Muscle, Sleep, and Mitochondria: What Actually Moves the Needle in Fitness and Longevity

Introduction and Fitness Physician Origin 0:00

As an ER doctor, I was seeing all these young people in horrible health and horrible shape and on all of these medications and disabled and like, you could have fixed this, just prevented this with just proper lifestyle. So that's kind of where I started. Everybody reaches out to me for I want to lose weight or I wanna improve my sex life or put on muscle or whatever. And then of course everybody just wants to do all the cool new things they hear about the IVs and the peptides and NAD and all this cool stuff.

I'm like that great, but that icing on the cake. We've got to build that foundation. You're listening to the Lifestyle Medicine Podcast with Dr. Ivan Rusilko, brought to you by Access Lab, where we explore new perspectives at the forefront of personalized health care. Well, welcome back to the lifestyle medicine podcast. I'm Dr. Ivan Russoco. We're powered by Access Medical. If your doctor is not checking your labs, he's not a doctor. And today we got the fitness physician, Dr Eric Bate. This guy does all the cool stuff, all of the other fitness enhancements, mitochondrial health, cellular health.

Everything you can possibly name and you don't get a name like the Fitness Physician without doing something right. So thank you so much for stopping by my man. Yeah. Thank you. Appreciate it, man Thanks for the intro and thanks for having me on. Looking forward to it. So I'm super curious. I mean, that's some of the best market I've ever seen. The fitness physician, where did that come from? We kind of made it up. We've got a guy who helps me with my marketing a little bit. And we kind-of coined the term.

Years ago, we were trying to figure out my focus. You know, I talk about everything like nutrition and fitness and training and hormones and longevity and peptides, a bit of everything. But I am really passionate about it. I don't know, I just, enjoy talking about fitness. So it just kind of like, he's like yeah, you look like the fitness, call you the muscle doc, the Fitness doc. I'm like all right, that's perfect. There we go. You have to kind look the part, right? That's the most important thing.

you can't take weight loss advice from a fat physician. That is one of the important things. Now a funny story, not to get off topic, but like that was kind of the thing. It's kind like you got to walk the talk, right? And walk, walk talk and talk. But I still remember when I was in traditional medicine, I wasn't ER doctor. And I remember making rounds and one of their cardiologists I'll never forget. Remember on the like on your like a button up shirt, you know, at the bottom of other buttons, there's always that little V that you're supposed to have.

Well, his was his belly was so big that he was sticking out and you'd see the V you see his skin and his Belly through. Sticking I'm like, how can you be a cardiologist and look like I like so I just kind of took that to heart I might you got to look the part man. I'd like No, I get if you're gonna sell wellness really longevity all that kind stuff. You can't look a slob You know what I mean? So it's not good to see that Yeah, you can be out smoking and looking and have a big belly and just It just doesn't work.

Doesn't it work? So talk to me. Tell me about how you can kind of take your patients from zero to 100 when it comes to fitness and basically everything metabolic. Yeah, for sure. So that's kind of what my, my how I got started as, as an ER doctor, I was seeing all these young people in horrible health and horrible shape and on all of these medications and disabled and like, you could have fixed this, just prevented this with just proper, lifestyle, so that kind where I started, everybody reaches out to me for I want to lose weight or I wanna improve my sex life or put on muscle or whatever.

And of course everybody just wants to do all the cool new things they hear about the IVs and the peptides and NAD and all this cool stuff. I'm like that great. But that's icing on the cake. You know, we've got to build that foundation. It's like, I know it's people kind of get bored when you talk about lifting weights and walking and eating, right? Nobody, you know. But the real medicine, but you got it. Do it, man. And you've gotta do it otherwise. I tell her I could have the magic pill and it not going to work if you're not sleeping, if your stressed, If you read like shit.

It doesn't work. So anyway, so I always start with that. I start was circadian rhythm. Let's talk with light therapy, sleep, stress, you know, exercise, eating.

Building the Lifestyle Foundation First 3:40

Uh, those are all the pillars. And then I talk about hormones and then, then we build everything on top of that so, but you gotta, gotta build your, your solid house foundation before we built the roof. No, for sure. What are some of your favorite hormones to actually check, uh, before you start anybody on your programs? Yeah, for sure. So I'm like you. I use access and I have my own custom lab panel that I made. It's huge, but I always check all your basic labs. There's a lot of gems in your basics stuff.

Your blood counts, your liver tests, what we call a chemistry profile. As you know, I was looking at all the inflammatory markers. My avatar is kind of like your 40 plus, 35, 40, plus man and woman. So most of my men are kind near or going through enteropause. My women are perimenopausal or menopauses. I'm checking all your estradiol, your progesterones, all of your thyroid hormones, not just the TSH, you're free T3, free for TPO antibodies, testosterone, DHEA, and all the hormones basically. And then all, the extra stuff, like I said, inflammatory markers, some of the things that people want, and those are important.

A lot of people wanna go right to testosterone or whatever, but I mean, you gotta look at the, uh, Some of, the other ones are even more foundational. Your adrenal, your adrenal output, insulin, um, stress hormones, inflammatory, markers. Those are huge. You gotta, sometimes you, a lot people forget about those through the glass over them, But I always start with that. And that's part of lifestyle piece. But the hormones are, are. Huge. I definitely got to address that if a guy or a woman is deficient in their hormones.

Again, that all the cool peptides aren't going to help too much if you're not fixing your hormones That's the biggest thing too. A lot of people don't realize that and you know, everybody thinks that hormones are in there. There's so much that goes into your actual body. Like you said, all the anti-inflammatory markers, you have nutrition, other things that are such a unique symphony that all kinds of need to be, that it all needs to in basically harmony for your body to at peak physical performance.

So I'm kind of curious, but when it comes to your aspects, as you mentioned circadian rhythms now twice, how do you explain that to patients and why is that so important? Yeah. So the way I could explain it is that I always like, you know, people are, most people were price conscious, right? So I'm like let's, we're going to start with the free stuff and then the cheap stuff. And then we'll go to the pricey stuff, and that usually excites them. I kind of like to blend, I mean, a little bit, old fashioned.

You know all the wisdom of the ancients is wise, so we go back to what these long lived societies and these, all these peoples in other countries that they're living really, really well for a reason. And I think we've gotten away from that. So I'm really big on natural health and, you know, technology is great, but I it's killing us, right? We're always in front of these bright lights, we're inside, or not. We should be outside most of the time getting sunlight, getting fresh air, moving all day, being as much in nature as possible.

Especially in America, where we are doing the opposite of that, circadian rhythm is huge you know if the light is in ground and the earth and it's very powerful I mean a lot of people think that's woo woo but now we're seeing all these medical studies backing this up what we've known for centuries so I'm big on like first thing in the morning go out and look at the sun for five minutes you get out as much as you can put your feet in get no movement throughout the day. You know, a lot of people are starting to get standing desks.

I tell people to take walking breaks, movement breaks or exercise snacks throughout today. Try to outside as much as you can. That's all free. Same with meditation, same with breath work. It's free, you know I'm big on like reducing stress with breathe work and then... The opposite at night, you know, what's everybody doing? They're on their phones or on Netflix. It's like, well, put everything on red light mode or at least get some blue blockers or something. And then, an hour or half hour before bed, try to turn everything off, read a book, pray, meditate, journal something, because all that blue light messes up your melatonin, mess up sleep.

Yeah, for sure. As you probably see us too, nobody's sleeping right. Everybody's stressed, so this is huge. So if we can fix your circadian rhythms, get you hungry at the right time of the day, eating at right the time, sleeping at time. Now you're going to be primed, your energy is going a little bit better, you are going be ready to work out the next day. Then we'll talk about diet, then we will talk exercise, and then do all the other stuff. For me, that's the easy part. It takes a bit of effort, but it's free and it is easy.

Again, it goes back to the basics. If your circuit rhythms are out of alignment, Kind of like, you know, look at shift workers. They're all messed up because they're totally off kilter. So we got to fix that first, that's first and foremost. And everybody wants to, yeah, if you're reading like crap, I guess we gotta address that. But again, start with the easy stuff. That's easy. It's low hanging fruit and... That is the real form of medicine. You know what I mean? I think of people, like you mentioned breath work, vibration, magnetism, drowning, all this different kind of stuff, That I that that is a purest form medicine, Like you said, it's free.

Obviously all these influencers and whatnot don't want to talk about it because you can't really profit off of it. But I think it's probably the most important part of it. You mentioned andropause. Us men don't really get too much credit. Everybody talks about menopause, but I also like to tell all my female patients too, because women actually go through androplause as well.

Hormone Testing and Circadian Rhythm 8:40

So did you see a lot of that aspect in your practice where you're treating both men and women for things like DHEA and testosterone deficiencies, or is it mostly just the men? No, both. And I'm really big on that for women. I think it's starting to get more awareness of late with women, but most women think, oh, I need, you know, estrogen or progesterone, what they're not aware of is they go through perimenopause. Testosterone and progesterone are usually the first two to drop and they get deficient and need that.

A lot of women are like, there's still all these myths out there like about testosterone. Like, Oh, it was just for guys. It's going to make me big and muscular and I'll grow a mustache and grow penis and all. No. That's not going happen. You know, if you look at, you convert the, the calculations of men, women actually have a same or more testosterone than, than men on an equivalent basis, but it drops pretty quick. So they need that and progesterone is often forgotten about, um, You, know but they that, and it does wonders for them.

And most of my women, almost pretty much all my woman who are on it, they love it. They feel so much better on. Um, so yeah, I addressed that with women first and foremost, They always want to talk about estrogen. I'm like, that's the last time of the fall. Exactly. The other TPA first, and then with DHEA, as you mentioned, cortisol, insulin, all those things that get short shrift, but those are very, very important. You have to address those first. And then, with men, same thing. I'm still busting the myths about testosterone and estrogen with man and all this other stuff.

So, I deal with that with med too. Like you said, Andropause is kind of forgotten about, it's important, So also another one that we talked about is somatopause. So you do a lot of things like IGF deficiencies and whatnot. Obviously if you're doing human performance, that's probably one of the most, if not the, most important hormone involved in that. It is absolutely and you know, growth hormone and IGF-1, they drop actually most of the time they dropped even before all the other ones. Exactly.

They start about what, 25? I think 28? Yeah, 20s and 30s. You know 20's and thirties they start, you, know so and that's like, one of parent hormones, right? So, oftentimes I address that all of time. So I'm always talking about ways to optimize your growth, hormone production or whether we augmented with hormones or peptides, et cetera, but we're just natural rhythms. But yeah, that's huge. You know, oftentimes, sometimes, especially if they're younger, if we fix that, they might fix their testosterone, their progesterone.

Exactly. It's one of the paranormal hormones, right? It turns everything on. Same with thyroid. Thyroid is massively important for all of you. If those are out of whack, then sometimes we can just fix everything, just fixing those two. Yeah, I've seen so many times with IGF-1 deficiencies, people were kind of hesitant about testosterone and whatnot. You start treating them for that, use something like a Tessamol or whatever, which can kind hit both pathways on that. And all of a sudden now you've corrected a thyroid issue, an adrenal issue and an actual gonadal issue just by treating one symptom, or I should say one deficiency in the entire system.

Yeah. Absolutely. Great point. Yes, absolutely. Then you tell people, they're like, oh, okay, that makes sense. Oh, shit. Right? Now, do you deal a lot with, with the adrenal glands as well? Like cortisol, DHEA, all that kind of fun stuff, epinephrine? Yeah, for sure. I mean, cause I, so probably you've seen it too. So many people are stressed and their cortisol is all out of whack. It's either too high or too low. And I'll treat them clinically. Sometimes we'll do blood record like a Dutch test or something like that to get a better feel for that.

But yeah, absolutely. Treat that all the time. That's foundation. Insulin in the cortisol axis is sometimes for, you know, put to put, to the back burner. looking at all the other hormones, but I think that should come first. You know, look, at least, uh, least out in the top tier fixing those things. So yeah, I deal with that a lot, whether it's just treating them with lifestyle and adaptogens and I've even done hydrocortisone therapy on some patients. There's a, you know you probably see at the great book by Dr.

Jeffrey, safe use of cortisol. It's an old book, and it is a classic and hundreds and hundred, if not thousands of patients treated safely with optimizing their cortisol axis. And that's, that is big. No, that's huge. And again, cortisol does everything. I mean, it causes bad conversion between T3 and T4, the kidney-urnin pathway. Cortisol can just really mess up a system. So, I'm here. That's out of whack. The way I kind of look at it, with lab testing, if you have a low IGF-1, you've a load DHEA, and if have either high or low cortisol upon wakening, there's definitely something off with the actual sleep cycle.

But that cortisol is just causing havoc on every aspect of the body. So figuring out ways, like you said, breathing, grounding. I think breathing is probably one of most fascinating medicines that's not used. Do you guys use a lot of that in yours? I try to. Talk to them about breath work and like, especially during the day, you know, take five minutes and do some box breathing or some four or five, seven breathing, or just slow deep breaths, diaphragmatic breathing. So much, so many of us are not doing it.

But I, one thing I'm not, I would like to, looking to delve into have a colleague who actually does a lot of classes on pretty advanced breathwork and how you can get all kinds of. literal physical changes with breathwork. You've seen these videos of people doing these crazy, you know, for like Wim Hof and all these different techniques, doing this really, if you look at a video, like what the hell are they doing? But like they actually get some changes. They've, fixing a lot of like, stress and insomnia and anxiety and, all of these things with really advanced breath work.

So I have a colleague who does that and she offered to me to watch one of her classes online. I'm going to do it. And so I think it's fascinating how much there is just with that. No, no, for sure. For sure and did you incorporate this kind of stuff when you're actually treating patients like you actually give them some ones designed for them? Like a diet exercise? Obviously, as a fitness physician, I'm sure that they're all getting exercises. Oh, yeah. Yeah. So how do you how Do you determine like who gets what?

Yeah. So I always ask the questions, you know, like, what do you, I was trying to get their goals, their, and what they really want to focus on. Then of course I asked them their symptoms, the cadre of questions and all the blood work. And then I kind of put a plan together with them. Some people like. You know some people are like no, no I've got I'm working with a trainer. I got my nutrition dialed in. You know prescription, you know, I need, uh, any hormone therapy or any peptide.

Women, Men, and Growth Hormone Optimization 14:20

They're ready to help with some advanced longevity strategies. But other people are like, yeah, need everything or other, or like as you, there's information or led. I, um, everything. And I don't know. Even though we're in a hell of a story, it's so confusing. So most of the time I'll put together a whole comprehensive plan. You know, we're going to talk about your sleep and here's some ideas. Here's, some breath work strategies, here are some nutrition guidelines here based on your lab work and your, your what you're telling me.

I recommend this particular nutrition plan or this general framework for a diet. You're some training programs. So someone say elevated triglycerides or overweight or we've got metabolic syndrome. And I'm going put them on a certain diet and nutrition plans just for that, you know? And now I've not given them like, a menu for. 40 days or something, but I'll give them like some general framework. I think these foods don't eat these food. Here's your training plan in general. How would you be during the week?

And then I'm going to go through the supplements that any prescriptions like hormones, peptides, and I may lay that out. So I kind of give him a whole comprehensive plan to kind follow. And that I kinda tailor from there. Some people are like, Oh, that looks great. Other people were like Oh my gosh, it looks awesome. Can't, I can't do all that. can we pair it now a little bit. so I try to customize it for them. Okay, cool, and so there's all the lifestyle aspect. And then of course we get into the fancy stuff like the peptides and all that kind of stuff.

What are your top five peptide? Oh my gosh, so many. I mean, I've been writing for them since like pre-COVID, you know, for almost 10 years now. You mentioned somatopause, all of the growth hormone peptidies are fantastic. They think they're foundational for most people, especially, of, course, we've got to do the FDA approved ones, right? The Somorilins, the Tessamorillins all, that kinda stuff, But the healing peptides that have been around, some of which, of course, we can't use, right? The BPC or the similar healing peptides.

And there's all the mitochondrial peptide, which are great too. The ModSC, the SS31s. I've used a lot of the thymic peptids for. Uh, immune system supports, um, some of the, uh, nootropic ones more for like anxiety, depression, like the C-links, the c-maxes. Um, they have some newer ones out now that are, approved, you know, P22, 23, all these different things, but there's so many. But those are some other, top ones that I've used through the years that, I get requests for that. I find that kind of like a multi-use tool.

Uh they work really, really well. And I also use some the gut peptides are great. You know like lorazetides. So many people have gut inflammation, gut infections now. Yeah. So, no, for sure. I mean, we do a lot of food sensitivity testing here. And again, I love how Axis does their food-sensitivity testing. It's pretty legit. And, you know, I was finding like things like KPV, LDN, those are two fantastic ones for overall inflammation when it comes to any type of food sensitivities. There's inflammation in general, along with BPT and thymusine beta oral.

Some of my favorites, and again, we've seen people with colitis with all kinds of different problems just kind of have that go away once you actually remove the food sensitivity along the actual different types of peptides and different nutrients for it. So, yeah, definitely. Do you do any microbiome testing or anything like that? Parasite testing? I have, yeah. Yeah. I've tested a number of patients, done some advanced, advanced gut tests. Um, I'm not used to access his gut test. So, um, need to probably look at that, but I used them like from like Genova, has them, a couple other companies that have like the pretty advanced test and looking for any, uh, looking at their microbiome and infections and things.

And they're, they are very telling oftentimes. Fixed a lot of people that by picking things up and modifying and treating them. They've got a double base that they've done great ever since we fixed them years ago. No, it's crazy. Well, once you put a fire out, so much easier than managing a bunch of fires downstream. You know what I mean? Yeah, definitely good. And a lot of people forget that, you know, your immune systems, pretty much house inside of your guts. So the whole problem is, if you have things like chronic EBV, chronic CMV candida, I've diagnosed Lyme disease and I think eight patients so far this year.

All these different hidden pathogens and things where your immune systems are just all shot up. You treat the gut, you're going to decrease so much inflammation because your system, I always tell people, is the second most expensive system in your body right behind your neurological system. So if you are able to quell that, that fire, then you get all this extra energy to actually enhance performance, which is kind of right into your market. I'm definitely glad to hear that you actually doing that.

What about mitochondrial health for you? Big time. Yeah, I've been in, uh, love looking at the mitochondria for sure. And I'm glad to see a lot of people more talking about in the last couple of years. It's gotten a little more attention. So, um, cause I see it all the time, people are tired or fatigued or worn out and like, well, you're, your, fueling your body, meaning you are fuel in your mitochondrion appropriately, or to your point, there's a toxin or a gut infection or micronutrient deficiency, something.

Uh, so I am definitely huge. I think the Mitochondria, one of the most important things to address. Um, and we try to, try hit it. How do you address it? I m curious. I mean, most of the time, fortunately, it's usually like things we've been talking about lifestyle, gut health, sleep, stress, the try to start with that. I means, yeah, there's the mitochondrial peptides, but sometimes they're kind of expensive. So I think you can, you know, doing the proper diet exercise, sauna, cold therapy. cleaning up the gut, you know, getting your sleep and stress dialed in.

And then you can throw in some eats, some mitochondria support supplements, things like CoQ10, PQQ, the B vitamins, carnitine, different things that are a lot less expensive than the peptides. You can get 99% of the way there just with that, if you do that properly. Um, and then kind of go from there, but I think that's huge. I thinks sometimes that the missing piece and someone's trying to lose weight or trying boost our energy. They're like, they're just fatigued all the time. Like, well, let's look at the lifestyle.

Let's get your cortisol. So get, your gut clean up the, get the low hanging fruit. And then that going to help your mitochondria indirectly.

Adrenal Health, Breathwork, and Custom Plans 19:40

Um. But then we do some of these other strategies and we can really jack, you know, the mitochondrial fueling. Well, we might do something short-term to, to assist them while we're cleaning up. We might use some methylene blue or some, uh, some oral intestinal oral and something that kind get those, uh, energy pathways running properly. But after a while, maybe we can drop those off after we get you your lifestyle cleaned up and get your, get the weight down, the sleep dialed in. And then, then the system kind of starts humming along.

No, for sure. For sure, and I always have to say, I think, cellular health is one of the most important aspects to go after, which would be the whole mitochondrial aspect. But then you have something like senoletics. You know, you've all these different zombie cells and cells in your system that are just consistently wearing you down. Are you taking a look at those? And if so, are you using things like FOX04, the santinib, corcetin, facetin? Are also tackling that with your performance? Yeah, sometimes I'll look at that.

I get asked a lot about some of the senolytics and like, you know, some my patients have done some things, as you mentioned, in terms of like I'm not used FoxO4 too much, but I have, um, done senolike protocols of whether some, there's a couple of companies that have some good, just nutraceuticals. They have a good senilike protocol, use a lotta spermidine, even use some low dose rapamycin occasionally. to help with that. Sometimes people will do a short-term fasting protocol with it. Some, some senolytic agents, things like, even things, like Fisetin and spermadine, different products like that, just to kind of reboot the system.

I think that works great, especially if somebody's doing something for a long period of time or they're stuck. sometimes it's a good, good thing to do. A few times a year, kind So I'm going to ask you a very hard question. If you had to pick all the different systems we just talked about, mitochondrial, sleet, gut, sonoelectics, if you were to focus on one thing, If I am a patient walking through the door and you're like, I´m a mess, what are you going focus first? Oh my gosh. It's probably going to be mitochondria in the gut and they're going be the top two for sure.

I think, cause most people are messed up there. Um, clean up the guy, work on the mitochondr. But the cool thing is you could do a lot of those things with the same similar protocol. Everybody's gonna be a little bit different, but we talked about, you know, everything we talk about getting them sleeping better, cleaning up their diet, get them exercising, some sauna, et cetera. We're gonna hit multiple things all at once. Uh, But yeah, I might have condor huge. And I mean, they were the engines.

They do. A lot more than that. Right. Cleaning things up, you know, a lot of times, especially with my, and my people doing performance, I try to get them properly hydrated with the amino acid blends. And like, um, uh, like to use a urolithin A a, to help with that mitophagy cleaning up those old mitochondria. Uh, that's an easy place to start. You know? It's a simple thing to do as opposed to all these complicated satellite protocols and kind of start, sometimes I'll start with. That and get him feeling a little bit better, get a low energy.

Then they, they start then they're motivated to kind work on all of these other things and kinda do some advanced stuff down the road. When it comes to the exercise portion, are you focusing more on high intensity, low intensity anaerobic, aerobic? What do you try to put your patients more or is it customized to what they want? Yeah, it is customized. I mean, as a, you know, the fitness, I'm big on muscle medicine, my muscle, medicine approach. So I've, so I definitely big strength training is first and foremost.

We have to build that muscle up because it's muscle. Muscle is an endocrine organ. It's the most powerful endocrine organ in the body and secretes myocons that have numerous effects on the. You gotta build up the muscle and then for me, like if I try to keep things super simple, look, if you do some strength, training three, four or five days a week and walk every single day, does that low intensity. That's good. That a great place to start. And then if they can handle that, then we'll start sprinkling in some other cardio on top of that.

I do like HIIT training of some type. A lot of people overdo it, do too much. There's something to be said to that so sprinkle that in maybe once a week or something, maybe twice a. But I also like if people, especially if their fatigued or worn out, they're not going to do that's actually going be counterproductive. So I'm really big on walking and doing some strength training. Then I even like doing a lot alactic training, If you're familiar with that, it's more of a lower intensity cardio without overstressing the mitochondria.

You can slowly build up your endurance that way. It kind of charges up the mitocondor. That's a cool training strategy right there. Now I'm curious. I've actually never heard that. Could you expand on that? Yeah, so there's a lot to it, but basically it's like when you do zone 1, zone 2, easy stuff, cardio like walking, then on the other end there are high intensity intervals, whether it is 30 seconds on, 30 minutes off, or there is Tabata training, there the Norwegian protocol people are talking about.

That's pretty high intensity and that's great to sprinkle at it because you do get that you build up your VO2 max, you built up through mitochondrial. But if you too much, a lot of people say that if your doing that too, much you actually, get the burn right, that lactic acid production. To a point that is okay, but if doing it too often, then that can actually give you detrimental to the cell. So some proponents in the fitness industry, I've talked about like do a electric training. You're pushing it almost to that point of where you're starting to turn a light to gas and then stopping and doing some walking,

Peptides, Gut Health, and Mitochondrial Support 24:20

some easy activity to kind of reset and do it again and reset. Typically you are thinking like a really fast movement like I think a kettlebell swing or a snatch or something for like five to 10 reps. And then that's it. You wait until like, it's usually like an EMOP every minute on the minute. So you do like five or 10 or five, seven reps and you just walk for the, until the minutes hits. Then you can do it again. and then you could do that for four minutes, five minutes 10 minutes 20 minutes. I think his name is Pavel Sasulin.

He's a big kettlebell guys. Been around for a long time. he, he has a lot of good information on his, his forum page about that, but that a cool thing to do too, especially if somebody doesn't like. Oh, I'm not going to. You know, Tabata where I hate, I, hate burpees or I don't like to do extra crazy stuff. Like, well, this is a great way to, to build up your cardio without killing yourself. So that's a cool way. But for me, build the muscle and walk, you know? Keep it simple. And then we can add from there.

If you start with that, most people are going to be pretty damn well. No, love that. Actually I want to go back on something we talked about earlier when it comes to women in testosterone therapy. Now are you, are doing mostly creams, pellets, or do you actually do the, sometimes the actual injectables? I like injectables and creams. Yeah, I've been doing creams and injectable forever. I think more and more people are starting to get into that. But those are the best ways to do it. They both work.

It's more of a preference for you. Same with my men, creams versus inject. If you do the right dose, the creams work fantastic, especially for men. A lot of guys are thinking of injectals, both women. I'd say it's probably 50, 50 or so. I mean, a lot of women like the cream. Um, but I have a lotta women who like to inject where they're like, I'm just too damn busy. And I can remember to do a cream every day. Id rather do it shot once or twice a week. Uh, it easy and it works. It works really, really well.

A lot women forget that it is there. The pellets I am not as much, number one I don't have an office anymore, do I'll tell them this, when I had one, and I was doing pellet. But I kind of getting away from them. They are a little too artificial in terms of you get too much of that bump and rise in the flow and they, they can. I prefer to kind of keep a steady state concentration at all times. And I can really titrate with the injectables and the creams. I keep them at a therapeutic level 24 seven, which I think is a better long-term for their health and they feel better on it.

So I, I'm not a fan of pellets whatsoever. You're putting something in there to take it out. It's just a mess. If you get women growing beers, you know, all kinds of weird stuff. Like, so yeah, and I was curious to see if you're using pellet or not. Yeah, I don't like them and I've had a lot of people come to me they've been on they don' like him and then I switch them over and they're so much happier on creams and injections. They just feel soo much better, they dont get those highs and lows and if they feel great, it works much bette.

What do you usually start a woman at when it comes to the injectables? I usually just start low, you know, just to be conservative, but it might even be something as low as 5 to 10 milligrams once or twice a week and kind of work up. I have had women go as high as 25 to 50 milligrams a we. Really? Yeah, so everybody's a little different, but I usually start conservative because you can always go up and if you go too high too fast, they're not going to be happy and then they are not gonna be. No they aren't.

Absolutely not. Well good, good good. So coming to a close here, I always like to ask two questions and the first one is kind of on par with this. If you're a man or a woman coming in from the traditional medicine aspect, And you're all of a sudden like, what is this wellness regenerative industry? What is something that they should look out for in their practitioners to make sure that, they aren't getting scammed or bamboozled and they're actually getting what they need. Something that's going to be efficient and actually help them with their actual quality of life.

Yeah, that's a great question. I think there's lot there. Number one, make sure they're working with a qualified health practitioner, right? I mean, as you know, we see everybody's on social media. Everybody's an expert on practicing. There's lots of people practicing medicine without a license. And I know there are a lot of coaches and trainers who have a lots great content. They know their shit for sure. But you still got to be careful. If you're going to get prescribed, you going get advice, make sure you work with someone.

I mean, I stay in my lane, they should stay on their lane. Just make are they qualified? Do they have a degree? Have they received training in these things? Not just a weekend course that they read a few books or interviewed some doctors or some nurse practitioners. Make sure they know what they're talking about. And then make that sure that have wide breadth of knowledge in different fields that you are interested in. Have a repertoire. In other words, are not just appellate doc. Like you said, a lot of people like They just bring them in for the pellets and that's all they do because it's a good revenue generator.

It's consistent and easy cookbook. Watch out for people that have like a cook book approach. There's lot of that. A lot these protocols. Like what's your protocol? What's, you know, everybody gets the same thing, same everything. And that never works. I've had people come to me, they get messed up because that it is not customized. So make sure they're. someone who's going to ask you a lot of questions about what you like, what will do what, you won't do your preferences because there's lots of options.

There's a lots ways to do things. And I'm not saying my ways are right when I don't know everything for sure. I want to come across like that for, sure, because I've not and I, but make sure you have someone, who is willing to work with you and customize the protocol for you. Do a deep dive, like ask all the questions, do all of the blood work and then put a plan. Yeah, and add multiple tools in their toolkit, not just, well, this is what we do and everything else. Nope, we don't do that. No, for sure, great answer.

Exercise Programming and Training Methods 29:20

I mean, that's pretty much the standard there. Make sure you're finding the quality on that one. Right. Second question is if you're a physician trying to get into this industry right now, because it's been like the California gold rush now. I mean, everybody saw after COVID how much profitability is in this. But also the efficacy, which is the most important part. What's some advice you can give to any healthcare practitioner, whether it is a nurse, a chiropractor, or a doctor, whatever it. If you are going to try to in his industry, what's the correct way to do it and what is incorrect way?

Yeah, I think kind of a harnessing onto what I, the last question is like, number one, get trained. Like if you don't know anything about hormones, bioidentical hormones or peptides or gut health, you know, train, take some courses, find a mentor to work with one-on-one, spend some time working with them. Don't just do like a weekend course and then just go out there and do stuff, join a group. that belongs, like World Lake Medical is great for the hormone space. SSRP, there's all different peptide groups out there.

International functional medicine was IFM, I think. So join a group, get a mentor, work with someone, you know, gets some advanced training, and then work maybe with friends and family that kind of ease into it and learn it. Learn the craft and study and take your time. Don't rush it, don't just jump in there and join this big group that's doing cookie cutter protocols and causing problems. You know what I mean? You're seeing more of the latter. People just seeing this as such a problem. I'm a cardiologist, so therefore I can jump in and do this tomorrow.

It doesn't matter. Usually the more specialized the physician is, the worse they do in this industry when they jump into it, because they don't understand this holistic approach. That word kind of gets muddled a lot, holistic, just because it's been so tainted with other things. But it is. You have to take a 30,000 foot view of this. you know, entire system that is the body and like, like that's why we went through, I don't know how many systems today and every single one is just as important as the last and you're only as strong as your weakest.

Yeah, absolutely. And I'd say just take your time. Even in some of the groups I belong to, there's people that like kind of complain or want this and they're like when they ask them and find a mentor, they could join a group. They're, well, what's the protocol? I just want to know just how you do it. What do I do? And then, and there is more too. You have to understand why did they get metabolic syndrome? Why did it get overweight? What's What's the, what are the biochemical pathways? What the physiology was the what's all the background?

Nobody wants to get there. Everybody just wants the cut the chase. Like, we'll just give me a protocol. You see it on social media all of the time. They're like, even then, you know, all that even like physicians or specters, they're coming into it. I've seen it, their complaining of went on our forum page. We have all these courses that you take over a year or two. It takes, and I have done them like multiple times and every time you pick up something new. You're learning. That's why you go to medical school to learn.

There's a lot more to it than what people think. And then not even to mention the Jim bros that like, you know, just are an expert because they play around with it on themselves.

Choosing the Right Practitioner and Getting Started 32:00

Now they know everything about medicine and like just drives me nuts. I'm still learning and I've been doing this for 20 some years. So don't tell me you'd know. Everything about Medicine. You read all the studies in the last year. It's impossible. Yeah, it's crazy. But so, Dr. Faith, where can everybody find you? So I am in Ohio and I do telemedicine all across the country. I'm a licensed in 37 states. So, I'll actually be joining a new group of late, which I... something completely different, but I will soon have my license in every state.

But I do all telemedicine, drerickprimex.com, Dr. Eric, the fitness physician. Most people go to my website to find me, doctorericprimex. com and or find on my socials under my name or under primex, I've got a ton of content out there. And most of it's free, pretty much all of its free. I haven't got eBooks and free stuff on the website. My own protein powders and some products and me books that I have for sale, but which everybody loves my powers, by the way. But I've got a, you just want some, feel free to stalk me and just watch all my videos.

I got, like I said, free content if you want to learn, But, uh, I'm happy to help. Rock and roll my man. Well, thank you so much for stopping by today. Again, it's a rainy day here in Miami beach. How's it in Ohio? It's actually beautiful. It was sunny and I was like, close to 70 today for once. Yeah. and a Thanks for joining us today on the Lifestyle Medicine Podcast. At Access Labs, every innovation we pursue is driven by one bold purpose, making personalized medicine more practical and accessible for patients and providers.

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