed that his genes changed expression and he got significant diabetes. If you look at him, because most people are quite diabetes with being overweight, that's not true either. You can look fantastic on the outside. He looked fantastic. He's a thin guy who bikes all over hills and mountains. And he changed. And he actually had to show his doctors there what was going on because they couldn't believe it. Another factor is, did you have inheritance that showed up? Because in this lifespan, we are living with poor food sources.

• 44:04Speaker 02

  So that even though we think we're buying healthy food when we buy a bunch of kale, which looks phenomenal, we're really buying kale that's been grown to look big and to get volume, but doesn't have nutrients because the soil is depleted. So there are a lot of factors that can affect one human being that might not carry on, but it means the propensity is there. It was built into your genetic profile. And in fact, pretty recently, there was a study that showed we now are beginning to believe what I believed for a very long time. And there's data based on hundreds of twins out of Northern Europe that shows that more than 50% of express disease is genetic.

• 44:48Speaker 02

  And it used to be a very simple thing. Oh, genetics loads the gun and lifestyle pulls the trigger. And most people would say it's 35% genetics and it's 65% lifestyle. And in fact, that's absolutely really not true. Because there are some conditions that are 100% genetics. For example, malignant melanoma. It it happens where the sun doesn't shine. It happens inside your body, in your brain, and in places that doesn't see the sun. So why is that? Whereas squamous cell and basal cell cancers, which can start out with actinic keratosis that should be treated so you don't get them, can happen because you're exposed, you golf too much, and you don't wear a hat, you don't put on sunscreen.

• 45:31Speaker 02

  So there's a balancing act there, Mike, and you can't, you can't make a general rule about it.

• 45:37Mike Carruthers?

  What about genes? I don't know how many there are. I can only think of one. I only know of one, and that's the BRCA gene. That if it's in your family, and you're a woman in that family, you're going to get breast cancer almost for sure, right?

• 45:54Speaker 02

  Not 100%. Even BRCA, when you measure BRCA, I'll give you my, my family history as an example of breast cancer as well. First of all, BRCA and other genes like it, which run in every ethnicity, but BRCA is, tends to be more common in Ashkenazi Jewish population. And in fact, it's only 1% of breast cancer. And so being exposed to toxins in the environment increases your chances of, of cancers, any cancers, colon cancer, stomach cancer. Taking an aspirin a day actually reduces your risk, and there's evidence for that. You take aspirin, a baby aspirin a day, or 81mg, or even 281mg, you can reverse your

• 46:35Speaker 02

  risk after several years of a lot of midline cancers, pancreatic, prostate, you name it, there are several. But if you go back to breast cancer, I have a deep genetic study of my body, and my twin sister too, which is obviously the same. And yet breast cancer runs in my mother's family. A lot of cancer runs in my mother's family. My mother was one of eight children. She lived till 102. She was exposed to a lot of stressors in her life because she's European. So she lived through the Holocaust. And as a result, every member of her family had cancer and a lot of breast cancer. A lot of my cousins. The good news there is that the kinds of cancer we have and the genes I have

• 47:20Speaker 02

  has shown that I don't detox well, meaning I can't take care of environmental toxins. It would be bad for me to live on a golf course. It isn't good for me that when I started this work 20, 30 years ago, I had a very high mercury because I lived on sushi, like particularly ahi tuna. I reversed that very quickly. My sister had no sushi, really. And so the risk of cancer in me by being exposed to, let's say, fish that have high levels of mercury is higher because I don't detox. I don't have BRCA. My family was studied. So there's a lot of reasons to, we don't know, but we can learn. And we can sort of adapt the choices we make in life

• 48:05Speaker 02

  so that we can turn around our future health destiny and live till 90, if that's comfortable, 100, 120, ultimately, maybe 150, in a real situation where you're healthy, where you can enjoy life.

• 48:21Mike Carruthers?

  Well, if you want to live a long time and be healthy while you're doing it, there's your advice for the last 20 minutes. I've been speaking with Dr. Florence Comete. She's an endocrinologist and leading expert in longevity and precision medicine. Her book is Invincible: Defy Your Genetic Destiny to Live Better Longer. And there's a link to her book at Amazon in the show notes. And Dr. Comete, I appreciate you coming on. Thank you.

• 48:48Speaker 02

  Thanks, Mike. It's been a wonderful conversation and I look forward to more in the future, should that make sense.

• 48:56Mike Carruthers?

  If you've got a tough conversation coming up, there's a simple phrase that can completely change how that conversation goes. And this comes from Bill Jensen, who wrote The Simplicity Survival Handbook. "Before you say what you really want to say, start with this: Help me understand." That one phrase does something very powerful. It takes the conversation out of attack mode and puts it in curiosity mode. Instead of sounding like you're accusing, even if you are, it signals that you're trying to learn, not judge. So instead of "Why did you do that?", you say, "Help me understand what happened."

• 49:40Mike Carruthers?

  Same issue, completely different reaction. Because people don't get defensive when they feel invited to explain. So if a conversation could get tense, don't soften your point, just soften your opening. And that is something you should know. Hey, would you do me a favor and help us by telling someone you know about this podcast? Sharing it, using the share function on your player, or however you want to tell them. Just get them to listen and help us grow our audience. I'm Mike Heruthers. Thanks for listening today to Something You Should Know.

• 50:14Speaker 03

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