Unlock Peak Performance with These Blood Work Secrets | Dr. Andy Galpin DSH #763
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one of the major mistakes people make with blood work is when they look at a marker and if it's low then they just take more of it sodium potassium is a great example of that if your sodium and or potassium are off increase in sodium intake might make you feel better initially but that's not going to get chronic elevations in sodium you had that ratio off that was causing that downstream effect but you didn't need to correct the sodium you needed to correct why the sodium was low

All right, guys. Dr. Andy Galpin here today. Thanks for flying in, man. I appreciate it, man. It's been a long time coming. We've been working on this for a while. Yeah, I think I hit you up almost two years ago. That sounds about right. You're up to a lot. I know you have a sleep company now, right? Absolute. Absolute rest, yeah. Sleep company. I have a blood work company called Vitality Blueprint. And then I just stepped in as the executive director of the Human Performance Center at Parker University. So I moved all my lab from California to Dallas. I moved all my lab from California to Dallas.

And we're able to do a lot of stuff in the area of human performance. Nice. My podcast just launched as well. Let's go. Called Perform with Dr. Andy Galpin. So it's been a busy year, my man. Yeah. A couple of years. That's a big move for you from Cali to Texas. What was the story there? It really honestly was an opportunity for me to do the type of work in the area of human performance that I want to do. So the facility we have there is 65,000 square feet. Wow. And it is brand new.

And the university's primary mission is to move on the forefront of human performance. So I no longer have to worry about being sort of a forgotten person in the background back there. The university as a whole really wants to move in that direction. So we have a ton of resources. We have a phenomenal graduate program. But really, the facilities and the resources and structure to do everything from sleep research

to brain functionality, we have a brain enhancement program there, to cognitive function, to physical health and VO2max and things like that. We really can attack performance not from the perspective of just sports.

We do a lot actually with NASA and astronauts. We do a lot with the military and then a ton with just the average person. So how do we get everyone performing better? However you define perform, right? So you want to gain more muscle or don't care about muscle. Fine. You want to live longer or play sports. Fine. You want to think more clearly. You want to be a better leader or a parent or a spouse. Like however you're defining perform.

We're trying to produce and disseminate more effective and practical research from that center. So it was just an opportunity I couldn't pass up. - Incredible. - Biological age calculators are quite honestly not very useful. They don't mean much of anything. And we actually have a lot of data now at this point to suggest that they're kind of similar to what would be an older way of looking at something like BMI. - Yeah. - It's crude. On the aggregate, across 100,000 people or a million people, it will give you a rough indication of who's probably healthier

versus those who are not. That said, at the individual level, it's almost useless because one of the primary factors, this is very technical, but just to show you like why, one of the primary metrics in that is creatinine. And that is actually, and there's a handful of other markers that are also known to increase with muscle mass. So we also know that having more muscle is advantageous for longevity, not disadvantageous.

So the fastest way to get a higher biological age is to lose muscle. Interesting. That's not good for health at all. So it is okay, but biological age shouldn't be looked at as anything more than kind of a, oh, rough example. Okay. And your situation actually explains it perfectly. Said you're 21, I'm sure you're globally healthy, fine. But now let's look at more metrics that are real to your physiology. Okay.

You said your blood work looked fine. I would guarantee you your blood work is not fine. I guarantee you it's not. Why? By fine, you probably mean you didn't have any medically diagnosed diseases. Yeah, I didn't have anything like super red or... Great. But what's red mean? Red means you didn't have any number way higher or way low, and specifically 95%.

So when you say high or low, red, you're meaning like nothing was way high or way low. The way that they generate those numbers is, first of all, based on a population, not you. That's based on a generally very sick and unhealthy population. You're not being compared to who you want to be compared against. Number two, in order for you to look red on that lab, you actually have to be with outside of 95% of people. So whether those bell curves are created, it's 2.5% on the high end, 2.5% in the low end.

95% chance. So if you were 0.1% in, let's just call this way, if you were in the 0.3 percentile, meaning 97% of people were better on that metric than you, you still would be flagged as green. So that's not optimal health. It just means you don't have a clinical disease yet. Let me give you an easy example. Most people are familiar with blood glucose. We know that having really high blood glucose levels

If that's consistent, you're going to have resting blood glucose. That's called type 2 diabetes, right? If you generate this one. Everyone knows that that's a bad thing. That said, the kind of normal high-performing number will be like 85 milligrams per deciliter for blood glucose. If you're 95, you have increased risk of retinopathy. You have increased risk of neuropathy. You have increased risk of all sorts of metabolic diseases. But you won't be told you're a diabetic because you're not technically a diabetic until you cross a much higher threshold.

You won't even be told you're pre-diabetic. - Wow. - But you're certainly suboptimal. You're not performing at your best and your increased risk of long-term disease and your short-term performance is certainly suboptimal. So things like that, when we hear this so often, it's one of the reasons why we created our company, Vitality Blueprint, is so you can take your blood work and have it analyzed from this perspective.

Let the medical system do what they do. They are phenomenal. All props to them. If you have type two diabetes or you wanna know if you're at risk of having a heart disease or had one, absolutely have a medical doctor look at your blood work. But if you wanna know, am I performing at my best? You are not here as a 27 year old person who's really into your health and performance clearly. I don't think you really care about your risk of cardiovascular disease 45 years from now relative to looking at your blood and saying, okay, I wanna know, am I performing at my best?

Is my physiology not just diseased yet? Is it at its best possible state? The quick analogy there is if your knee was in tremendous pain and you went to the doctor and they took an x-ray and they said, well, you don't have a broken bone, therefore your knee's fine, but your ACL's torn in half. That blood work you talked about is the x-ray. It's just a cursory screen. Is it yes or no you have disease?

Almost always and this is why people get dissuaded off of blood work so often because they have the experience you have I'm not feeling my best. I'm not performing at my best. My numbers aren't great, but my blood work says I'm fine. Hmm Well, you aren't fine. You're just not medically diseased yet. But as a 27 year old who's not fat frankly, it's unlikely any of your blood metrics would ever not be in that range and

So that's point number two. Then point number three is you compare that stuff to the biological age, right? And hopefully you're, I could go on, but you're getting a little bit of sense of, I promise you your blood work wasn't dialed in perfectly. And then I know that to be true for the most part. I'm being a little bit arrogant here, but I've just seen this so many times.

When we actually looked at a more direct marker of your health and performance, like your VO2 max, by your admission, it was poor. - It was poor. Yeah, I got my results whenever you were ready. - Yeah, so it's like, what are we really looking at here? Why do I care about a biological age number when I can look at something like VO2 max? - All right, so we got my VO2 max results here. - Yeah, so it looks like you scored, I'm trying to interpret this, something in the neighborhood of about 37 milliliters per kilogram per minute,

which for a 27-year-old, I would say is actually like slightly below average. But according to my standards, I'd say that's very poor. Oh, wow. The same thing, again, according to a medical standard, you'd be slightly below average, but the average person is not particularly fit. Yeah. So by a, are you doing your best? Are you in a good spot? The answer would be no. You're very low. Now, that unit, we'll just call it 35 milliliters per kilogram per minute. It means how many milliliters of oxygen

You can bring in per kilogram of body weight per minute. The reason I'm breaking that down is your denominator there is your body weight. And so oftentimes people can have a reported lower VO2 max simply because their body weight's higher when actually they're okay. They can bring in and utilize enough oxygen. It's just a fact that they need to lose 10 pounds or 20. You're not that. Yeah, I'm pretty- Very lean. Would you say I'm underweight?

I wouldn't necessarily underweight. I'd say under-muscled. Okay, because whenever I look up the averages, I'm way under. Yeah, I would say that. Under-muscled, I could live with a little bit of under-muscled, but I can't live with that low of VO2 max. We would absolutely want to improve that. You will see significant improvements in your survival rate, likelihood of dying for any reason over the next 100 years.

More importantly, probably for you, though, you would actually see improvements in your day-to-day life. Wow. Just from increasing the VO2 max score? 100%. When you're as low as you are, if you're going from good VO2 max to great, you won't notice that much difference in a day-to-day. You'll notice a lot of difference in your long-term survival risk. But day-to-day would be okay. But in your case, going from suboptimal to just kind of average, it would have a functional change in everything from...

Your recovery between workouts, to your restfulness, to the energy expenditure you feel throughout the day, to your heart rate, to how calm you feel. They're not massive differences, but they would be differences that you would be able to perceive if you're paying enough attention to them.

That's incredible. So you'd recommend people to take a VO2 max test? It's a strong, strong thing to do. There's a lot of ways you can do that. You obviously did that at a great facility. It looks like you were attached to a metabolic cart. Yeah, they hooked me up to a machine. Great. You were on a treadmill or a bike? A bike. Great. Okay, that's interesting to know. Generally, you're not a cyclist. I'm not. Great. Generally, people will score about 10% higher.

on a treadmill than they will on a bike. Okay. Because more, much, much more muscle mass is involved. So we would actually probably look at yours and say, you're probably closer to the high thirties, low forties as a true VO2 max, but that's okay. It's still bad. So it, you know, we're kind of splitting hairs a little bit. If you're trained specifically in cycling, that's not the case. Not the case. Yeah. Specificity wins here. But in your case, I'd say, yeah, you want to do it.

So you can do it at a facility like that. It's not ultra common, but it is a huge trend we're seeing in large part because people are understanding the importance of VO2 max. It's oftentimes, depending on the research you look at, it is very commonly the number one predictor of all-cause mortality. What that really means is you could measure anything, and it's actually much more predictive than general clinical risk factor markers like coronary artery disease, smoking, diabetes, diabetes.

VO2 max will outpredict them in terms of how long you will live and your risk of all-cause mortality. So it's incredibly important. People have been espousing that for a number of years. In fact, this really started in the late 1980s. Stephen Blair out of South Carolina started doing stuff, then Jonathan Myers out of Stanford, and a whole bunch of people started doing these big database studies where

You've got 300,000 people, 500,000 people, 750,000 people. And you can look at, hey, over the course of this study, 160,000 died or 40,000, like giant databases of people who lived and who didn't. So not small studies. And VO2max is just outperforming all these other metrics. Wow. Like really consistently outperforming

And again, here I'm not really describing one study or one scientist from one lab. I'm combining what has collectively been shown over at least 30 plus years of research in multiple labs in men and women and different ethnicities, socioeconomical populations, et cetera. So I'm confident in saying it the way I am because it has been established so well across multiple communities. So that said-

People are getting aware of that and they're saying, okay, great. I should get my blood pressure checked. I should have my physical and I should do all those things. If you can go the extra mile and you can get some of the advanced testing that you got, some additional, that's all great. That's great. If you want to look at biological age, fine. If that, it's not that important, but okay, fine. However, you really want to get dialed in on a one-stop shop of how healthy you are. VO2 max is an excellent, excellent measure. Mm-hmm.

You can do that in the lab like that. If you can't afford that or you live in an area that doesn't have access to these, you can actually search. A lot of clinics, a lot of hospitals, there are longevity clinics popping up everywhere. A lot of universities are starting to open up their services and they're typically, as a standalone, somewhere between $50 and $250.

So that's unaffordable for many people. They don't have $50. But many people can gather a couple of hundred bucks for a test that's that critical. If you can't run, you can cycle. If you can't cycle, you can row. You can swim. You can walk. There are sub-max tests that you can do if you can't go all the way up. And so if you got a bad knee...

or you got a bad back. There's still lots of ways you can get things done at a different price point, at a different level of accuracy, as well as different restrictions that you may feel like you have. So most people can get pretty close.

And it is a certainly worthwhile thing to pay attention to and take a look at. This is eye-opening for me, man, because I've had on some of the top holistic doctors, you know, Brian Johnson, Dave Asprey. I've never heard any of these guys talk about VO2 max test. Oh, really? Yeah. They talk about these supplements and like these biohacks, but never this. Look, that stuff is fine. And I know Brian very well. I was just with him. So I wouldn't say anything here now that I didn't say to him.

But he measures his VO2 max. Oh, he does? Yeah. Okay. And he is one of his top training markers. He's very interested in it. Actually, I think I was literally there maybe 10 days ago.

And he, I think his VO2 max right now is 58 milliliters. Wow. So he's better than me. Yeah. And he's almost 50 years old. Damn, that's double mine. I got to step it up. So he's very concerned about that. I don't know Dave at all, so I can't speak to his concerns, but it's one of these single top things that Brian is paying attention to. Okay. And what are some proven ways to increase the score and how long does it take from what you've seen? Great. Okay. Let me go backwards. How long does it take?

This is a spectrum. If you are really unfit, low, you'll respond much faster and much more. If you're really pretty fit, then there's an asymptote, right? There's only so much progress you can make. For example, for me to take Brian from 57 to 60, it might take us six months. Wow, just for three points. It might. It might take us two months, but it might not, right? Like it's getting pretty far up there. I'm pretty sure I could put three on you in about a week. Wow. Like that wouldn't take that long at all. We could probably put 10 on you.

even, you know, pretty, pretty quickly. So how fast it can prove it by how much is dependent upon your starting point in large part. You want to think about your view to max as being roughly 50, 50 genetics, 50, 50 lifestyle. So whatever your number is, I don't know how hard you train, what you do for your training, how much you work out. But if you're not really that into it, then it wouldn't be crazy to think we could take you from a mid thirties to

to a mid-50s over many years. That could certainly happen. We wouldn't get there in a year or six weeks or anything close to that, but we could absolutely get there. And I know that because in my coaching program, we have seen that hundreds of times with, we coach everyone from 25-year-olds to 65-year-olds and more, men or women, pro athletes, non-athletes,

every day in your podcasters, whatever. We've seen VO2max jump up easy, 10 milliliters per kilogram per minute in a six month period, if not more, plenty of times. So that's how much you can progress and what you can kind of expect if you do it right. Now, how do you do it? The beautiful part about this is VO2max has a central and peripheral component. What I mean by that is half of it is your lungs and your heart. Okay, the other half is your blood and your muscles.

So we can attack either side or both there. What's that mean? If you like to do long, low intensity, easy stuff, certainly works. If you want to hike around here, there's phenomenal hiking in the Vegas area. You want to do zone one or zone two, or I don't even care what zone you're in. Sure. No problem. There is substantial growth that can happen there, particularly for, again, lowly trained people.

If you want to do, hey, man, I'll do whatever it takes. I don't have an hour to go do my workouts. I don't have 90 minutes. I certainly don't have five hours on a Sunday for a hike. I got to get this stuff done in 30 minutes. Fine. We can get it done in five minutes. There's a tremendous amount of research on high intensity intervals.

This could be 20 seconds. It could be 30 seconds. It could be a minute long. You can extend that all the way up to four minutes long. You can rest what we call one-to-one. So one-to-one would be equal amount of work, equal amount of rest. 30 seconds of work, 30 seconds of rest. And do that five to 10 times. You could do that in the longer case, you know, four minutes of work.

Four minutes of rest. That'd be an eight minute thing and do two or three rounds or four rounds of that. Or anywhere, honestly, in between. You could run. You can lift weights. You can do kettlebells. You can be in an assault bike. You can be in an activity class. You can do this a lot of ways. And I like to approach VO2Max this way because I want to make it as accessible as possible. So if you don't have this equipment or you hate the style of training or you got an injury to work around or you really love being around people or you hate being around people,

There are many scientifically documented ways to make the type of progress I talked about a second ago with a unlimited number of methods. As long as you're challenging your lungs, your heart, and your muscle, you're going to get there. Now, based on certain people and their individual physiology and what's going on, we might actually, as a coaching practice, I might coach you very specifically. I would give you a very direct program.

But I don't know anything sort of about, you know, we're doing this kind of for everybody. So globally, we will use all of those. I coach a very high profile NFL player, the top linebacker in the NFL. And we use a very different approach than we take for one of the highest, one of the best quarterbacks in the NFL. Both need to improve their VO2 max.

So when I say you can do this, I literally even mean two people in the same exact sport can have a different approach based on their limitations. We can see improvements in VO2max without doing almost any exercise by simply improving mechanics, how you breathe, your technique. Can you actually use your diaphragm? So we can get that approach done a lot of different ways. It doesn't have to be cycling or running or jogging or low intensity or high intensity.

You can get there a lot of different ways. Nice. Do you see VO2 levels dropping with age similar to testosterone levels in men? It will draw. And now we've actually done research on this probably a decade ago. I went to Stockholm, Sweden, and we did an interesting study where we looked at VO2 max in 80 plus year olds. And what we actually did is we cherry picked a little and we looked at folks that were world champions and Olympic medalists in the 1940s and 50s and had not stopped training. Hmm.

These were all cross-country skiers. So you're literally talking about guys in their 90s who are racing cross-country skiing and have done 55 years straight of the race or 62 years straight. These are some actual numbers that we had. And we compared them to aged matched non-exercisers. We wanted to see, okay, what the VO2 max looked like. Well, there's a line, yours is about, we'll call it again, call it 35, 37. Mm-hmm.

There's what's called a line of independence. Now that happens at about 18 for men and about 15 for women, roughly. What that means is if you fall below 18 or 15, depending on who's listening, it becomes really hard to live independently. You can't live by yourself, particularly if you get past sort of age 50 or so.

If you're 22 years old, you can kind of manage, right? But as you get to middle age, certainly later in age, if you have a VO2 max of 10, you can't live by yourself because normal daily activity, it's called ADLs, activities of daily living, putting your shoes on, getting groceries, that requires a VO2 of 12. Wow. Or 14. Yeah.

Or 15, right? You can't go to the bathroom because you're at eight. Dang. Right? And it's like, okay, you're doing 80% of your VO2 max just to move throughout the house. You're not going to functionally live very long by yourself. And so I'm not super concerned about your 35 right now. What I would look at this and say, okay, I can actually plot exactly how much you will lose over the next years. And then I could look and say, all right, man, when will you cross below 18? Hmm.

Will that be when you're 50? Will that be when you're 55, 65, 70? Because there is a roughly known rate of decline of VO2 max that happens with age. We were able to plot that with our cross-country skiers. Now, the folks that were non-skiers were still age-matched, 80, 86, 88-year-olds, a bunch of things like that. Their VO2 max was around 20, 22. Now, again, we selected people who were living independently. That's who we recruited. So we knew that they were above that standard, but they were just...

this far above it. Meaning if they got a cold, if they hurt their hamstring or tweaked their back and they lost a little bit of aerobic fitness, they were going to fall below that line. They were on the threshold. Our consequence is skiers are

We're almost double that. I think our group average was like 38 milliliters per... Actually, it's about your number. Oh, yeah? 80, though. That's impressive. Oh, 80 to 90. Yeah, 80 to 90. We had 90 plus drones. So there's actually more recent research that has suggested that decline of yield to max with age isn't necessarily...

required to happen just because of age, it can really be ameliorated by training. So as long as you train, stay consistent with that, you can greatly slow down that decline. And it's about 10% a year, right? Yeah, about 10%, no, per decade. Oh, per decade. Yeah, about 1% per year, roughly something like that. Got it. But again, you have a lot of control over that because 50% is

but then the other 50% are going to be your lifestyle. So you have a large amount of control over it. Got it. And another thing that drops every year is testosterone. And these days people see a low testosterone number and then they start immediately supplementing it to raise it, right? Yeah. So, I mean, that's fine. This is an open bag here. I want to be really clear that I'm not a medical doctor. So,

If you think you need medical intervention, then that's awesome. We work with a number of phenomenal physicians in this area, Dr. Ryan Green at Monarch Athletic and Dr. Gabrielle Lyon in Houston. And so I'm in full support of those things. That said, for me, if someone comes in with a moderate or low testosterone, I'm way more interested in understanding why.

If you feel like you need medical, okay, great, fine. Not against it at all. But we really need to understand what's happening. This is where our precision stuff comes in. So you were mentioning earlier that you had some recent blood work. I sort of asked you before, how much did they take? Yeah, four vials. Four vials, right? We're probably going to take closer to 20. Crazy. And the reality of it is, I mean, four vials gets someone like you

very minimal information. It would be pretty standard. You probably got a, well, let's refer to it as a CBC and CMP. 30 to 40, maybe 50 markers at most. But I have world championships on the line. I have business deals that have to work. We have people who are valuing their health more than that. And so we want performance at its highest level. 40 molecular markers is not going to give you that answer. So if you really want to get to a level of

understanding why your testosterone is the way it is or optimizing, understanding what micronutrients are there needed for you, how to optimize and directly select your supplementation so you're not wasting any time. This requires a lot more precision. So actually, to be totally truthful...

Two perspectives here. One, this is what my company Vitality Blueprint does. It will analyze, interpret, and tell you exactly what to take from a nutritional perspective, not just macronutrients, but all the way down to the micronutrient, as well as supplementation. If you don't understand how to read blood work from, again, particularly not a medical perspective, then this is what that software will do for you. Additionally, though, at our full immersion program, we're going to combine all that blood work with urine, with stool, with

With saliva, with sweat, with hair. I want to know everything going on in your body. When I have hundreds of millions of dollars on contracts online or Paris Olympics were on the line, we got a shot every four years to go after this. Or even if you're not an athlete, it doesn't matter. But something is important. Really common ones here are just, I feel terrible.

I don't care what it takes. I can't feel terrible anymore. There's not even a large amount of money on the line, but I'm just, I have headaches every day or we get a lot of sexual dysfunction stuff. My energy, my mood is terrible. I don't know what's going on. I've had my blood work checked and there's nothing massively wrong. These are really, really common things we do. But when we look across our system, we now go, oh, again, maybe something is not medically wrong.

but there's certainly suboptimal physiology and we can see why. And getting back to your testosterone question is, I'm looking for why the testosterone is suppressed to begin with, right? So if it is low, I'm going to look at the rest of the things, at things like cortisol levels. Now that's on most tests. People are going to look at that. That's stress, right? Right. Okay. But cortisol is good too.

You want it to be super high in the morning and you want it to be lower in the evening. So it's not just the number, it is when did you collect the specimen? Did you collect it multiple times throughout the day so we can get a cortisol curve of you? It's not just the one time spot. Did we get it from your saliva or did we get it from your blood? There are different markers of cortisol in those specimens and you wanna make sure you're interpreting those things

Then I'm gonna also look at things like DHEA, sodium potassium ratios, albumin, blood glucose. Funny enough, people have no idea how albumin and blood glucose actually will tell you a lot about testosterone. - Really? - A ton, right? So I can look at that and go, oh, okay. I'm gonna rip this one off because this is a very recent example we had for one of our clients at Rapid Health and Performance, that's our full coaching program.

When we looked at this, testosterone was down and we said, okay, awesome. And we look, uh, we had had, I was also sort of telling you earlier how many people we've had come to us from TRT. Right. Bad experiences with that. Um, and I'm,

Just want to make sure it's clear I'm very supportive of that stuff. But most of the moderate or higher profile blood work companies are really there to be intermediates between you and getting hormone replacement therapies from Teladoc or Ozempic and things like that, right? Fine, not against it.

Preventative medicine is harder than it should be. So I'm fully supportive of those things. From my perspective, that's not what our blood work stuff is going to do. We're gonna look at it and say, okay, great. You went in TRT, you felt great, now you felt terrible.

Now you want to get out of that game. How do we correct this? Or you never went on TRT, but you don't want to, but you feel terrible, nothing's worked, and you want to figure out why your testosterone is down. Okay, great. We can look around the system and see, all right, well, if sodium and potassium are telling us that you're in a hyper-stressed state, even if cortisol is fine, because cortisol will respond acutely, meaning it'll go up by many folds,

if you had someone cut you off on the way to the blood draw. So you've got to be really careful. Sodium and potassium, though, are highly stable. People think of them as electrolytes for hydration markers, and they are, but they are one of the few things in your physiology that your body will hold extremely consistent.

It doesn't want to move them at all. It will move things around them to keep them stable. So when that ratio gets low or gets high, you're getting towards the area of either Addison's or Cushing's disease. That's why your cortisol got off.

While your cortisol got off, then that's what we know that it has an antagonistic relationship with testosterone. That's what's suppressing testosterone. So in this particular case with the client last week, it had nothing to do with him having low testosterone and needing more testosterone. It had everything to do with us walking back and figuring out why his sodium-potassium ratio is off. We get that corrected, cortisol comes back down to earth, and that allows testosterone to go flying back up. Wow. And we have seen...

Doublings of testosterone, I can't tell you how many times, with no hormones, no advanced supplementation at all. It's just a correcting of physiology, getting out of the way, and letting your body do what it wants to do. It wants to have it in the correct spot. You just gotta get those, what we call performance anchors. You have some anchor holding that shit down, you just gotta get it out of the way, and then really we try to get ourselves out of the way and not overcorrect.

Because as much as we know about physiology, there's more that we don't know. And so we don't want to orchestrate too many things. But if there is a clear thing that's happening that's suppressing and that's leading to a chain reaction, then we know that's what's going on. So when I said earlier, hey, one of the major mistakes people make with blood work is when they look at a marker and if it's low, then they just take more of it as a supplement. That's a huge mistake. Sodium potassium is a great example of that. If your sodium and or potassium are off,

Increase in sodium intake might make you feel better initially, but that's not going to get chronic elevations in sodium because remember that's held stable. And that wasn't the problem to begin with. You had that ratio off that was causing that downstream effect, but you didn't need to correct the sodium. You needed to correct why the sodium was low. And many things could be causing that, but a very common one of that is suboptimal or dysfunctional sleep.

over a total allostatic load, which can be caused by a number of things that are happening. But really, we're going to continue to work backwards on that chain, figure that out and go, this is the one or two key things you have to go do. And I don't need you on 55 supplements. I don't need you on a super specific routine. I don't have to have you buying really wild technologies to correct phase. Sometimes we can do that stuff, but we usually are able to bring it down to a couple of things and we would be able to be like, all right, my man, go do A and B.

And then come back and then just watch the testosterone take off. Wow. I love that. Yeah. It happens really commonly. Just from one or two simple tweaks. Easy. Yeah. I mean, I'll give you one example. This is my business partner, Dan Garner. He's just an absolute wizard with physiology. And this is his story, but it happened in Dallas where he had a client who was struggling with testosterone and couldn't figure out why. So the client kind of wanted to just do a few markers. Mm-hmm.

Didn't get much there, had to come back and add markers. And so this was a many month long process, right? It's one of the reasons why we don't do that anymore. It's like, just why waste time when we can just get everything measured at the beginning, save months and months of work for a small increase in cost. So, but he didn't do that. So it took a while. Eventually came down and the normal things weren't working. Sleep wasn't working, stress and all those calories and carbohydrates and many things that go onto that weren't working.

So eventually Dan was like, okay, there's something happening in your environment. So with all of our clients, we actually run a full environmental scan of their room at all times. So CO2, dander, mold, pollen, allergens, we're scanning their living environment for those things.

He didn't have this technology, Dan, at the time. But what he realized was in his blood work, there's a marker in there called basal fields. And basal fields are hyper responsive to environmental stressors, right? Now, I might like actually are probably our basal fields are probably pretty high right now because it's- The lights? Poison outside. Oh, the fires, yeah. Yeah, the smoke is terrible outside. But his basal fields were off the chart. And he realized that there's something in his environment. And so the client was actually leaving his house every day

and turning right and walking. That's great. But he was walking in a part of his neighborhood that a particular set of trees were in. And for whatever reason, you wouldn't say he was allergic to those trees, but something was reacting to those trees. So Dan, the only change he had to make was go out of your house and turn left. Walk on a different path.

All he had him do was walk on a different path. He didn't interact with those anymore, those trees anymore. His basal feels calmed down and his testosterone shot back up. No way. Just from walking left. Just from staying away from things like that. Wow. That's fascinating. Those are rare stories. I'll be totally honest. I don't want to hypersensationalize it. The vast majority of success we've had with things like testosterone-

are absolutely the big rocks. Sleep, stress management, exercise, for sure, for sure. But there have been those cases many times over where it is something wild like that. So I don't want anyone to leave that and be like, oh my God, I freaked out about their environment. You're still going to have the most wins by a country mile. Sleep, stress management, exercise, positive relationships, so on and so forth.

But those other things can exist and they're not insanely hard to find if you just know what you're looking at. Yeah. Environment is definitely important. Have you been seeing a lot of mold in your blood work? People struggling with that? Not really. Okay. It has come up. We will see it occasionally, but I'd say more often than not, people come in because they're like, I've checked everything else and I'm now freaked out. I think maybe I have Lyme disease or I've got mold in my house. Like something else is going on. And I could just tell you, honestly,

That has happened, but it's generally not the case. - Okay. - It's almost always something real in their physiology. Not to say mold isn't real, of course. That's certainly a real thing. It's very bad. Get it out of there if you can. But it's been pretty rare that that was really happening.

Unless they have overt signs, they see mold in their house or something. Okay, great. But most of the time it's been something else going on. They have an underlying sleep disorder that they didn't realize. They have some other really dysfunctional practice that is generally a healthy thing, but it wasn't healthy for their physiology. There was a micronutrient deficiency that was really off. Some immune marker was down. These are generally what we call hidden stressors. So these are putting a tremendous amount of stress on your system

But you can't necessarily pinpoint it, right? Like you don't, you're not drinking, you're not smoking, you're not like doing all these things where you're like, well, that's why I feel terrible. And so people get really freaked out because they're like, I'm doing all the right things, but something's happening. And again, I really, I would...

Pretty much venture to say it's never been a case where we couldn't figure it out. Wow. So everything's fixable for the most part? In terms of that one, right? When it's like, I'm pretty sure I'm old or something and it's like something else has been going on. It may have been anything up and down the strain from some of the more advanced blood work stuff we can do.

Two other markers, two against sleep, two stress management or what other things are happening. Hydration, actually, people just totally eliminate hydration. They like say it, but no one really pays attention to it.

We have had many people who come in for things like brain fog, erectile dysfunction. They are swearing they have mold or something like that going on, sexual health problems. And they see almost instantaneous improvements within a day of managing hydration appropriately. Wow, that's simple. Just drink more water. Again, it's not the average person, but it is a very simple one to fix. If you're feeling tired all the time, if you're having some of these other things, mood, word recall,

Exercise performance, of course, thermal regulation. I get hot all the time. If you are really poorly hydrated, not if you're a little bit dehydrated, but there's evidence as little as a 1.5% dehydration, this would be by body weight, can induce statistically significant changes in mood, word recall, accuracy, psychomotor skills, attention to detail,

arithmetic, things like that. So it is a really easy fix. It's something that anyone can try and you don't have to spend a dollar. You can get no blood work done. You can start right there. And worst case, you went pee a few more times for a couple of days than you needed to. But you'll be really surprised if really getting on top of your water and hydration, you'll be like, oh my gosh, like I actually...

It's not going to perfectly fix everything, but you can see some pretty substantial changes pretty quickly. It doesn't always happen, but we have plenty of those cases. How much emphasis, I know you specialize in sleep, how much emphasis do you place on those sleep scores? I just got an eight sleep and it's good, but I don't know how accurate those numbers are. Yeah, eight sleep is fantastic. Conflict of interest, disclosure here, they're a sponsor of my show as well. I don't have any other financial ties to them, but they have been great. I have...

three eight sleeps in my house like i put them on my guest bed i put them wow your guests are spoiled yeah so i love the product that said we put zero emphasis on those sleep scores really no we don't use them for that at all okay um not that i i wouldn't ever the the function of the mattress from its cooling and thermal regulation is exceptional and i've been saying that before i ever had any financial relationship with them so you go check the records the facts are out there

But that said, absolute rest is our ability to analyze sleep is so high that like, why would we go down to a wearable kind of thing? Got it. We're actually able to run full FDA approved clinical grade sleep studies. So the exact same thing you would get if you went to a sleep hospital from your own house. Wow. With no wires. Oh, how does it measure it then? We have actually a way more advanced technology that we can do that with.

probably over a hundred peer reviewed scientific publications on it at this point. So it's well, well, well, well established. And we can do that. And we can also do that a hundred nights in a row if you want. So you don't have to worry about like, oh, I slept really weird that night because I knew I was getting measured or this weird thing's going on. It's called the first night effect. You know, the first night and I'll tell you kind of sleep weird. If you go to a sleep, no one has ever had a sleep study done.

is going to go to a sleep and be like, I slept normal. People watching you from a mirror and you're in a gown and on a terrible bed. It doesn't happen. So we do those sleep studies from your house. And because it takes a very small device on your fingertip, it's not going to introduce or intrude on your sleep at all. Nice. So when we can do that, there's sort of like really no point for it. And we can do that for a very low price point. It's fairly cheap to get that done. Most sleep clinics are going to be five to eight grand out of pocket, depending on your insurance. Yeah.

Right now, typical wait time is like three or four months. Holy crap. It's kind of like blood work too, man. Like most people, if everyone listening, I had put your hand up right now and it's like, hey, have you had a sleep study done? You know, some hands will go up. And if we ask like, well, how beneficial was it? Not many hands will stay up because it is that x-ray example. It's sort of like you have a clinical diagnosed sleep apnea,

or Bruxism or something like that, or you don't. It's like, well, then I still feel terrible because that ACL is torn, right? Like, so there's a lot of things that you will not see in a sleep study and also has a lot of problems, right? It's not my normal sleep environment. So in general-

The sleep data is helpful, whether it's on the eight sleep or sleep clinic, that's great. But that's only functionally telling you how you're sleeping, how many hours you slept, right? The time you fell asleep and how long it took you to fall asleep. And the eight sleep is actually pretty good at, you know, were you rolling over a lot? Things like that. None of those things are telling you though why you're sleeping that way. So then you don't know how to solve it. And that's always the big problem with the sleep clinic, right? It's like, told me I had A, B, and C, and they gave me a CPAP.

Full support of CPAP if, you know, again, I'm not against it, but okay, was it an actual pathology? Was it something in your physiology? Was it something in your psychology? Was it something in your environment? Environmental scanner comes in. Is it something in your behaviors? Why? Once we know why you're sleeping that way, now I know exactly what to do to solve it. I can give you really easy examples of this. This was in a major league baseball player, highest contract player.

in the sport at the time, really successful guy. And boom, sleep issues, right? Had done the kind of full wires everywhere thing and really got nowhere. We came in, looked at it. We realized 80% of his sleep issues were happening when he was on his right shoulder. Wow. And so we fixed it by saying there's like a $15 backpack you can buy on Amazon. Wow.

It's like a reverse fanny pack. Yeah. Basically, right? And so what it does is it allows you to, you put it on your back so you don't sleep on your back at night. No, his problems were on his back, not his shoulder. That's what it was. So we put that pack on there. So he either had to lay on his right side or lay on his left side, but he didn't sleep on his back. So we saw a 90% drop in waking events night one. Crazy. And they never came back. He wore that backpack for a few months. Then his body learned, we either sleep on this side or that side, and he

He doesn't have to wear it anymore. He just naturally does that. And again, we had a 90%. This has been many years. Reduction in waking events, night one, and it stayed consistently the rest of his life. Incredible. We worked for years on his sleep and got nowhere until we built this technology and

Built absolute rest and then, boom, solved that problem instantaneously and never had to look back. Wow. Is there an optimal sleeping position or was that just a case-by-case? So that's the other thing is we analyze everything by position. So we know exactly what's going on when you're on your right side, left side, stomach, back, right? So for you, maybe back is fine.

Maybe buyback is terrible. The reason, again, we can give those specific recommendations is because we are looking at that level of detail. We have a lot more stuff we can actually do with cameras. We have facial recognition technology where we can look and see, is there something anatomical?

That's causing it, right? Wow. Like, is it like you can take all the sleep supplements you want, but you need to actually get something done in your tongue. And there's, there's, there's actually solutions, non-surgical solutions to things like that from mouthpieces to tongue exercises. These are very well evidence-based things, right? These are not things my company created. Lots of scientific research behind all these things. So there's many examples we can get to.

So if you and I both went in and got a study done, I might be told I need to have a down regulation routine prior to sleep. You might be told you actually need to do these tongue exercises, right? And neither one of us would be told that we need a supplement or, you know, your producer in the back would be like told, hey, you don't need to do really any of that stuff. But then actually this supplement we think would actually help. So the solutions have again become highly effective. And the reason we have so much success in our companies is because it's like as much as we can, we're trying to figure out why problems exist, right?

whether it's your testosterone, whether it's your sleep, what's going on here, whether it's your nutrition, whether it's your VO2 max, and give hyper-specific solutions. And so our success rate's really high. Everyone misses a course occasionally, but it's very rare because we have so much data that we know exactly what's causing problems,

We're not just sort of covering up symptoms. We're not just trying everything and giving you a thousand things to go do. And most people just aren't going to do that. So our adherence tends to be really high. People tend to follow our programs because there's precision there and they tend to resolve issues pretty quickly. Yeah, I love your philosophy because a lot of people get overwhelmed, I feel like. Of course. I mean, I get overwhelmed. I'm just like, oh God, I got to do this and this. And sometimes you're like,

I just want to hang out in front of my giant TV all Sunday and watch football. That's what I did Sunday. So are you using AI to analyze all the data? Cause you collect so much. It must take a while to manually sift through that, right? For the most part, we do it manually. Really? Wow. And that's, we have, of course, those things going on as well for all the companies. But in general, my philosophy is if you're going to come in and work with me and this is what you want, you're going to get me. You're not going to get an AI version of me, right? You're not, you're not going to get those things. Now,

We have created smaller programs within Absolute Rest. We've created smaller programs within Rapid Health for that. You can't afford to come all the way up and do direct with me. Can we get really close? But if anyone is working with me directly is going to get me because there's still insights I get. There's instinct. There's feel from talking to the person, working with them. AI is just not there yet. The other fundamental problem with AI is it's only as good as the data you feed it.

So if we go back to your blood work issue, I only have databases on so many people. And so now if somebody comes in that I haven't worked a ton with, I don't know what their reference ranges are for that situation. I don't really have any data to feed it. And so I need to be able to use my instincts a little bit. I need to go find new papers. We need to go do other things, talk to friends, talk to colleagues like Gabrielle or Ryan and say,

What do you think about blah, blah, blah? And then get inside. So, um, we make sure while that stuff has been very accurate, um, when people have one shot at something, I'm not just going to toss it to AI. Yeah. We're sort of do it, but then we're, we're always like, you're going to get me as best as I can. I love it. Uh, I want to ask this cause it was Olympics hot right now. And you mentioned it earlier. Are you seeing anything with blood work with people on Olympic? Anything interesting? Not really, to be honest. Um,

We have had plenty of people in our program that are on Ozempics or Ozempic-like things that are doing okay. We've had some that are not, but I would say we don't have a particular trend. One thing I'm paying a lot of attention to, of course, is one of the long-stream effects of muscle mass, right? Certainly if Ozempic's primary effectiveness is helping you reduce caloric intake, and that comes with an enormous amount of loss of fat,

That's a win. Some muscle is going to go with that. But for most people, that's probably a fair trade, right? Most of our population is not 10 pounds overweight. They're 80 or 110 or something like that. So if they lose 20 pounds of muscle on their journey to 80 pounds of fat, that's probably a net win. Where I'm more concerned about is the people kind of using those drugs to lose the 10 pounds.

And now if that's coming with five pounds of fat, five pounds of muscle, and they're already moderate or low muscle, then like that becomes a real problem and a concern. We just don't have the data. I've seen data on both sides. It says, hey, my God, people are losing a ton of muscle. And then other data is like, I actually...

Maybe it's not, or maybe, so I don't feel like I'm completely comfortable with saying, yes, it's for sure gonna cause you to lose all your muscle, or no, it's gonna preserve it, you're fine. My instinct is gonna say that if I had to bet, you're probably losing more muscle with that stuff than you'd like. That said, the people I work with that utilize those drugs or recommend them strongly encourage people to lift weights and make sure their protein intake is really high. I actually suspect if you do both of those, I think you'll be okay.

With those drugs, it's hard to do because your hunger is gone and then like your desire to eat protein gets pretty low. Most people don't do it. So the reason these drugs are so effective is because you can just take them and not do anything else. So I think if done properly, I think it's probably okay. I think on a large population database, on aggregate, it's probably a win. But we will definitely pay attention to it. It's not an issue with our athletes. None of them are taking it. It is certainly an issue for our 45-plus athletes.

year old crowd, particularly our women. And now we're getting very concerned with loss of muscle through menopause and post-menopause. So the female clients that we work with, we really want to make sure that they're not under-muscled. And so that's something we monitor carefully. But other than that, I wouldn't say we've seen any massive things from the blood side that are like

It could happen. Maybe somebody else has, but we haven't noticed that. It's still pretty new, right? Yeah. There's no long-term. Again, frankly, we don't have a tremendous amount of people that come to our program on those. Yeah. Like we're not a fat loss company. Not what we do. Yeah, I feel like your clients are all in pretty good shape coming into it. Not really. No, we've had plenty of people who are like, hey, look, I don't do anything. I drink 20 beers on the weekends. I eat French fries and burgers all day. Yeah. And I want to get started.

But if I'm going to do this thing, I want to do it right. So we've had, I'd say, I don't know, 15% of our clients are like that. They don't do anything at all. A bunch of negative stuff. Certainly I talk about that most of the time are kind of elite performers, but at least 15% of our people are like, I don't do anything. We've actually had, you know what's funny? We've had a ton of

really young gamers. - Oh, PC gamers, right? - Yeah, 'cause they make a ton of money. - They do. - And we didn't know this until recently. The one that I have here in Vegas is crazy. - There's one in Vegas. - I don't remember what it was, but they do like Super Bowl numbers. - Oh, the eSports, right? - Yeah. - HyperX Arena at the Luxor. - It's wild. So we had a bunch of people from that, and it's like, yo, they're younger than you.

and they don't do anything but sit and game and they're just like man and they're super skinny right no oh the opposite yeah they're just enormous because they just eat doritos and sit in a chair yeah all the time and take adderall and you know like just get going as much as they can cognitively and they obviously they work like a swing shift basically because they're up gaming until four or five in the morning right and then they're so we've had a number of people like that um it was like okay we don't have to have you to be a high performer

in terms of dialing every part of your lifestyle in, but we gotta get you off of death's door. Like you're really in a bad spot. - Wow. - We just gotta get you to moderate. And from their perspective, it is strictly an investment. Generally these people haven't been like health junkies at all. They're not big into working out or basketball or anything, but they're thinking, okay, I'm making 2 million a year playing games. If I can go up 10% in cognitive performance reaction time, then I go from 2 million to 3 million.

It's a very easy investment. The ones that have come to us, that's been their mentality. I could see that. I used to live that lifestyle. That was probably the worst I ever felt. It's horrible, right? I was gaming 16 hours a day. Yep. My body was so weak. I was so skinny. It was terrible. Yeah, you feel awful, right? Sleep schedule is awful. So they're like you and they don't eat or they just like munch all day long. Yeah, there's no in between. It's either really fat or really skinny for PC gamers. We've not met anybody in that world who's like pretty healthy. No, I can't think of anyone that I would- They're all trashed. Yeah. So we've had a lot from the sleep perspective of it.

especially when they're playing like tournaments in the Netherlands. I think we had, there was a big League of Legends or something. There you go. That's what it was. Yeah. So we had some people from that one and they're like, yo, dial us in so that we're,

on the right things so we can perform our best with our sleep cycles what do we need to do because of the lighting situation and engagement and when should we wake up when should we go to sleep when should we what should we do post gaming and all this stuff so we're able to dial them in pretty well yeah and then i forgot the name of the team we have a whole team for league of legends we did that with and they crushed oh yeah they improved yeah that definitely yeah it was huge it was awesome yeah because reaction time is everything in esports decision making right it's it's all that and then it's what people don't understand about e-gaming is it's fatigue too

It sounds funny, but sit in front of a computer for 10 hours. You're going to get very, very tired. Physical energy gets really, really low. You start seeing small, there you go, we talked about hydration. One, 2% loss of hydration is gonna have a significant reduction in reaction time. Other metrics that are important. So fatigue becomes real, sleep becomes real, energy becomes real, desire and tension becomes real. And then it's just such a really detrimental physical practice.

that they're not exercising not moving so energy gets really really low breathing gets problematic and then they get into the one of the bigger problems is because they're gaming and they're they're in basically fight or flight the whole time because they're executing and performing and competing

that they have a hard time getting out. So they're stuck kind of in fight or flight at all times. You see a lot of mouth breathing, chin start to drop and like opening up. And that leads to a whole cascade of physiological problems like hyperventilation. I mentioned earlier sodium potassium ratios, right? If you hyperventilate,

You're over-breathing. This will actually result in what's called respiratory alkalosis. And so you actually dump too much CO2. You over-breathe. You get rid of it too much. And so CO2 concentrations get low. This causes you to be in an alkalitic state in your pulmonary system, in your lungs. Your kidneys respond to that by creating metabolic acidosis. They're going to do that by altering sodium potassium.

And so it wants to put you in a metabolic acidosis because it needs to balance the pH because the other side is alkalitic. Remember, acid-base is kind of the opposite. So you've breathed yourself into a base state, if you will, and now you will put yourself in a metabolic acidic state to make the entire system balance. And you do that by excreting and changing electrolyte concentrations. So that's when we can pick up on that stuff because now we're looking at those ratios and going, okay, we see what's happening.

In this case, you don't need more sodium. Even if your sodium is low, you need to stop over breathing. And then everything gets corrected. Cortisol goes back down. Testosterone goes back up. Common example that we've seen there. So it can be seen in a lot of different ways. Yeah. And that's tough when you're gaming though. It's intense. Super hard. Your breath just starts going. Yeah, of course. Right. Cause you're, you're on at all times. There's very little breaks and nutrition's off. It's,

It's tough. Lighting is crazy. There's only so much stimulation you can take. Yeah, eight hours straight of that. Yeah, people don't see these things. They just see a game and they're, you know. Yeah, we've had actually the gamers and poker players. Poker players. We've had a ton of poker players in Vegas. Really? Online. So that's what made me think of it because a lot of them are online. Right. And we've probably had a dozen or so World Series of Poker guys online.

some girls actually too, but a lot of the online ones. So they make their living doing that. And it's the same kind of issue. - Yeah, you got to sit down all day. - Bingo. - Make important decisions. - Games don't start till at night. And yeah, you gotta make real decisions. You gotta memorize things, you gotta pay attention. So there's a lot going on. - Interesting, yeah. - So they're hard sports actually. - Yeah, 'cause just being sedentary is really bad for you too, right? - Terrible. Everything gets worse. I mean, you can't pick a metric.

cardiovascular health, endocrine health, your hormones, your immune system, your mental health, your sexual health. It all gets worse with sedentary behavior. And I bought a standing desk, but I just, I can't use it, man. It's so easy to just sit on those. Yeah. You know, one mistake people make when they jump to standing desk is you don't have to be all or none.

Right. It's not, standing is not inherently that much better than sitting, which you want to think is movement. This is really classic Kelly Starrett stuff, right? It is a movement that you want to be, not a stand versus a sit. So my recommendation would be not necessarily to go full standing desk, but you need to do both. Float back and forth, right? So a lot of people will do like a walking treadmill desk. Yeah, treadmill desk. Okay, fine. I don't do that personally, but I will bounce back and forth literally between the sitting and the standing. Okay.

And I will do a large percentage of my meetings if I can, not sitting. So I have earphones and Bluetooth earphones if you need them. And then I'm back up. I'm like bouncing around. I'm walking up and down. I'm fidgeting and I'm doing that. It looks weird as hell. I do that too. That's a really good idea. So stand for 10 minutes, sit for 20 minutes.

Get up and move around. Mix it up. And you can work for hours without ever changing. Love it. So movement is the key there. Yeah. Dr. Andy, it's been a blast, man. I could talk to you for hours. Yeah, man. This is really fun. That was a quick hour. Where can people learn from you and potentially become a customer? 100%. Yeah. I mentioned absoluterest.com. That's easy for the sleep company. We also talked about Vitality Blueprint as our software blood work company. Our full coaching program is called Rapid Health and Performance.

And then at the top of the funnel there for everything is my podcast, which just came out. It's called Perform with Dr. Andy Galpin. It's not weekly. There's no guests. It is just 10 episodes. You can go binge that whole thing. And episode season two will be out early next year, I think. So Twitter and Instagram are the easy places.

to follow along for science communication, things like that. But you can pick your poison for the rest of them. Perfect. We'll link it all below. Thanks so much for coming on. Yep. Thanks for watching, guys. See you next time.