Understand the hidden biology of longevity | Miskawaan Health

[00:00:00]I had a patient who was like, he came in and he told me, "I don't feel well. You know, I've checked all my viruses. I've done X-rays. I've done everything and they tell me I'm fine, but I don't feel fine."

[00:00:10]>> What are some things that they're missing in those traditional health checkups?

[00:00:13]>> It's not only like just because this is the right thing for that person, it's going to be the right thing for you. A lot of women think that PMS is normal.

[00:00:20]So, like a week before their period, they can be cranky. They can have a lot of pain. They can have headaches, migraines. Like, this is not normal.

[00:00:27]This is your body trying to give you signs that it's not okay.

[00:00:31]>> There's something wrong. Yeah. What would you do to fix it then? It's just a hormone imbalance or is that basically what we're looking at?

[00:00:37]>> Sleep, exercise, food, stress. These are the four major things that we try to correct. You don't need to be taking all your vitamins for the rest of your life every day, you know.

[00:00:47]>> And I always tell my patients like I don't want you to be normal, you know. I want you to be optimal.

[00:00:58]Welcome to the Tiger Podcast. Today we're joined by Dr. Ronnie from Msawan Health Clinic for a conversation about why so many healthy people still feel unwell. You may have been told your blood tests are normal but still feel tired, foggy, inflamed, heavy, or simply not like yourself. So, what does normal really mean? And is there a difference between being free from disease and actually functioning at your best? In this episode, we'll explore the hidden biology of longevity from inflammation and hormones to sleep, recovery, metabolism, and the growing world of advanced therapies. Most importantly, we'll look at how to move beyond quick fixes and understand what your body is really trying to tell you. Ladies and gentlemen, please welcome Dr. Ronnie.

[00:01:49]Uh well, all right guys, I'm here with Dr. Ronnie who is the head physician here at Mscoan Health. Uh how are you doing today, Dr. Ronnie?

[00:01:56]>> Yeah, I'm good.

[00:01:57]>> Yeah. Well, I wanted to ask you a little bit about uh your first uh your background and how you uh ended up getting here to Msawan as uh at your current position.

[00:02:08]>> Right. Okay. Well, um I'm a medical doctor. I have experience with longevity, functional medicine and regenerative medicine for over about 10 years now. So uh what got me into like functional medicine or longevity is because about 10 years ago I was quite sick and the conventional medicine I mean it's great for everything that it does but we kind of got into like we hit a wall with the treatments and I tried to find different things that were out of the scope of conventional. That's when I started looking at my own health in the way of diet, gut health, >> and looking at other other aspects and adding it on to the conventional treatment and kind of helped myself and got into um the idea of how to um how do I explain this? So like basically I just learned how to integrate like functional stuff with conventional and that's basically my approach here. So I usually work with patients to I try to find the middle road, try to find the best of the conventional and the functional stuff and then find what works best and I feel like uh personalized care is what I do >> and that's what's really important to me and yeah so that's how I'm here.

[00:03:29]>> Yeah, that's a big it's a big hallmark of MSGA, right? Is uh creating like a personalized healthcare plan for individual patients, right? Exactly.

[00:03:38]because each patient is coming with a different set of uh you know problems or or uh strengths and weaknesses that kind of a thing and what I love about it as you said here is that you're not dismissive of the conventional medical treatments you're just trying to find ways to supplement it and and probably uh increase the the the success rate of treatment. Yeah, I love it. And uh speaking of longevity too, that's a big trend these days. Everybody wants to live healthier much longer, right? And you it was it was very funny. I was see I just saw today on social media. It's so funny. Uh it was uh Tom Holland, you know, Spider-Man >> like and uh it was one of the James Bond guys from like the 70s or something like that. And here's both of them at 29.

[00:04:24]>> And the 29 in the 70s looks very different than the 29 of today.

[00:04:29]>> Oh, how so?

[00:04:30]>> It just looks way younger. Like the 29year-old looks like how I would think a 29y old the other 29year-old from the 70s looks like he's in his 50s.

[00:04:38]>> So it feels like we've come a long way.

[00:04:40]>> Yes, definitely.

[00:04:41]>> Yeah. In terms of you know just overall healthcare and things like that. But why why is longevity this this area of medicine so interesting to you?

[00:04:49]>> To me I think longevity is really interesting because I think people are not are more aware now and they don't want to wait till they get sick anymore.

[00:05:01]Like I think uh with conventional medicine we were looking at the statistics of people when uh when we look at their blood reports or anything like that we were looking like waiting till they get sick to do something.

[00:05:13]>> But I think this new generation or where we're at today people understand more and they don't want to get there you know people want to >> prevent this and see what they can do before they get really sick. And I think that's really interesting to me. I think that if uh we can prevent illness, if we're going to live um for until we're in our 80s or 100, whatever the longevity goal is, we have to live with a good health with like a good health span, not just like lifespan. So, I think that's really important to me.

[00:05:45]>> Yeah, absolutely. I mean, what good is all of that those extra years if they're not uh functional?

[00:05:50]>> Yeah, exactly.

[00:05:51]>> Yeah, it's an important aspect. And one of the things you brought up too is uh prevention versus treatment, >> right? Uh everybody is much more keenly aware of, you know, what are what are we putting in our bodies, right? Probably shouldn't eat that McDonald's tonight, maybe eat a salad. And it's those uh little steps that might improve health outcomes in the long run.

[00:06:12]>> Um my next question I want to ask you, so okay, I try to do well. I exercise. I had a salad for lunch today. Thank you very much.

[00:06:21]>> Good job. Yeah. And uh you know I I go and do my blood tests once a year just to make sure everything's okay, but uh and everything is relatively normal.

[00:06:30]Sometimes I still feel tired, a little fatigued. Uh why is that? What am I doing wrong?

[00:06:37]>> Oh, okay. Good question. Um when you go for your blood test, like a regular checkup at the hospital, they will check just like uh there's a reference range for when they check you. So for example when they check your thyroid the reference range is the range of normal people which normal people the the the gap of people that they use are basically like when they say they're normal means they like mostly sedentary mostly they're not >> they don't have to be the exact like perfect people you know so the reference range is really really wide I think that's the problem and so sometimes times you're on the the lower end of the spectrum or the higher end of the spectrum, so you don't feel that great.

[00:07:24]>> That's pretty interesting. So, it's like they're comparing me to maybe people who aren't living the healthiest lifestyles in the first place.

[00:07:32]>> Exactly. And I always tell my patients like I don't want you to be normal, you know? I want you to be optimal. And that's what we we aim to be. We don't want to be just every other person walking on the road.

[00:07:43]>> I love that distinction. We want to be optimal, not normal. That's great. Cuz if I hear the word normal, I'm like, "Okay, cool. I' I've survived another year. I'm good. But maybe I'm not living my best life."

[00:07:52]>> Yeah, definitely.

[00:07:54]>> Wow. Sad. Well, I need to spend more time hanging out with you.

[00:07:57]>> Uh, yeah. So, how much of this is like a function of not doing things in an optimal way versus, you know, I'm just getting older. Everyone gets older and obviously the body changes in that kind of way. Uh, what's the difference?

[00:08:13]>> I think that's the problem. I think that you know most of us accept that all these things are just like part of aging but it doesn't always have to be. I think that in longevity there's something called inflammaging where like if you if you have chronic inflammation for a long time uh that's what causes all these problems with aging. Uh well to to elaborate on that is that inflammation happens like there's acute and chronic inflammation. So if you have acute inflammations like if you get a cut or something your body responds to it by producing like uh redness, swelling or something like that to help you heal, right? But if this kind of inflammation happens inside your body means that your body is trying to fight something all the time means that your body's using all its resources to try to >> to to cover that inflammation. It's using all the resources and that what that's what increases the aging in your body because you're using up a lot of your body already. H interesting. What what could be some of these common causes of internal inflammation?

[00:09:14]>> Um like insulin resistance. So if you like have if you eat a lot of sugar in the past and your body is trying to produce uh insulin and you have too much insulin, it's called insulin resistance.

[00:09:25]So this is inflammation in the body. Um other sources are like oxidative stress.

[00:09:30]Supposing you don't sleep enough then you have oxidative stress in your body.

[00:09:33]And then nutrition of course you have like ultrarocessed foods and all that.

[00:09:37]That's all what causes inflammation in the body.

[00:09:40]>> Yeah. It's one of those frustrating things where it's like, yeah, I I feel like I kind of already knew these answers, didn't I? Like maybe don't eat so much sugar, maybe get a good night's sleep, maybe uh yeah, not the processed food. Uh but it's so hard in in the modern world with all of these conveniences.

[00:09:56]>> Yeah.

[00:09:56]>> But uh yeah, I don't know. Exercise, I imagine, probably helps, too.

[00:10:00]>> Yes. But like too much is also stressful to the body. So I think like because in general we get an idea from like whatever social media or friends or people that we know about what we should do and then we just think like that's the right thing for us. But I think personal personalizing it based on your age group, your blood results like it's so important. It's not only like just >> uh because this is the right thing for that person, it's going to be the right thing for you. For example, like uh I have a lot of patients who have adrenal fatigue. You know, for them, they can't uh do heavy exercise. When they do it, they feel horrible.

[00:10:38]>> Yeah. So, I mean, personalizing this is just so important.

[00:10:42]>> Interesting. Yeah. Sometimes too much of a good thing can be too much. That's for sure.

[00:10:47]>> Uh well, let's talk let's let's hear about some of these maybe quote unquote higher performers uh that come in here.

[00:10:54]They're doing everything right. They generally feel good. What what do like if their checkups look fine on paper, do they still have other complaints maybe that that aren't being addressed? And how would you address them?

[00:11:06]>> There's the people who have all the information from online and they've used all the good stuff that everyone says they should use, but they're not getting the results that they want. So these people, it's because we haven't corrected the basics yet. So when you use just try to use stuff on top without correcting the basics. basics I mean like lifestyle nutrition exercise all of that they don't get the results that they want >> then I also have patients who are like CEOs or whatever like you know highly functioning and then they come in they say okay they have brain fog or they cannot function as well anymore even though they think they're doing all the right things >> um yeah >> brain fog so what else um oh recently I had a patient who was like he came in and he told me. I don't feel well. I've gotten checked everywhere. You know, I have a fever every 5 days >> and then his fever would go away and then after his fever goes away. He'll be okay for like 2 days and then his fever will come back and he's gone to all the hospitals, got everything checked. He's like, you know, I've checked all my viruses, I've done X-rays, I've done everything, and they tell me I'm fine.

[00:12:16]>> And he's like, but I don't feel fine. We did a whole panel of blood tests and you know we found the problem what it was and then we were able to correct it for him to feel much better. So I think that like there's definitely a gap there like he doesn't have a disease but he definitely has something else that maybe they're not addressing.

[00:12:35]>> Interesting. Yeah. Well, and that's uh the importance of this personalized care because like going to the hospitals like I I've been to the hospitals here in Bangkok, some are very very nice, but sometimes I just feel like when I go for my my annual health checkup, I'm just being herded like like cattle to the next place and it does there's no personal touch really and uh that uh is a little troubling considering it's you know health is wealth. It's like the most important thing in our lives.

[00:13:01]>> Have you ever done any longevity stuff before? I don't think that I have and yeah I'm in my 30s right so I I still have that uh >> you know illusion that I'll be young forever whatever so it is something that I especially after having conversations here at MSAN >> that I I'm learning a lot >> it's time that's all right all right >> you know when you hit your 40s especially for men everything really changes like if you if you start early it's a good time it's never too early to take care of your health >> yeah that's a very good point Yeah. All right. All right. We'll talk after the show.

[00:13:36]>> Um, yeah. So, speaking of that, like these standard checkups that I go and do all the time, what like you know, they tell me, okay, your cholesterol is this fatty liver, blah, blah, blah. What are some things that they're missing in those traditional health checkups?

[00:13:51]>> Good question. Um, where do I start? I think that, okay, let's start with metabolic diseases, right? and metabolic diseases. Now, when it comes to blood glucose, we no longer think that like waiting for the A1C, HBA1C is what they check like to to see your cumulative blood sugar for the past 3 months and that's where they tell you like oh are you diabetic or not. I think it's not uh it's no longer enough like what what I what I'm trying to say is um we need to check for fasting insulin. we need to check for insulin resistance because that comes before diabetes. You know, it's like the pre-diabetic state and when you catch people there, we can still reverse it. Whereas the the general health checkup will just show you, okay, uh are you diabetic or not?

[00:14:36]And if you're not, then you go about just going um >> maybe just eating the same way or whatever, living the same lifestyle, and maybe that's not enough because you you won't know one day you'll just become diabetic and you wouldn't have caught it, you know, in between. So that's definitely one thing. And then when we look at uh cholesterol levels, I think that in functional medicine, we're looking more into like apo B, lipoprotein A, like things that are more specific because cholesterol is not always bad.

[00:15:05]>> And when we look at hormones, I think that the major issues are thyroid. women by the time you're in your 30s like most women or a lot of them have some sort of thyroid issue especially if they've gone through like pregnancy or you know having babies and fertility issues or anything like that there's always a thyroid component whereas uh when you check in the hospital the the blood results they wait quite long like for you to be properly hypothyroid to treat you >> but I think the subclinical hypothyroid roid, which means that like when you're in between, um it's so important because clinically these patients don't feel well at all. And if you can catch it early, we can reverse a lot of the thyroid problems.

[00:15:52]>> And uh other than that, it's like testosterone, estrogen, all these things. For men, you know, by the time they hit 40, they feel like they don't feel like themselves. They're not as happy as they used to be. the loss of libido, you know, these are things that we can catch a lot early earlier on. And uh for women uh after 35, you start menopausing.

[00:16:14]So >> yeah, >> got to be look out for that. I've heard not very good things about that.

[00:16:20]>> Yeah. So, but if you catch it early and you like you can slowly move into menopause and like it can be like very graceful and not so tiring and not as bad as people talk about. Yeah.

[00:16:33]>> Interesting. Yeah. And this is what I guess that that distinction, right?

[00:16:38]Like, hey, no, no, you're okay. Pat on the head. Bye-bye. But then like actually what what can we prevent like further on down the line? Like I might be okay now, but there could be signs of something worse coming on down the line that we can address >> presently.

[00:16:51]>> Exactly.

[00:16:52]>> Um so yeah, uh let's let's say then all right, generally healthy person gets their their blood test uh and everything is okay, they feel okay. more or less have are there like things that we might not catch, right? like where I'm like like let's say I'm feeling healthy and then my blood test comes back all right but then what what are some areas you guys might scan where there could be something like missed like even like like cancer markers or something like that where I I feel okay everything seems okay but maybe it's not what what could be missed >> okay so usually what we do is like we do a whole panel so we check your metabolic markers like I said it's a little bit more detailed than the hospital so we catch things a bit earlier we check your hormones which is usually not check in the hospitals unless you have an issue.

[00:17:40]We check for inflammation markers.

[00:17:42]That's like I talked about chronic inflammation. So we catch that as well.

[00:17:46]So that's how we start. And if your blood results are not good for these three or like the general picture is not okay, then I usually focus on >> rebalancing that first and making sure there's no inflammation, metabolic markers are okay, hormones are optimized. Once we get that correct and we can you know everything's all balanced then we look into the functional things. Functional things are like your you know gut and your stool exam and uh doing things like I mean nowadays it's really cool. We have things that they can diagnose your like it's called true age. So it looks at like your longevity and sees um the pace that you're aging per year. if you're aging like ahead like too quickly like you're supposed to age one year per one year that you're aging but some patients are aging at like two years ahead.

[00:18:36]>> Yeah. So you can check that you can see like which organs are having more problems like there are a lot of cool functional tests that we can do.

[00:18:43]>> Interesting. Yeah. Uh so then what how do you go about uh treating these things? So if there is a problem say inflammation like what does the treatment process look like? Is it lifestyle changes or are there medical treatments?

[00:18:54]>> Uh yes. So we do a lot of counseling and talking to the patient about lifestyle changes because I truly believe that if we don't get that right there's no point of doing everything else. So the initial like first few consults that we meet the patient we uh talk to the patients and um yeah get try to get the basics right.

[00:19:14]So the basics are sleep, exercise, food >> basically and stress. These are the four major things that we try to correct and then um along with that we do supplements and then some IV treatments and anything else that's needed. So there's some more advanced treatments that we look at as well.

[00:19:32]>> Right. So I IV treatments uh what would that entail like uh just somebody sitting in here watching a TV and uh just hooking up for an hour or something like that?

[00:19:41]>> Yes, >> more or less. Yeah, I think I've done one here. remember I've gotten a few of them uh doing these uh kinds of podcasts and it's always interesting because I do feel a difference.

[00:19:51]>> Yes, I think everyone's like at some sort of micronutrient deficiency because of the food system everything is a lot has changed.

[00:19:59]>> So even getting like vitamin drips like you like if you feel a difference is because your body >> is in some sort of deficiency you know.

[00:20:08]So >> yeah, I and that's uh something else that I do and I've talked I think before about this. I take a lot of supplements uh your fish oils, your what there's there was one thing I'm trying to think there was something good for heart health that I was talking about >> co-enzyme Q10 >> that that's it I think. Yeah. And uh you know digestive enzymes, probiotics, blah blah blah. I take all that stuff uh orally. Is that going to be as effective as maybe coming in for like an IV treatment instead? Uh um I think both has its place.

[00:20:38]>> Okay.

[00:20:39]>> Um so oral supplements are good for like long-term maintenance and uh when we're working with patients that are like far away or something, we use supplements.

[00:20:47]But in the case that there is some like acute problem that we need to fix, then we try to do IV treatments cuz absorption is much better and then we get quicker results.

[00:20:58]>> But I think both both player like it's all about uh the right timing for both of them. Okay, cool. Yeah. So, all right. I'll keep taking my pills then.

[00:21:07]Thank you very much.

[00:21:08]>> Um, yeah.

[00:21:09]>> Do you actually take >> I do every day. Every day. I have like a whole like uh cabinet full of them and uh I I I divvy them out like by the week or something like that. So, every day I just take this different times a day too. B12 in the morning, blah blah blah.

[00:21:23]Like >> I think a lot of the patients do that too. Um the problem is they don't know what like >> I don't think that you need to take everything every every day. And I feel like there needs to be like a little bit of a plan of what we're doing. Like you don't need to be taking all your vitamins for the rest of your life every day. You know, I feel like initially you >> replenish what's missing. Like so I usually work with patients with like vitamins and minerals first and then we kind of see uh once they're okay their body's a bit more balanced and you work into like phytochemicals or then there has to be like a logic or a plan as to what we're doing and then that changes usually every 3 to 6 months so that we're working towards a goal. I think that since the longevity um idea has become like quite mainstream and a lot of people are trying to do supplements, they are um supplementing but not correctly.

[00:22:19]>> Right. Interesting. So, okay, I I'll show you my list and then you can tell me. All right, we'll talk about it after. But uh yeah, it is uh I I mean it's just another symptom for me of uh recognizing I am getting older and maybe not everything in my diet is covering everything that I need. Yeah.

[00:22:38]>> And uh I guess that's where the blood tests come in and and having a professional monitor the situation is probably a good idea.

[00:22:45]>> Yes, exactly.

[00:22:47]>> Well, let's talk a little bit about hormones because like I said, I am getting older. I'm getting closer to that that big 40. Shut up everybody. All right. I don't want to talk about it.

[00:22:55]But uh yeah uh hormones obviously are play a big impact more than I expected right uh uh since I've been learning about things here at MSCON uh how does it affect like when your your hormones are maybe you know lower testosterone than usual how's that affecting your sleep your mood everything and and then how do we correct it >> oh okay good question so when I talk about hormones that uh with my patients we talk about four major hormones so the thyroid the adrenal glands the sex hormones and then insulin. I think these are the four major like players that we try to look at and hormones work in like a symphony. So basically you cannot manipulate one or without >> working on the other one. So when I check patients I look at the whole panel and then see what's going on. um when you are aging these hormones will start reducing of course with like uh normal aging process and like I said when we look at let's go through each hormone so because of the modern lifestyle and because we're always like chronically stressed because of the traffic or whatever it is work meetings or whatever the adrenal glands go through a lot of stress the adrenal gland is uh an organ above your kidney and basically ally they um help you go through physical and mental stress right and uh throughout your life you have many um bouts of like stressful events and that's what uses up the adrenal glands. So by the time you hit like 30 35 some people have already like used up a lot of the reserve that they have and they go into adrenal fatigue and that makes you wake up and feel like uh you're exhausted when you wake up and you need like multiple coffees to just stay alive >> for the day and then you need by evening you need to take a nap or something like that. So this this is all like early signs of adrenal fatigue >> for adrenal glands. We just the lifestyle changes are very important things like even stopping caffeine >> uh that like with some of my patients just stopping coffee really really helps that because >> by drinking coffee you're like pushing the adrenal glands to work more if that makes sense.

[00:25:10]>> Yeah. like uh so yeah lifestyle like reducing stress which is not easy but we have to discuss what they can do. I feel like a lot of people lose their passion by the time they're like in their 30s because they're just busy working and they forgot what they really liked to do when they were younger and uh getting that back so that that's the way that they de-stress is really really important.

[00:25:35]>> And um >> yeah, so that's for the adrenal gland.

[00:25:38]So, fixing up their sleep and then caffeine. Eating breakfast in the morning. That's uh really important as well. When you have adrenal fatigue, breakfast before 10:00 a.m. really helps.

[00:25:50]>> Um, and yeah, addressing stress, like I said, doing stuff that they enjoy. So, getting them back on that and then slowing down their exercise. People who have adrenal fatigue uh sometimes are also really high performers. So they love to go and do like heavy exercise and it just makes them like crash even worse.

[00:26:08]>> Whatever we like if we try to reverse adrenal fatigue, we have to try to um we have to try to slow down.

[00:26:17]>> Mh.

[00:26:18]>> Yeah. And I think just slowing down and telling going back and speaking to my patients for hours about how to how to slow down >> is really really important. Yeah.

[00:26:28]>> Yeah. It's almost like there's a mental health aspect to all of this. Of course, too. And it's interesting to me too because some of these solutions are counterintuitive to what uh I would think would be leading to a healthier lifestyle. Like more vigorous exercise, right? I like I I don't know how intermittent fasting. Is that a good thing? Cuz I always skip breakfast.

[00:26:46]Yeah, maybe I shouldn't be doing that. I don't know. I guess I need to check my adrenal glands and then we can find out.

[00:26:51]>> I think it's great. It's just like you have to see if it's right for you, >> right? Exactly. And that's what I mean.

[00:26:56]It's so personalized this whole health journey. And uh yeah, like listening to cookie cutter influencers telling you what worked for them, selling their whatever supplement or something like that is is not the approach. Uh look, it's good for views, but >> this is our health like and we have to take it seriously. How is it um how is it different for women, let's say, as they're getting older?

[00:27:18]>> Yeah. So, for women, um thyroid and estrogen. I'll go with thyroid first because I think that's one of the major problems and it comes up first for most women. So thyroid problems come up usually like I said before like by the time you hit your 30s uh there's usually some sort of thyroid dysfunction and uh we have to look at it like the when you go to the hospital and you have a thyroid issue they wait until the numbers like there's something called TSH and they wait till that hits about five before they give you any drugs to help you or they look at like the other numbers and um the normal range is 1 to Mhm.

[00:27:59]>> And there's a gap between two to five that people don't feel great. And uh no one addresses that. That's called subclinical hypothyroidism.

[00:28:10]>> And uh at that point, women are gaining weight and they're eating the same, but they're gaining weight. They're constipated. They're feeling like, you know, they don't have energy. And uh when they go to the hospital with this and they say these are their problems, they're told that they have to wait until the numbers look like, you know, over five for them to get any help. So this is where we come in and we help a lot of women with subclinical hypothyroidism and we realize that a lot of people with thyroid problems is they have some sort of autoimmune aspect to it as well. This is called Hashimoto's thyroid hypothyroidism and um maybe this I don't know if it's too detailed but I don't know.

[00:28:57]>> Okay.

[00:28:57]>> Yeah. Hashimoto's. Let's go.

[00:28:59]>> Yeah. Hashimoto's is um so basically if they have Hashimoto's means they have antibodies to their thyroid >> and that means that there's a whole gut aspect to it because by the time >> I think that a lot of people by the time they finish college and come out and work there's a lot many years of dysfunctional gut health because like you wouldn't have eaten you know the right foods or anything in in university or anything like that and then um so when we address these thyroid problems for women, we have to uh address the gut issues so that we can reverse the whole thing. It's not about giving them just a pill, >> right?

[00:29:37]>> And I think that that's what that's a big gap for women's health. And the thyroid is so important for your metabolism and for your uh for women's like heat system and metabolism and it's one of the hormones that goes before the other hormones. So if we don't correct thyroid, we start seeing problems with fertility and ovaries and we see problems with um like their menstrual cycle >> and yeah, so I think it's really important. I think this is the big gap.

[00:30:07]So for women's health, I always talk to my patients that you know your um your cycles is like your report card for the month. M >> so yeah I mean it's because a lot of women are like happy or they don't know that this is a like getting >> a normal cycle is actually um >> what what do I want to call it like >> getting a normal cycle is absolutely necessary right >> yeah and and like you must not have PMS like a lot of women think that PMS is normal so like a week before their period they can be cranky they can have a lot of pain they can have headaches migraines like this is not normal this your body trying to give you signs that it's not okay.

[00:30:49]>> There's something wrong >> or if your cycles are not on time or if you're bleeding too much or too little.

[00:30:54]Like these are all like signs that your body is trying to give you and you know people are ignoring it and just thinking like oh this is normal because my friends have PMS you know it's it's it's a term that everyone accepts, right?

[00:31:06]>> Yeah. Yeah.

[00:31:06]>> Yeah.

[00:31:07]>> Very pretty much every ex-girlfriend I've ever had has told me it's just a normal fact of life. So >> it's definitely not.

[00:31:14]>> Hey we got to fix this. What would you do to fix it then? It's just a hormone imbalance or is that basically what we're looking at?

[00:31:19]>> Mhm.

[00:31:20]>> So then it it's it is a hormone imbalance like usually uh could be from like too much estrogen which is causing them to be like if they have estrogen dominance then they have a lot of like pain >> and they have a lot of like mood swings, right?

[00:31:32]>> So estrogen dominance comes from back to basics again not having enough fiber, your liver not working well um basically. Uh yeah, so your body being imbalanced, not enough sleep. So we have to work with lifestyle first and then also with supplements to help reduce the like bad estrogens basically help you with like liver supplements as well and then we also basically yeah try to fix try to fix this.

[00:31:59]>> Yeah. Interesting.

[00:32:00]>> Yeah.

[00:32:01]>> Well uh let's talk back about the men too because we we touched on it briefly about uh testosterone, >> right? how when that goes down later in life for men, libido is obviously something that's thought about, but of course it affects you in so many different ways. Energy levels. Uh how else is is this an issue for older men?

[00:32:20]>> Testosterone is so important for men because uh testosterone is to do with your brain health, your blood vessels, your card cardiovascular health. It's all to do with testosterone. So when your testosterone levels reduce, it's not just the libido that's a problem, but it's like your overall general good well-being like you know that's affected. So uh monitoring this and you know making sure that they're at optimal levels is just so important.

[00:32:47]Mhm.

[00:32:48]>> So, it's it's that's what's funny to me is like thinking about testosterone, at least in pop culture, the way it gets framed is like, oh, you know, bull shark, blah, blah, blah. You're like just young and, you know, I'm a man, blah, blah, blah. But it's it's a completely like holistic tes like hormone, right? Like it affects so many different parts of of your well-being and health. And I've seen so many people now like uh friends of mine that have begun taking uh testosterone as older men and they swear by like now like they they they were like this was like they went and got checked out. They're like all right testosterone and they're like it completely changed my life just addressing that hormonal issue.

[00:33:31]>> Exactly. Yeah.

[00:33:32]>> Very fascinating to me.

[00:33:33]>> You know how women get menopause, men get andropause. That's also a thing. Why that doesn't make it why is menopause not for men and uh you know >> but yeah same kind of idea though right >> but then the idea of testosterone I just want to add a little point is that a lot of times people are supplementing with testosterone but if you don't get the basics right go back to it again >> it's um it can be dangerous as well >> fair enough >> yeah because testosterone is in your muscles >> like so if you build enough muscle you can maintain the testosterone that you're injecting and you know and you're detoxing it well and all that. So >> being mindful of that is really important.

[00:34:14]>> Medical supervision really like definitely don't pick some up on the back alley or anything like that.

[00:34:19]>> Well, uh cool. All right, that's enough of the hormones. Let's uh we were talking earlier too about um sleep and and recovery and uh obviously sleep is very important. Is it possible to get like what the ideal amount of sleep is different for different people? Is that right? or is it more or less the same kind of window?

[00:34:38]>> Good question.

[00:34:41]So, it's a lot of debate. Well, I think now with the smart watches, so everyone has this whole like recovery percentage and all that that they have to hit. So, I'm happy with that. I think that it uh people are are more aware.

[00:34:56]>> So, I'll just touch up on points that I think are new uh about sleep. I think the latest research is about the circadian rhythm. So they talk about how um uh the number of hours is not as important as the time that you go to sleep and the time that you wake up.

[00:35:16]>> Yeah.

[00:35:17]>> Interesting.

[00:35:17]>> So I mean of course you need like to get good rest and deep sleep and all that but uh there's a whole study on going to bed at the same time every day and waking up at the same time every day.

[00:35:29]And when you wake up, you you see some sunlight and that resets your whole circadian rhythm. And that is also so important. And because every every cell in your body has like a clock gene.

[00:35:41]>> So it like resets with the sun. M >> so there's a whole different aspect now about like it's not about trying to get 6 hours or 8 hours of sleep but it's like trying to get to bed at the same time every day >> because it's not possible for shift workers or anything to sleep at like if you say 10:00 p.m. it doesn't work for everyone you know >> so it's just trying to get to bed at the same time every day and try to wake up at the same time every day and on the days that you cannot sleep at the right time or the same time you have to wake up at the same time.

[00:36:11]>> Oh >> so that like cycle is really important.

[00:36:13]So, so it's Friday night, right? I plan on going out and having some fun tonight.

[00:36:19]>> So, what you're saying is it's okay for me to wake up because I usually wake up around like 8 in the morning. That's when I wake up, get ready for work.

[00:36:25]>> So, if I stay up later tonight, go out and have some fun. I should still wake up at 8. Yes. Is what you're >> saying. Exactly. And get some sunlight in the morning.

[00:36:33]>> Okay. All right. Then maybe I could take a nap in the afternoon if I'm I don't know. Are naps good? Can I take naps?

[00:36:40]>> Yeah, naps are great.

[00:36:41]>> Okay. All right. Good. I don't take them too often, but uh that's very interesting to me because that's a little it's I'm learning uh here because I would always think, all right, well, I've stayed up too late. I should make up for it by sleeping in later.

[00:36:54]>> Honestly, it doesn't ever work for me anyways. I wake up and I'm just up like because I'm on that 5day a week work schedule where I'm always going to sleep and waking up at the same time.

[00:37:02]>> And that's your natural biology. Like your body is waking up at the same time because that's the correct thing, you know, for your body. So, yeah.

[00:37:10]>> Yeah. I I don't fight it. I don't fight it. My girl, my girlfriend fights it.

[00:37:13]She's like, "It's Saturday. I'm going back." I'm like, "No, no, I'm up and I'm doing stuff." So, >> go for a run.

[00:37:20]>> Go for a run. All right. Calm down, doctor. All right. It's my weekend.

[00:37:24]Thank you very much.

[00:37:26]>> Um, all right. So, let's move on. Uh, now, all right. Longevity. Longevity is trendy, right? Everybody's talking about it. But, uh, there's a lot of key words, right? supplements, peptides, IV drips, advanced therapies.

[00:37:41]>> Yeah.

[00:37:41]>> Uh, how are you separating real medicine from hype stuff that you see on social media?

[00:37:47]>> Um, good question.

[00:37:52]>> Is it hard to >> No, it's it's not. I think that uh the trends will keep changing like whatever sells will just trend. But I think that personalizing the medicine is just so important. Not that everything that is advertised is great for everyone. So like I said, we have to look at the basics for the patient first and like I told you, optimize like metabolic health, optimize their hormones, optimize their inflammation and all that first and then see what is needed at what time for each person. So it's not like everyone, let's talk about peptides, right? Like everyone is talking about peptides and how they they come into the clinic and they're like we want to use peptides and we've heard about BPC and we've heard about Matzi and we've heard about RETA and give me this and give I'm like no I cannot give you peptides because peptides only work if your body is working.

[00:38:44]>> So we need to go through some blood tests make sure that we know what's going on with your body because if we want the peptides to work we need to know that your body is okay. you know, like it's it's no longer like just okay, here's the train, take some stuff.

[00:39:00]But, you know, a lot of patients still get that kind of answers from other I don't know, places to maybe cut this.

[00:39:07]>> Don't name names. Don't name names, but yeah, it happens.

[00:39:10]>> It happens. Yeah, it happens. And I think that um I think finding someone who really listens to what's going on. I think I I I value talking to my patients. I think they're listening to the whole story.

[00:39:23]Sometimes it takes like many hours to get the whole story of that patient and focusing to uh making a plan with them.

[00:39:32]>> Mhm.

[00:39:33]>> On how to optimize each part, you know, on what we're trying to do. There should be a plan. Um there was a time when NAD uh IV drips were like a trend, right?

[00:39:45]So, everyone used to come in and be like, "Hey, we want NAD drips." And I'll be like, "Okay, we need to see why you need it." If you know what I mean. I'm trying to say like I think that like uh we need to Yeah.

[00:39:58]focus on the basics first. See something that we can do long term.

[00:40:02]>> Yeah.

[00:40:03]>> Yeah. Yeah. Something that is more sustainable and then we use these uh new >> technologies or whatever new things that we have as an addition to the good basics that we already have.

[00:40:15]>> Right. And I feel like, you know, it's so funny. I come from a place in America, right? We have, we're one of the only countries that does like advertising medicines and prescription medicines on TV. So >> Oh, really?

[00:40:28]>> It's crazy. I think it's like us in New Zealand. We're the only ones that do it.

[00:40:32]But and then people like go into their doctor's office, ask your doctor about whatever blah blah blah blah. Are you do you do you wake up tired in the morning?

[00:40:40]Like you know what I mean? And yes, I guess. I don't know. Now it's in my mind. And now what's crazy is that that's not like just on TV commercials.

[00:40:49]Now it's everywhere with social media.

[00:40:51]Like there are influencers, there are people that are selling like whatever concept. Hey, this worked great for me.

[00:40:57]You should check it out. I imagine you get a lot of people coming in here requesting all sorts of things they saw on a TikTok.

[00:41:03]>> Exactly. Yeah.

[00:41:04]>> And you're like, well, hold on. Like that maybe maybe that works for that guy. Maybe he's just making it up. Like how about we trust medical professionals here?

[00:41:12]>> Yeah. Yeah. And I think everything should be um datab based, you know, here it's like evidence based and >> you know, >> oh, you and your science, look at you.

[00:41:20]Like that's it's wild to me how many people like, as someone who works in social media, there's so many people selling all sorts of different products and unproven things and supplements and they make a lot of money doing it. It's crazy. So take it seriously, everybody.

[00:41:40]Alert. Um, yeah. How would um you I guess we've talked about that a little bit. I was going to say what what does a medically grounded approach to longevity look like compared with trendled approaches? I think we've just talked about that.

[00:41:53]>> Don't just follow the trends. You need to like understand the underlying biology of what you're working with.

[00:41:59]>> Yes. Yes. And I think it's very personalized.

[00:42:02]>> Personalized.

[00:42:03]>> Well, uh let's end with some practical takeaways then. So, uh, for someone who is feeling older than they should, like something's not quite right, what are some of the the signs that they should be paying attention to that maybe they should get checked out for?

[00:42:18]>> I think uh definitely starting with sleep. If you're having problems with sleep, I think that's uh something that you need to address. Um, if you wake up and you feel like you need to snooze your alarm like multiple times because you don't have the energy to get out of bed and you don't feel fresh, that's something alarming and you need to get checked. Um, if during the day you need like I said multiple caffeines and to keep you like you know energetic, this is not normal. So you need to get that checked out. And uh for women um definitely their cycles. If your cycles are not regular, these are some things like key uh messages from your body. And the other thing that I talk about a lot is uh stool consistency. If you if you can pass stools, if you cannot pass stools every day and or if you do pass those every day, but it's not formed, >> then something is not right with your gut.

[00:43:13]>> Yeah. Good to be monitoring that closely.

[00:43:17]It's very important. You know, gut health is 70% of your immune system. So, >> yeah, for sure. Like, uh, that it's it, you know, it's something that people feel a little I mean, Thai people don't feel ashamed talking about it, I'll tell you that. But like in the West, it's something where just like I really want to talk about it, but it's definitely such an important signifier uh of what's going on generally. Um, yeah. That's what I've learned at least. Uh what let's say as people are getting older in their 40s, 50s, 60s, what are some some common mistakes that people make as they're getting older when trying to improve their health?

[00:43:52]>> I think accepting that uh you're just old, you know? I think that's the first mistake you made. Like if you when you're in your 40s or 50s, just being like accepting that this low energy is just because I'm getting old or oh, I'm just gaining a lot of belly fat because I'm getting old or I'm >> uh not sleeping well. I wake up in the middle of the night because all my friends wake up in the middle of the night. You know, all the if you're getting old, you don't sleep well. I think accepting the fact that you're old is the first like mistake that you can make cuz I think that uh honestly you can feel great even when you're 80 90 if you if you're doing the right things and uh yeah I think that's the first mistake that people make is accepting that this is okay we've normalized functioning at like zombie level you know as okay which I think is >> it's not yeah >> right yeah so don't accept it don't go down without a fight Yeah. And and honestly, it's not even that much of a fight. A lot of the times it's just about addressing what are the issues that you're dealing with.

[00:44:54]>> Exactly. I think it's discipline.

[00:44:56]>> Yeah.

[00:44:56]>> It's discipline.

[00:44:57]>> That's uh we all struggle with that though too, don't we?

[00:45:00]>> But honestly, at the same time though, it's like it's there are things that you know you should do. Exercise, right? Get enough sleep, eat the right things. But uh when you're having that guidance and there's more of like a checklist vibe, right, uh from a a health professional like yourself, it makes it easier to follow, right? Like just say just just tell me what to do, doc, and then okay, now you know what to do.

[00:45:23]>> Yes, >> just go do it. Like that's uh that's discipline in its own way. But uh yeah >> and when we personalize it, sorry to interrupt, but I mean when we when we personalize it, we try to find a way that is uh sustainable for you because what works for you is not going to work for the next person. So I think having someone to guide you to do like on what to do that works for your lifestyle is very important.

[00:45:49]>> Yeah.

[00:45:49]>> Yeah. And also like you said sustainable make sure that they're habits that that people will continue to follow. Exactly.

[00:45:55]As well. Of course, discipline's a thing, but uh some people like cheat days and things like that. Um I don't know. I think it's uh an important uh thing that you're trying to do is personalizing the the treatment for each of the patients and making sure that they're doing what's right for them.

[00:46:11]>> Exactly.

[00:46:11]>> Because, you know, whoever you're seeing on social media is going to have a very different set of circumstances shortly.

[00:46:17]>> Well, I I'll let you uh end with one last uh question. I just want to ask uh if there's one thing that you want people listening to this to take away from the conversation, what would it be?

[00:46:28]>> I think that health is one of the best investments you can make and uh the earlier you invest, the better. So, if you're looking at it from uh that kind of perspective, I think that this is worth it. It's a it's the best long-term investment you can make.

[00:46:44]>> Yeah.

[00:46:45]>> Very well said, Dr. Ronnie. Thank you so much for talking with me today. I learned a lot and uh yeah, you've given me a lot to think about. So, I appreciate everything.

[00:46:55]>> I'll see you back here probably sooner rather than later >> as my patient next time.

[00:47:01]>> Well, thank you, Ronnie. Cool. Are we good? How much time?