[Transcript] – One Comprehensive Health Test To Rule Them All? How To Get An At-A-Glance “Clarity” Report Of Your Genetic Age, Death Risk, Gut Health, Ideal Diet, Exercise, Sleep & Much More.

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Transcripts

From podcast: https://bengreenfieldfitness.com/podcast/self-quantification-podcasts/health-report/

[00:00:00] Introduction

[00:02:47] Podcast Sponsors

[00:06:40] Guest Introduction

[00:09:43] How Matt and Mike's Report Is Different from All the Other Reports Out There

[00:14:19] How the Report is Utilized–From Doctor to Patient

[00:18:24] Sleep and Circadian Genetics

[00:26:57] Diet and Nutrition

[00:33:36] Podcast Sponsors

[00:36:15] cont. Diet and Nutrition

[00:40:36] Methylation

[00:46:10] Vitamins and Micronutrients

[00:49:34] Balancing Gut Reactions vs. Genetic Pathways to Superfoods

[00:52:06] Exercise and Recovery

[01:00:17] Neural Behavioral

[01:01:54] Microbiome

[01:06:40] Cardiovascular Disease

[01:10:03] Longevity

[01:14:12] How to Take the Wild Health Clarity Report and Final Comments

[01:17:34] Closing the Podcast

[01:19:24] End of Podcast

Ben:  On this episode of the Ben Greenfield Fitness Podcast.

Matt:  It really helps you figure how to optimize your health and then maximize your health span. And we take all that and try to contextualize it for you as well.

Ben:  Let's walk through that. How can this report advise people as to how they should be eating?

Mike:  You know, 95 years old. Decreasing your cholesterol is only going to decrease your risk of a heart attack by the age of 95 by 3%.

Ben:  I'm a Renaissance man of fitness, but I'm never going to be professional powerlifter or an elite marathoner.

Matt:  We're working on the basketball score. We'll have that on the next version as well.

Mike:  Yeah.

Ben:  Health, performance, nutrition, longevity, ancestral living, biohacking, and much more. My name is Ben Greenfield. Welcome to the show.

Well, folks, as you know, there's all sorts of crazy tests out there you can get down on your body. And I'm visiting today with a couple of really smart docs about one of the newer varieties of such tests that I've been pretty dang impressed with. It's called Clarity. And my interview today is with the good doctors, Mike Mallin and Matt Dawson from Wild Health. I think you're going to dig it.

I do have a couple of special things I want to tell you about, something kind of out of the ordinary. My twin boys have a cooking podcast and they're hiring for that cooking podcast. If you want to check out the podcast, that's gogreenfields.com, or if you just do a search for Go Greenfields in any of your favorite podcast players. They do about a 10 to 15-minute plant foraging, sometimes a chef interview. Sometimes in an inventive recipe, they do everything from paleo style donuts to pumpkin and superfood mushroom risottos, and all manner of smoothies, and cakes, and steaks, and all sorts of crazy recipes. I'm lucky I get to eat like a king here. I would probably be morbidly obese if it weren't for my exercise habits based on my wife's and children's cooking chops.

But anyways, they're hiring. They're specifically wanting to hire a social media coordinator to handle all of their like Instagram, and Snapchat, and TikTok, somebody who's really savvy, so to speak, in terms of social media, and who also preferably loves all things food, and health, and cooking. And so, I'm going to give you the URL where you can apply to be the social media coordinator for the Go Greenfields Show. So, you just go to gogreenfields.com, just like it sounds, gogreenfields.com/apply. That's gogreenfields.com/apply. It's all pretty straightforward from there. So, spread the news if you know somebody who would be a good fit for that position.

In addition, you may have heard me talking a lot lately about colostrum because I consider it to be a Swiss army knife for everything from immunity to performance to your gut and beyond. There was one recent study, those really impressive is a double-blind, placebo-controlled, randomized clinical trial in both men and women where they're given actually a relatively small single dose of bovine colostrum. They measured their immune-related markers within an hour after they consume this colostrum. They saw in the research a big increase in what's called phagocytic activity, as well as increased levels of T cells and natural killer cells. Those are all markers of incredibly enhanced immunity. In other words, a single very small dose of bovine colostrum showed beneficial systemic impacts on innate immune function. That's just one of the reasons that I prioritize taking bovine colostrum during sickness season. I take it on a regular basis, just because I had so many other benefits for things like growth hormone, and recovery, and muscle building. And I don't just take the 150 milligrams that they used in the study I just described you. I take a whopping scoop. The scoop is not big, but one scoop of colostrum that I use is over 3 grams. It's 3.2 grams. That's the exact dose in the Kion Colostrum.

And the Kion Colostrum, it's incredibly pure colostrum. It's minimally processed. We preserve all the active nutrients, proteins, and peptides, which you aren't going to find in a lot of colostrum products. And we include probably the most bioactive component from the immune system standpoint of colostrum that exists in very large amounts in our colostrum. It's called lactoferrin. In addition, it's all ethically sourced and is grass-fed, pasture-raised, antibiotic-free cows in what's called bioactive powder form. I recommend the way that you consume it, if you're not going to put it in a smoothie, meaning, it's going to hit the digestive enzymes in your mouth anyways, which activates a lot of the growth factors in colostrum, you literally put it straight into your mouth and let it sit with your saliva for about 60 seconds or so, and then swallow. And just in the same way that a newborn baby or a newborn mammal would consume colostrum, they'd be sucking on mom's teet getting the colostrum. They're moving around in their mouth, mixing with their saliva, then they swallow. That's the best way for you to consume it if, again, you're not going to put in something like a smoothie or a drink where it's going to hit your salivary enzymes anyways. So, you get all the immune-boosting and many other benefits of this superfood for 20% off. You go to getkion.com/bengreenfield. That's getK-I-O-N.com/bengreenfield.

And then, finally, this podcast is brought to you by Organifi Gold. You may have heard me talk recently about my pumpkin pie smoothie. It goes great with that. So, they have the Organifi Gold pumpkin pie spice flavor. I mix that with some of the Kion Colostrum that I just told you about, a little bit of bone broth, a little bit of stevia, some sea salt, whole bunch of ice, and then I blend that up super thick, top it with a little bit of dark chocolate or a little bit of bee pollen from my friends at the Beekeeper's Naturals, some unsweetened coconut flakes, and oh my goodness, it is the best pumpkin pie spice smoothie you're ever going to–I was going to say lay your eyes on, but I suppose put into your mouth with a heaping spoon. So, anyways, the Organifi Gold, they're offering this for 20% off right now. You go to Organifi with an “I,” organifi.com/ben. It's chock-full of turmeric, ginger, reishi, Turkey tail mushroom, a whole bunch of immune-boosting superfoods. I feel like I'm saying superfoods a lot in today's podcast intro, but it's fantastic. So, you go to organifi.com/ben for 20% off of anything, including your Organifi Gold Pumpkin Spice from Organifi, with an “I.”

Well, holy moly, folks. I have like a 50-page health report sitting in front of me right now that has tied in my genetics, my epigenome, my microbiome, a whole bunch of factors, blood biomarkers, stool, you name it, and it's pretty comprehensive. I literally have just been pouring over at this morning in preparation for today's show because it's a brand-new report rolled out by some folks you may be familiar with if you have been a listener for some time to my show, the good physicians over at Wild Health. Now, Wild Health has basically just rolled out this brand new, impressively, comprehensive biomarker's test that they worked with a bunch of MDs, and PhDs, and data scientists, and software developers on. That just takes all of your data and puts it in one place and then spits out a pretty cool report based on what is found from your data. And it even ties in wearables, like I know that this report got connected to my Oura ring, et cetera. So, all sorts of cool things.

But my guests today are Dr. Matt Dawson and Dr. Mike Mallin. These guys are multi-time repeat podcast guests on my show. They're the lead physicians at Wild Health, which you can check out over at wildhealth.com. They have locations and physicians spread all over the U.S. I interviewed them about precision medicine a few years ago, and then we came back and did a whole podcast about DNA. And then, a couple of months ago, did another podcast on biohacking the brain. What I'll do is I'll link to all those previous podcast episodes with these guys if you go to the shownotes for today's episode, which is at BenGreenfieldFitness.com/clarity, like C-L-A-R-I-T-Y, BenGreenfieldFitness.com/clarity.

My first guest is Dr. Matt Dawson. Hello, Matt.

Matt:  Hey, Ben. It's been a long time no see.

Ben:  Long time no see. It's in like five days I think I was down there at the Kentucky Castle with you eating oxtail and bone marrow at that wonderful farm to table restaurant you guys have. So, yes. For those of you listening in, I have just returned from Kentucky where my only mistake was not kicking Matt's ass in basketball as is my traditional approach when I visit Kentucky. And Matt, he's a wealth of knowledge in all things precision medicine, as is his partner in crime, Mike, Mike Mallin. What's up, Mike?

Mike:  Hey, Ben, how are you doing?

Ben:  I'm good. I am a little bit overwhelmed with the size of this report that's on my desktop, but I think we'll remedy that shortly. And while Matt is based out of Kentucky, for those of you listening in, Mike is actually based out of Oregon. So, between the two of these guys, they have the U.S. completely covered. So, fellows, welcome back to the show.

Matt:  Thanks for having us. We're super excited to show you this today, Ben.

Ben:  Oh, yeah. So, tell me about the history behind this report. You've been hinting to me for few months that you guys have been working on something behind the scenes, but I'm just curious because as you guys know, there's freaking like Viome, and Onegevity, and WellnessFX, and InsideTracker. I mean, you can't swing a dead cat by the tail, so they say, without hitting some kind of fancy new comprehensive biomarker report that's available on the internet. So, I think that's probably the first question that I'm going to get from folks, and the first thing I'm wondering myself. What is this report and what makes it any different than anything else that might be out there?

Matt:  Yeah. So, it's a great question. So, we have been obsessed with the idea of precision medicine for several years now. So, we know that there is a tremendous amount of power when we look at DNA, but we also know that there's a lot missing. Just to look at someone's SNPs, for example, just doesn't give you much information. So, people will talk about polygenic risk score, so combining different DNA and different SNPs to give you risk scores. So, that's good, that's better, but there's also blood biomarkers. There's also a microbiome data. And there's all of this that we bring together and to do multi-omics. So, that's the real Holy Grail in the next step, being able to combine it all for better recommendations.

And we were doing that, but that's hard. So, to take all of that into account, when Mike and I first started practicing this way, we would have hundreds of pages of data in front of us, all these SNPs, tens of thousands of SNPs, all the bloodwork, the microbiome, the patient questionnaires, and we try to bring it all together. It's a lot of fun, but it's difficult. It will take hours upon hours. So, we have been obsessively, like you mentioned earlier, working with MDs, PhDs, data scientists, software developers to really systematize this and to get a one report that you can use, the 30 to 50 pages, depending on how much data we have to put into it. It really helps you figure how to optimize your health and then maximize your health span. And we take all that and try to contextualize it for you as well. So, not just give you the multi-omic report, but then talk to you about your lifestyle and figure out how to actually give you recommendations that fit within your lifestyle to quickly get you to that optimization.

Ben:  Okay. So, basically, this is largely, once someone comes to you, and let's say they've got–in my case, it was a whole Dropbox folder of all my labs over the past few years that I shared with you guys, along with access to some of my wearables, like the Oura ring, for example. You guys don't have like some monkey in a corner going through all of this, tapping away at a keyboard. What you've done is actually developed like a software algorithm that pulls in all this data so it's scalable?

Matt:  Yeah. We were the monkeys and we decided that we hated tapping that in. So, yeah. I mean, it's been over a year we've been working on this, a large team, like we mentioned. And so, now we just upload all of the data into the program and we get the report, and then we could just sit down and have fun, and run through it with you, and talk about it.

Ben:  Okay. Cool. I'm going to see if I can find any holes as we go through the report to see if I can tear your algorithm to pieces here. So, be forewarned. Oh, and by the way, again for those of you listening in, if you go to the shownotes at BenGreenfieldFitness.com/clarity, we're also going to be video recording this as well if you guys would rather follow along with the screenshot overview of each page that we go through. And then, I'm also going to, at that same URL, have my comprehensive report available for any of you who want to download it and snicker at all the things that are wrong with my body. I'm just going to put that all available while blurring out my address and phone number and all my sensitive data. So, that's all going to be over BenGreenfieldFitness.com/clarity.

So, basically, the overall vision here is you guys, with this massive health clinic, with all these locations across the U.S., what you want to do is be able to allow physicians to free up time to meet one on one with their patients about their results from a test like this without actually having to put together this comprehensive report themselves, which would take hours and hours and hours. You're essentially using software algorithms and AI to generate the report, and then the doctor gets on the phone call, like we're doing right now, with the patient.

Matt:  Yeah. And that's a really important point. So, you talk about tearing holes in this and ripping it apart. We have to take this in the context of you. There's no report that's ever going to be able to fully capture you, who you are, Ben. So, we're going to get as close as we can with all the algorithms and the AI, like you mentioned. And then, we're going through it step by step and talk about all this and see where there are holes where we need to apply our brain and your knowledge about your body to adjust it. So, it's really important that this is in the context of a provider and patient relationship.

Ben:  Okay. Got it, got it. Well, the report itself is it's beautiful, it's multi-colored, so that's good. It's a good start. Delivered to me in a PDF this morning via email. And as I look at it here, there's obviously the title page, and then it begins to delve into kind of like my overall health assessment. And I actually want to largely hand the reins over to you guys to walk me through this the way that a patient would be walked through this as we educate the audience about the things to look at when they're looking at their own lab results that might influence decisions that they make. So, where do we start here?

Matt:  So, let me just grab what the report is, and then I'm going to let Mike jump in because he's really the one that really led this, the development of it all. So, we start with an overall assessment. So, we have a little graphic here of your tree of life, and then we had to put a couple of corny graphics in here. And in this tree of life, we have the roots, which are the things that we really want to have a good baseline with, your insulin resistance, your cardiovascular disease risk, your cancer risk, your sleep, exercise, your gut health. And once we optimize those, then the leaves of the tree, things we focus on are like a mindfulness track we have, our brain optimization, longevity, biohacking. We get into those things. So, that's what that graphic is about. And we start off with just an overall objective score. So, health optimization score, out of 100. Not surprisingly, you have the highest score that we've ran so far.

Ben:  Really?

Matt:  You do. So, you're a 91 right now. And what we do also, we work towards optimizing people, maybe graduating them from the program, eventually. And this score helps us figure out how long. So, we're going to need to be working with you for a few months, for six months. And technically, you fall under the graduated. You're the first person who's graduated without us actually helping them out in here. But the thing about the score is you get a number, but we tell you why. So, we see where are the areas of improvement, how we're going to get that score up, and then we start working from there. And the overall score is both an objective score, you got a 91 out of 100, and then we also, to contextualize that, show you your epigenetic age. So, for example, you had run one of the epigenetic test, and so we show you your epigenetic age where you are, as well as that objective score, and then we start diving in.

So, the areas that we look at are your diet nutrition, how to optimize your macronutrient and micronutrient intake. Your exercise and recovery had optimized that and we have a specific plan that is based on maximizing longevity, which we would adjust with the patient depending on what their goals were and what they do. Talk about sleep optimization, how your DNA fits into that. A neural behavioral segment, a segment on your microbiome if you have the microbiome report, and how we're going to improve that. Looking at your chronic disease so we know that as Americans, [00:17:04] _____ is cardiovascular disease. We have a risk calculator show you your short and long-term risk of cardiovascular disease. Then, we get into longevity genes and how to maximize your health span, and then we have a bunch of nerdy stuff at the end, some glossary of terms, and all the SNPs that we look at. So, that's how it's broken down.

Ben:  Well, who picks what's important? I mean, because obviously, like you mentioned, you have like this tree of life that primarily is focused on insulin resistance, cardiovascular disease, cancer sleep, exercise, and gut. But I'm just curious, was that something you guys subjectively decided to include in the report? Why wouldn't something like, let's say hormones, be at the base of the tree, for example? Who chose what actually feeds into this?

Matt:  We had to just arbitrarily pick some, I mean, hormones we're going to cover. Like, we have your hormone labs here and how to optimize that, and it will play a little bit into your long-term risk and longevity. And so, all of these components are part of it. We just had to pick some overall big-ticket items that we would talk about with people.

Mike:  We tried to create something that's going to continue to grow with us and with our patients. So, I suspect that probably in the coming month or two, we'll be adding things like hormones to the roots. This is a living document and it's going to change over time as we develop new things. But we had to commit to, say, six things that we felt were just the absolute most important things that we had to address.

Ben:  Got it. Alright. So, do you want to go through this thing chronologically so folks can learn some stuff by going through my report?

Matt:  Yeah, for sure. Let's dive into diet and nutrition for it.

Ben:  Sounds good.

Mike:  So, here, if we look at your tree, Ben, the only place where we gave you any orange in your roots was on sleep, and that was from looking at your Oura ring

Ben:  Orange, meaning, something that could be improved?

Mike:  Exactly, yeah. So, even if I look at the next page here, it tells you your Wild Health score. So, you get 91 out of 100. And those numbers were all for sleep, basically. So, that's really the only area that we really identified that there is a significant opportunity for improvement.

Ben:  And that was based on my Oura ring data showing–what was it? Was it a certain element of sleep that was considered unfavorable, like deep versus light? Was it the amount of sleep? Does it get that detailed?

Mike:  It does, yeah. So, we dock you points for your deep sleep, your REM sleep, and your total amount of sleep that you get. I will give you credit that you give yourself greater than eight hours every night for sleep. I think your average is about 8 hours and 15 minutes. But you only come out with a little over seven hours of sleep on average if I look at the last three years of data.

Ben:  I'm going to push back just briefly here. One thing that–and I think this is almost like a little bit of a failure of a lot of these sleep wearables. I take a 20 to 40-minute nap every single day. And when I do that, even though I often am sleeping, say, seven hours for an eight-hour night in bed due to, let's say something like restlessness at night or a long sleep latency, I actually find my readiness, my HRV, everything is just fine as long as I'm taking an afternoon nap. And I find some of these wearables, they actually don't factor in me crashing for an afternoon siesta. So, I think some issues with sleep can be mitigated with simply an afternoon nap and/or meditation session.

Matt:  Yeah, 100%. So, this is exactly what I was talking about contextualizing. So, when we see this in your data, our first question, and before we say you need to improve, is do you wake up without an alarm? Let's talk about your sleep. When do you go to bed? When do you wake up? How do you feel? Do you nap during the day? Things like that because, yeah, these wearables, they don't pick up everything, and sometimes they don't read on different individuals perfectly as well. So, all those things are really important. So, that's what we're talking about with the report is never going to capture all that. That's why the relationship in the conversation is just really critical.

Ben:  Right. Okay. Got it. So, basically, I got docked on sleep, and that's why my overall health score isn't that great, or is not as high as it could be. And then, based on that, well, it looks like this report actually starts with diet and nutrition, but I don't want to confuse people by airing away from sleep too soon. Is there a section of the report that specifically focuses here on like genes that would be related to circadian rhythm or anything else that could advise a patient or someone looking at this report about sleep?

Matt:  There is, and sleep is going to be a little more guided just by the conversation. So, we talk about when you go to sleep with the last two hours or so before sleep, what your morning looks like. And then, we get into light and dark, and EMF, and all the things, the temperature, all things that affect your sleep. So, we do look at your genetics. And so, if you scroll all the way down, if you want to skip to the sleep area there, there are–

Ben:  Okay. Yeah, I see here. Page 24, my circadian genetics. So, you guys actually looked at certain gene SNPs, it appears here, that specifically affect my personal sleep patterns.

Matt:  Exactly. So, we're [00:21:49] _____ in PAS2 polymorphism. And this is associated with eating late. So, you have a slightly increased risk of cancer, not a big risk, if you have alterations in your circadian rhythms. So, we tell you not to eat late at night. You also have an ADA polymorphism. And this is important because people who have disrupted sleep, they are probably going to have potentially some issues with overall well-being. So, it's another reason we want to focus on your sleep. So, you get a few SNPs here. Again, the sleep, it's more kind of behavioral and just talking to you and optimizing over time. And it takes a little bit of time because we have all these things that could affect your sleep in a positive way, but we want to do experiments with you, like you had an FAH polymorphism. They said you would probably have better sleep with CBD. So, I don't know if that's true for you or not, but that's one of the things we do immediately.

Ben:  So, my endocannabinoid genetics dictate that CBD would help me to sleep. It looks like another interesting one on here is even though I'm a fast coffee oxidizer, this gene called the ADORA2A gene shows that regardless, I should stop caffeine consumption after noon because I have the gene that carries increased risk for altered sleep with caffeine intake. And that's interesting because I've always thought I could get away with little bit of caffeine after noon because I'm a fast coffee oxidizer, and it doesn't really seem to disrupt my sleep that much, but I should maybe experiment with just totally stopping, even though I'm a fast coffee oxidizer, caffeine consumption after noon.

Matt:  And this is exactly why we want to look at multiple SNPs at the same time. So, for example, you are fast caffeine metabolizer, so we know based on several studies that may improve your athletic performance. But with this ADORA2A polymorphism, you probably want to time that correctly. So, being able to know those things in context is really important.

Ben:  Okay. Yeah. Another thing that's interesting here for context, because I get this a lot, I have this conversation with athletes quite a bit, is you highlighted just a few moments ago the gene that, the NPAS2 gene, that shows that if I eat when it's dark or I eat too close to bedtime is going to disrupt sleep. Yet, especially when I was competing heavily in triathlon and Spartan racing, and a little bit less so now, even though I'm pretty physically active, I do a tough workout, typically in the afternoon or–the later afternoon, early evening hours, kind of like pre-dinner. I find, if I'm physically active, my sleep actually goes a lot unless I have a meal about two, two and a half hours prior to bedtime.

I actually have heavily disrupted sleep patterns because I lay awake in bed at night hungry, and I suspect I also get reduced melatonin secretion due to absence of carbohydrate intake, unless I actually break some of the rules that guys like Dr. Satchin Panda will propose and eat an evening meal. And I actually eat a pretty hefty evening meal, typically like 1,200, 1,500 calories for dinner, and I sleep so much better with an evening meal. And the only time when that wouldn't be the case is if I'm not exercising, like if I've just done a yoga session that day or an easy walk or something like that.

Mike:  One thing I'll often do for that, Ben, is I'll look at the Oura ring data and look at your resting heart rate and see if there is an elevation in your resting heart rate in the first half of the night, which we'll often see if people are eating too soon close to bed because you're spending too much energy metabolizing, keeping your heart rate up. If you're not getting that and still eating right before bed, then you're probably doing fine, and that probably means that you've got fairly fast transit or you needed the extra energy. So, it's good to bring in the Oura ring data with that and trying to get an idea of how you're metabolizing while you're sleeping.

Ben:  Right. Yeah. It would be interesting to correlate sleep patterns with the actual activity patterns. And this is probably too far out in the future, but maybe also bring in like a nutrition tracking software and say, “Well, this is what this person ate on this day.” Pair that to the activity levels and then step back and look at how sleep is affected.

Matt:  Yeah. We do that all the time. So, we do that through our health coaches. And what I would say about you, your food intake and sleep is you're not normal and no one is normal. So, that's why this subjective feedback that you told us about your workouts and things and how you sleep is really, really important. And then we design experiments. So, you say, “This is how I feel with these foods at this time.” And then, if someone is interested in really optimizing in digging in, then yeah, you just use Cronometer or something like that to track. And we have your Oura ring data that we're pulling in and we can look over time. I mean, we do this at a patient just came to me yesterday. In his Apple Watch, it had episode [00:26:19] _____ the week before. And we were able to go back to that exact instance and look at what he ate the night before because he was tracking the Cronometer and there's Oura ring data. It really helped us dig in to combine all of that the same time. So, those trackers and being able to have that is really helpful as we combine it with your baseline genetics and blood work.

Ben:  Okay. Makes sense. Well, we got sidetracked there going–like starting off halfway down through the report, going through some of these sleep parameters, but it is interesting how you guys tie in. I thought the most interesting part was looking over some of my specific genes and how those affect my sleep patterns.

But then, we were also, before we took that rabbit hole down into sleep, you had mentioned that one of the first things that is shown on this report, and I could see this with the report in front of me, is diet and nutrition. So, let's walk through that. How can these reports advise people as to how they should be eating?

Mike:  So, we start off with macronutrients. So, fat, carbs, saturated fat, protein. And then, we go into micronutrients and methylations. So, we're starting here with the macronutrients and we display these risk scores. So, you have a fat intolerance risk score, carb intolerance, and saturated fat. And that includes a combination of your genomics, as well as your laboratory values to decide what sort of scores you get here. So, here, I'll just tell you your carb intolerance score of 58% is coming primarily from genetics because you have no evidence of insulin resistance. If there was evidence of insulin resistance, then your carb intolerance score would be altered by that. Same goes for saturated fat. So, this is primarily genetic. If your cholesterol was elevated or there's other evidence of saturated fat intolerance in your biomarkers, then that would be increased as well.

So, this gives us an idea of sort of how your body is, what your body is best apt at using for energy, whether it's fat, carb, or saturated fat. And it's amazing the variance we see in patients regarding all of these scores. And I'll tell you, Ben, I'm actually surprised that your intolerance numbers are as high as they are because it's higher than a lot of our patients.

Matt:  Yeah, I think you're–

Ben:  Well, I find this also interesting, guys. And I know this podcast is going to be rife with interruptions, and hopefully, my audience can bear with me as I threw all my questions out there. So, this report is saying my saturated fat should be less than 7% of my total calorie intake. One of the reasons that it says that is because I have high cholesterol, although I have zero risk factors such as glucose, high triglycerides, inflammation, et cetera, that would potentially make that cholesterol atherosclerotic or cause it to become a risk factor. Furthermore, I feel amazing when I eat a higher fat intake, although this says, “Eat less red meat, less butter, less ghee, less MCT oil, et cetera, and more nuts, seeds, fish, extra virgin olive oil.” Some of those I agree with, some of those I'll push back due to the industrial seed oils, and linoleic acid, and omega-6 content, et cetera.

I actually don't quite agree with those recommendations, but I feel really, really good eating a high intake of monounsaturated and saturated fats, particularly. And this report seems to indicate that cholesterol is considered to be a bad thing, but I know that both of you guys are aware that it's not. I know you guys are well aware of a lot of the flaws with cholesterol being vilified. Is this report spitting out recommendations that aren't taking into account whether or not the cholesterol is actually a true risk factor?

Matt:  No. So, again, this is about contextualization. So, in general, we do know that higher LDL, much higher LDL is going to increase your risk of cardiovascular disease. However, for you, it's really important to put this in context, one of your just your overall risks–

Ben:  Well, wait, wait, wait, I'm going to stop you. You said it'll increase risk of cardiovascular disease. It's a factor that's necessary for increased risk of cardiovascular disease, but that in alone is not sufficient. I would say that statement isn't true.

Mike:  By itself, no, it is not enough, but over time over the course of 50 years, like you have no insulin resistance right now, there's no inflammation, so we're not worried. So, the way we talk about this with someone like you is we do not need to push that number lower. Like, you're totally fine. How you feel and how you perform is going to be the most important component here. But what we can look is, okay, what about 50 years from now or 60 years from now? And this is not something that we would make a change on. So, for example, when we go down to your cardiovascular report, we see that what would happen if we did try to push your LDL from 125 to 100, what would happen? Because if you just go to a regular physician, a lot of times they would try to do that, they would try to get you to go under LDL.

And what does that mean for you? It means that as a 95-year-old, by the time you are 95, you may decrease your cardiovascular event rate from 33% to 30%, a 3% absolute reduction, which is tiny. That means in alternate universes, 1 out of 30 Bens would benefit from pushing that down. That is a tiny benefit, and probably not worth the effort to do it either changing your diet or certainly not medications. So, again, we would never just hand this report to someone because we don't want them to be confused by their LDL being in the red category at 125. You do not need to decrease your saturated fats. So, if you were to just look at DNA and you were to just look at lab test and look at kind of the standard dogma for medicine, we would be saying decrease it. But again, we take this report. We talk to people about it and figure what their goals are.

Now, if you were 70 and you had insulin resistance and you had inflammation, your risk calculators would be very different. And so, we would be trying to push that number down. So, the report is never going to stand on its own. It's a jumping-off point to actually be able to practice precision medicine when a physician and patient are talking to each other and they can talk about what it means to decrease your LDL from 125 to 100, which is not much benefit for you, if any. And so, we just would not recommend that you do that.

The better way to look at the saturated fat intolerance, Ben, is almost as a measure of whether you're likely to respond to reducing saturated fat in your diet in terms of, would that reduce your LDL cholesterol? So, if I look back at your LDL cholesterol, it's because I've got a ton of them in that document that you shared with me, 125, which is what your current concentration is higher, a good bit higher than you have been in the past. So, I'm not sure how your diet has necessarily changed over the last four or five years, but I suspect that the difference is probably related to saturated fat based on what I see here regarding your genetics. And this saturated fat intolerance that you're seeing at 53%, that is actually 100% from your genetics because you don't get any bump from an LDL cholesterol of 125 because realistically, that's pretty low, especially if I look at how high your HDL is, your total cholesterol numbers. I mean, your ratios are pretty good. Your triglycerides are excellent, right? And as you mentioned, there's no inflammation, there's no insulin resistance. There's really no reason otherwise to suggest that you've got a significant risk factor for cardiovascular disease. And like Matt was saying, if we plug you into the risk calculators and we look at your risk at 95 years old, decreasing your cholesterol is only going to decrease your risk of a heart attack by the age of 95 by 3%.

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Just to throw this out there, I'm definitely not a guy who's jamming down butter and coconut oil and lard all day. I actually get the majority of my fats from monounsaturated sources, although I would say my saturated fat is definitely higher than what is recommended here, which would be 7% of my total calories. However, I'm not one of those guys who endorses the keto fat bomb approach versus a more Mediterranean fat approach with the clarification, like I mentioned earlier. I think too many people who are eating a higher fat intake or prioritizing fats are getting too much industrial seed oils, linoleic acid, omega-6s, seeds, nuts, et cetera.

The other thing that's interesting on this report is I note that it says I'm intolerant to carbohydrates. This is, I assume, based on a genetic reading. It says reduce simple carbs and consider a high-fat, low-carb diet. But directly underneath that, it says, “You're intolerant to high fat diets and are unlikely to respond well to a high-fat diet.” So, which is it? Do I eat the high-fat, low-carb diet, or the high-carb, low-fat diet? Because if you scroll down to Page 37, it tells me I need to be eating a high-carb, low-fat diet based on my insulin resistance scores. So, the report seems to be giving me mixed messages when it comes to high-fat, low-carb versus high-carb, low-fat. Is that kind of a relic of the algorithm spitting out recommendations in a specific section or what's going on there?

Matt:  Yeah. And this is with medicine in general. You're going to have multiple labs, multiple genetics all the time. They're going to be conflicting, so you notice that these boxes with the recommendations are text fields. So, it starts with a general recommendation based on your genetics and your labs, and then we adjust it based on the context and based on which is more important because there's always going to be any DNA calculator or something you put where you upload your raw data and then you get recommendations. You're going to find a lot of these things that are conflicting. And you have to just talk about the power, like what each one does in different directions, changing them up or down. So, that's where the conversation again and it's going through it step by step because for someone who is not as active as you, for example, doesn't have your lifestyle, it may be that with just your genetics, decreasing your saturated fat lower to that level may confer a benefit, but for you it's simply does not. So, we change those text field based on how all of this comes together. After the long conversation.

Ben:  Got it. Yeah. I think that's super important. It's something I actually see over and over again. It's not just in your guys' report, but in a lot of these reports where you can tell which parts are spit out by a computer. Sometimes the computer makes seemingly contradictory recommendations in different sections of the report, which is why, again, I think is really important. I actually hop on the horn with a doctor or nutritionist or someone, even when you're going through a comprehensive report like this, because like you were just noting, Mike, for example, someone, let's say, might fit genetically into the category of a high-fat, low-carb diet, that might be the diet that is found to be correct for them genetically, a ketogenic approach. But what that computer doesn't know is that that person signed up for an Ironman triathlon and they're exercising for two hours a day, and their carbohydrate throughput needs might be 40 to 60% on some days of their total calorie intake. And so, sometimes the computer doesn't recognize that or take that into account.

Mike:  It's virtually impossible to create a report that's going to be 100% accurate without like an unreasonable amount of input beforehand. So, I mean, if you sat down and filled out a 300-page survey, I could probably make this report that accurate, right? But you're not going to do that. You don't want to do that. You'd rather have a conversation with me about it. So, one thing you haven't seen, Ben, is that all of these recommendations are all completely editable by the physician as they're talking to you, and they can say whatever they want. And that allows us to modify as we're sort of going through this. So, think of this more is like a blueprint, a starting off point that we can use to make some recommendations and are really tap with you in a very granular level about how you want to live your life. Maybe you feel terrible on a high-fat diet and you don't want to eat that way. Maybe, like you said you're doing an Ironman. So, these are really important aspects that we have to go over with patients. And really, this report is just the jumping-off point.

Ben:  Yeah. Okay, cool. That makes sense. Alright. So, we got into the weeds there a little bit in terms of some of the macronutrient ratios that are recommended in the diet section of this report, but I'm seeing that also in the diet and nutrition section, it gets into some other things like metalation, et cetera. So, what do we cover next here when it comes to the diet nutrition piece?

Mike:  So, next up, but as you mentioned, is methylation. So, when we look at your homocysteine level and sort of chart that on optimal to sub-optimal level, yours was 6.8, which is phenomenal. So, that's really good news. And then, we look at the reasons that your methylation could be inadequate. So, we have things like a choline risk score that looks genetically at what your risk is for having a higher dietary choline requirement. We look at a fully rest score, which is really mostly just looking at your risk for requiring elevated B vitamins, or in THFR function, for example. And then, we also look at TMAO because this is a good place for us to sort of evaluate what your risk is for having elevated TMAO levels, whether you think that's a risk factor for cardiovascular disease or not.

So, when we go through those, you, for example, you've got excellent methylation, which is probably a function of a good diet and supplementation, I suspect. And then, looking here, your highest risk is really associated with choline. So, we'll see here that you've got a PEMT malformation, you've got MTHFD1. So, both of those probably increase your choline, dietary necessary choline intake fairly significantly. And you'll see that here. We'll basically make recommendations regarding your homocysteine level in elevation or evidence of decreased methylation here, make recommendations regarding whether it's choline or whether we need to increase your B12 or your folate intake. This would be where you would see all those things. Because you have normal homocysteine, there's very little recommendations to be made regarding methylation. There is, however, probably some question regarding the ALT and AST. So, one thing I noticed on your labs, Ben, was you fairly consistently had some minor elevations in your LFTs. Has that ever been looked at?

Ben:  The LF, was that the liver enzymes, the LFTs?

Mike:  Yup.

Ben:  Yeah. That is pretty common, especially in folks, as you guys know, who have done any type of hefty exercise session anywhere from one to three days prior to the test, which is usually the case with me. The couple of times I have tested and not shown elevated liver enzymes were after kind of like washout recovery weeks. So, I think that my elevated liver enzymes are a relic of things like weight training, resistance exercise, high-intensity interval training, and the same things that would influence a doctor to tell someone who came into their clinic and had like hs-CRP test. And if that doctor did not know that person worked out hard the day prior, they might tell them, “Well, you're at high risk for a heart attack because of your CRP levels,” when in fact, all that happened was the person exercised the day prior. So, I think the elevated liver enzymes are due to exercise personally.

Mike:  Yeah. I 100% agree with you, and I suspected that that as the case, your LDH was elevated with it, which is also common. And we sometimes see that also as an elevation in the creatinine. And yours is, Ben, fairly consistently just very mildly elevated. I will say, however, that people who have a PEMT polymorphism often have slight elevations in their AST and ALT, especially if they were on a high-fat diet and they're not giving you adequate choline. So, sometimes what I'll often do is if there are elevations in AST and ALT, I'll actually up the choline intake in patients to see if I can get their cooling levels elevated so that we can help package that fat and get it out of the liver, because this can sometimes be evidence of early non-alcoholic fatty liver disease, which I think is unlikely in your case because you have zero insulin resistance and we know that you exercise regularly and eat well. But in the setting of a PEMT polymorphism, that's totally something to think about.

Ben:  Yeah. It's interesting. I mean, considering especially the fact that based on the bloods that you guys are working with, I'm eating not a strict carnivore diet, but I'm eating a diet that's pretty high in things like salmon and pork chops, and ribeye steaks, and bone broth, and large amount of liver and shellfish. I'm getting in a lot of things that would tend to lend a great deal of choline to my diet. The only thing I don't eat a lot of are eggs. I might have like four eggs a week. So, I feel like I'm getting a decent amount of choline, but what you're suggesting is that I could potentially step that up even more and see benefit?

Matt:  Yeah. And we don't like to guess, so we like to set up experiments and be objective about this. So, for example, this happens all the time, elevated LFTs or elevated CRP, and we talk. And yeah, they had a hard workout the night before. Well, in that case, great. Let's just take a few days off, let's recheck. And if everything is normal, awesome, we're done. But if it's not, then let's go down this path. Maybe it'd be an ultrasound for the NAFLD, or maybe you try choline. We'd like to set up these objective experiments, really fair this out and not just say, “Yup, hard workout, we're good.”

Ben:  An ultrasound for NAFLD, meaning, looking with an ultrasound to see if non-alcoholic fatty liver disease is present.

Matt:  Exactly.

Ben:  Interesting. Never actually done one of those, but that would be–it'd actually be, I don't know if you guys heard the Big Heart Health episode that I recorded down in L.A. where we just did every test known to man on my ticker. It would be interesting to, based on the history of elevated liver enzymes, just double-check and see if there is anything else going on in the liver from a diagnostic standpoint rather than just saying, “Well, every single time it's high, it's due to exercise.” I wouldn't be opposed to doing a little bit more digging, just to check because that happens to be a somewhat important organ last time I checked.

Matt:  Yeah. We want you to keep your liver.

Ben:  Yeah.

Matt:  Yeah.

Ben:  Okay. So, we've got this methylation part of the diet nutrition where we look at things like folate, choline, homocysteine, B12 liver enzymes, things along those lines. And then, it looks like the report moves on to vitamins and micronutrients. So, what can we learn from that?

Mike:  So, these are predominantly going to be gene SNPs, although there are some labs as well. So, you already mentioned that you're a faster caffeine metabolizer. So, that's mentioned here. We talk about things like SLC30A8, which is related to a zinc transporter. And I don't know if you notice, Ben, but your zinc levels have been kind of low pretty consistently.

Ben:  Yeah. I ran out of that black ant powder. I should probably start [00:46:54] _____. That stuff's like 10 times higher in zinc than shellfish or any other source. And I was using that, I'm not joking, for a while in my coffee, and then I just quit, but looks like my zinc's kind of low?

Mike:  Yeah. And genetically, your predisposition for that. And if your zinc levels are low and you've got this genetic predisposition, you get DOMS more than other people. So, this could be–

Ben:  Delayed onset muscle soreness?

Mike:  Exactly, yeah. So, using, especially people who have the specific SNP, we often have them take zinc after strenuous exercise to help reduce the DOMS, basically.

Ben:  Yeah. I think a lot of people aren't aware of that, that there are genes like that SLC30A8 gene for delayed onset muscle soreness, or the other one that you guys have listed there, the COL5A1 gene for tendinopathies, and potential for increased collagen breakdown that would dictate that if someone is listening in and you're struggling with post-workout soreness and you're doing everything right, all your recovery, biohacks, modalities, et cetera, for something like that SLC gene, increased [00:47:54] _____ intake, or if you have that COL gene, as you guys note on my report, increase your collagen intake with things like–you have listed there sardines or bone broth as sources of collagen protein. And I think a lot of people–that's something that's not discussed a lot, is if you get sore a lot, there are actually genes that can dictate that risk for soreness.

Matt:  Yeah. And with like the collagen 5A1, there are other considerations as well. So, for example, you should probably not be on a fluoroquinolone like ciprofloxacin or levofloxacin if you do get sick. So, just knowing these things can really make a big difference because that increases your risk for Achilles tendon rupture as well. And having that gene plus taking that antibiotic, you're going to be at more of a risk. So, it's good information. And I think another important point here is we talk about increasing your collagen. We give you food examples. Sometimes we could fall in this trap of reductionist medicine and talking about these individual vitamins and minerals, but we always are going to be pushing people to get these in foods if possible. The whole Wild Health, the wild is partly due to this multi-omic approach. It's kind of wild out there and advanced medicine, but it's also an illusion to the wild in the wilderness and getting these things from nature anytime we can.

Ben:  Yeah. That makes sense. And I appreciate the real food recommendations that are on here as well. So, the other part of the diet and the nutrition recommendations is it looks like there are certain, speaking of foods, like superfoods that you guys recommend that are going to be especially good for me. We talked about some of those collagenous sources, foods that are rich in zinc. It appears that some of my superoxide dismutase and glutathione genes would dictate that I could use perhaps some support from antioxidant-rich foods or cruciferous vegetables, et cetera.

And this leads me into another question that I know people are going to ask. So, I'm just going to jump right in and ask it. When the report says, “Eat more foods high in folate, like leafy greens, cilantro, arugula, chard, watercress, rutabaga, bokchoy, et cetera,” let's say I eat those foods, artichoke, dandelion, spinach in decent amounts and get things like gut distress, bloating, gas, a lot of things that have shifted many people to take a more carnivorous approach, for example, due to plant anti-nutrients or fiber causing issues, et cetera, how do you guys kind of jive how the gut response to these superfoods versus how some of these genetic pathways respond to the superfoods?

Matt:  Yeah. As you notice again, it's a free text box. So, we have very few things listed here, but we have a lot of ideas. So, we talk to you about not only what do you like, but what have you tried in the past. And then, we run some experiments based on your past experience, your DNA in your bloodwork, and then what you want to try. I mean, we were talking to Paul Saladino in a couple days for our podcast. And we frequently will have someone try a carnivore diet for certain reasons. And other people were much more plant-based than the animal-based. So, this is partly DNA, partly bloodwork, but then what have you tried, what worked for you, how did you feel any different diets, and how did you do the diet. Maybe you did the carnivore diet, but all you ate was muscle meat. But that's not the way to do it. So, we do a little bit of education here to get you on the right diet for you and the correct way for you as well. And I want to know a little bit more about what sort of bloating you're getting and what sort of symptoms you're getting with some of these foods, too, because I might be thinking about SIBO or microbiome problem. So, I mean, there are other things to contextualize here and consider, and that's why the conversation is so important.

Ben:  Right. Exactly. That's what I find with a lot of people is typically, it is either SIBO or SIFO, like a small intestine fungal infection that can contribute to bloating and gas in the presence of otherwise healthy foods. It's something that I think a lot of people, especially very active individuals, tend to have more gut inflammation anyways, tend to deal with. And so, it's always something that you need to take an individualized approach to for sure. And in my case, I found I need to mitigate those foods and that my gut is much more stable when I'm not eating large amounts of fiber, raw vegetables, et cetera, and potentially even using things like supplements to get some of my glutathione or some of my antioxidants without the large food bulk.

Mike:  Definitely, yeah. That makes a lot of sense. And that's why it's just so important to have a good conversation with your patients.

Ben: Yeah, yeah. It looks like you guys also dig into, after you get through the food recommendations, exercise and recovery. And we obviously talked about some of those things that would affect like collagen breakdown or delayed onset muscle soreness, but it appears you also make some pretty–like there's an actual full-on exercise program written out for me here. So, what are you guys looking at when it comes to dictating how someone should exercise or how someone should recover?

Mike:  The main things that we look at are genetics and your preferences. So, the most important things are your genomic predispositions for different types of exercise, and then what kind of athlete do you want to be? I mean, it's important. Obviously, just because you've got an endurance preference doesn't mean I'm going to go out and tell you to run a 5K. You might be more interested in building strength. So, that's completely going to change the plan that we create for you. But we can use the genetics to help us design that plan, and that's what basically we're doing here. So, on this page, we're looking at sort of endurance versus strength. We're looking at faster, slow recovery, and we're looking at your own genomic preference for intensity. And looking at each one of these genes, we can then use that to manipulate the weekly or monthly plan that we create for you. So, here, Ben, you are extremely balanced in all these areas. So, you're right in the middle on an endurance versus strength. I think you had a slight preference towards endurance. You're dead middle for recovery.

Ben:  I've noted that. I think I did a DNAfit test years ago and it's frustrating. It basically means I'm kind of like a Batman. I'm decent at most sports and can get through CrossFit workout, but also a marathon, and also a powerlifting session, but I'm, based on genetics, never going to be stellar at any of those. I'm just like middle of the road. I'm this complete balance of endurance and strength.

Mike:  Very negative on your stuff. I think I'd call your Renaissance [00:53:51] _____.

Ben:  I'm a Renaissance man of fitness, but I'm never going to be a professional powerlifter or an elite marathoner.

Matt:  We're working on the basketball score. We'll have that on your next version as well.

Ben:  That's true. Yeah.

Mike:  So, all these different genes here allow us to sort of create this report. And what we've done is, I'll skip to the next page and actually show you the report, we've created these specific longevity exercise plans that taken all of that into account. And right now, there's about 12 different plans, and these are designed towards people who have a preference towards strength, endurance, if they have no preference, and then as well looking at their genetics to help decide how to create the plan for them. And it's basically anywhere from four to six days of activity broken down into things like HIIT training, zone 2 cardio, sprint interval training, strength training, core mobility. So, we really try to go over every aspect of it and try to hit it from all different directions. And then, if we go back to your exercise plan here, we can actually talk with some of the specific SNPs that come into play here, like we mentioned, the COL5A1 and the SLC. But also, there's ones that sort of play here in terms of recovery, like IL6, CRP, SOD2. All of these are affecting the hormetic response that you get from exercise and how we can use that to determine how regularly you need to be working out, how you should respond to that hormetic response with recovery.

Matt:  In this report, this exercise plan is not something we would give to like our pro-athletes who are saying, “This is more of a beginner plan, where to start.” If you're a pro-athlete or really advanced like someone like you, then we're just going to take your plan and maybe give some slight suggestions and modifications. So, this is really not for someone like you, but it is a helpful thing if people just don't know where to start.

Ben:  Yeah. It's interesting. I notice that one of the things that you guys have on the exercise recommendations is you look at sex hormone binding globulin, which is something that can bind to total testosterone, limit the availability of free testosterone that's active in circulation. And if that is extremely elevated, sometimes you'll have recommendations as you have here, like discontinued fasted training or other parameters that could increase stress dramatically or cause elevated cortisol, which seems to go hand in hand with high sex hormone-binding globulin often. Add carbohydrates before and after the training session, et cetera.

But I'm curious if you guys run into this because there's one population that I have noted no matter what tends to have elevated sex hormone-binding globulin. And I suspect it has something to do with the fact that that's also a protein that's responsible for some amount of fat shuttling throughout the body. And that is active individuals eating a high-fat, low-carb diet. Even people who are total yogis, low stress. I often see this in my clients who were even like independently wealthy, low cortisol, and they just have high sex hormone-binding globulin. And the one time I see it happen even without stress and without a lot of other endocrine issues is high-fat, low-carb diet combined with physical activity. Have you guys seen that in your own practice much?

Mike:  I have, definitely. But I'll tell you, Ben, it's hard to tell the difference between that and too much stress. And sometimes I struggle with how best to measure that and come to a decision of, oh, this is probably just your diet and high fat. So, in those patients, I'll often end up getting a DUTCH test and getting better idea of their HPA access to try to figure out what exactly is going on because as you know, a single cortisol level is not a very good measure of what your current stress level is. And I'd see this all the time where patients who are just overstressed, not getting enough sleep or exercising too much, not getting enough recovery will get elevations in their sex hormone-binding globulin.

And I also will say that I don't always treat SHBG, especially if your free testosterone is normal because it's not really that important if you're getting a normal amount of free T rolling around. But if it is an issue and, say, your T is borderline, or you've got low free teeth and there are things that we can do to help intervene there outside of just telling you to sleep more and exercise less. And that's where things like, for example, boron comes in or dim, or just maybe even changing your diet as you mentioned.

Ben:  Yeah, yeah. It's interesting. The only other interesting relic on SHBG that I've come across is actually very high fiber diet. Also appears to Jack SHBG levels up. So, that's something else that throws a wrench into the equation. It's again something interesting to look at, but I think it needs to be contextualized. I think many people beat themselves up for having high sex hormone-binding globulin when it might not be an issue. And it could be a relic of diet activity levels and not just rampant stress or endocrine dysfunction.

Mike:  Yeah. I mean, you could make a case for just checking a free testosterone and not even checking SHBG because it tends to get people upset because it's all out of range. But if there are free Ts not low, then it doesn't really matter.

Ben:  Yeah, yeah. And then, after you spit out these recommendations based on genetics for exercise, I notice there's a whole workout program that's actually all written out. And this workout program, is this generated by a computer based on my strength/endurance balance from a genetic standpoint?

Mike:  Yeah. So, this is a full month basically that we spit out. And it's, like I mentioned, broken down into multiple different sections. We're actually getting ready to release Version 2 of this already, which is really exciting. So, it's going to include more direct preferences. So, we'll have plans specifically for powerlifters, for runners, for cyclists so that we can really get more granular with the types of exercise, types of activities. And also, we're creating mesocycles. So, instead of just having a single month or a couple of month plan, we're going to have an entire year of plans that we've created out for our patients. And people would get to sort of decide, “Alright, I want to do the cycling plan,” or, “I want to do the powerlifting plan,” and that will allow them to really get granular in terms of what they should actually be doing as opposed to this one which is really just designed very generically for longevity. It's like let's hit all the major things that we think improved longevity.

Ben:  Yeah, yeah. Somebody needs to go through with the spell checker though. A lot of these exercises are spelled incorrectly. You guys may want to audit the–whichever part of the computer is writing these out. But the program itself actually looks pretty comprehensive. So, it's kind of cool that someone could take this and actually go forth and just have an exercise program that's customized to their genetics, which actually there is some research showing that you do see better fitness gains when you exercise according to genetics. So, it's not just something folks are thrown out there. I've seen some interesting studies on improvements in fitness when you train based on your endurance and strength tendencies.

Now, after exercise, then it comes back to sleep. We already discussed sleep and went through that section. And so, it looks like after sleep, then it gets into something called neurobehavioral. What's going on there?

Mike:  Yeah. So, neurobehavioral, we actually talked about some of these already. Matt mentioned this when he was talking about your FAAH gene, which is the one that determines how you use basically CBD and whether you get a sleep benefit from CBD. There's other things that pop out here, just sort of in like neurocognitive function. Like, for example, this BDNF. You have a BDNF SNP, which means that you produce less BDNF and would likely benefit from things like lion's mane, for example, or exercising regularly, which I've heard that you do sometimes.

Ben:  Yeah. Or sauna. Sauna is amazing for BDNF.

Mike:  Yeah, absolutely. Yeah, I've heard you do that, too. And this is the same place you'd see other things like COMT enzymes, which you don't have anything interesting there, so it didn't populate according to this program. But it will talk a little bit about sort of your risk for anxiety, your risk for dopamine in the prefrontal cortex, BDNF, FAAH, things like that, which will give you some idea of tips and tricks to hack your neurological function, I guess.

Ben:  Yeah, yeah. And the one on CBD is super interesting that fatty acid amide hydrolase function based on breakdown of cannabinoid CBD and THC. It basically says I have less addictive potential towards CBD and THC and better sleep with CBD. I think some of those endocannabinoid genetics are just fascinating.

Mike:  Absolutely. And then, if you had the opposite version of the FAAH, you would actually get better anxiety response with CBD. So, even people who don't get the sleep response usually have a better anxiety response with CBD. So, that's kind of positive ways, I guess, to look at it.

Ben:  Yeah. And then, it gets into microbiome. And I should clarify, you guys didn't send me test to take you. I think in this case, you took my Onegevity results and pulled them into the test in the same way you took my Oura ring results, other lab results that I shared with you. And so, someone can literally take the tests that they've already have done and then send them over to you guys to feed into this clarity report. And it looks like you did that with my microbiome panel. Did you find anything interesting when you pulled in my gut results?

Matt:  Yeah. It's like the rest of your stuff, Ben. It looks pretty good. So, your inflammation score was extremely low. Your diversity score was extremely high, and that's the pattern you want. Low inflammation, high diversity. So, those are good things. If we pull out specific floor, there were a few that were interesting that we could talk about. Like, for example, your proteobacteria were a little bit high. So, 57th percentile on proteobacteria and we really prefer you be in less than 30% range. And things like prebiotics, probiotics, sometimes berberine can actually help with proteobacteria. I'm not sure if you've taken berberine in the past. And having high levels of proteobacteria is going to cause things like, for example, IBS symptoms, metabolic syndrome, obviously not an issue. But autoimmune disease is something to think about as well. So, sometimes you get autoimmunity from the proteobacteria themselves. So, something to potentially work on. Another one, the [01:03:13] _____. We can also increase prebiotics here, can also call some IBS. I probably [01:03:19] _____ talk about your any IBS symptoms on air. But these are areas where there is some opportunity for improvement that we could look at specifically.

Ben:  Got it. So, you're looking at specific bacterial strains and saying, “Okay. This one's low, this one's high. We can take dietary interventions to, say, increase Akkermansia or to increase bifidobacteria.” And if you guys found, because I've seen some pushback against companies like Viome, Onegevity, et cetera, that just because you have certain gut flora that there's not a lot of evidence that by taking probiotic XYZ, you can shift the bacterial balance in any specific direction. What are your guys' feelings in terms of the evidence right now in terms of being able to significantly shift gut bacteria based on something like probiotic implementation with the specific bacterial strain that you're low in, for example?

Matt:  Probiotics are extremely difficult to get much benefit from, I think, for the goal of changing your specific gut bacteria. So, I think you're stuck with prebiotics in that case and changing in lifestyle and dietary interventions. I will say that if you look at the F to B ratio, which is a common thing that's been looked at in lots of research, that changes pretty readily with dietary changes. So, if you eat, for example, a high-carb diet, you're going to have a higher F to B ratio. So, your Firmicutes is higher than your Bacteroidetes. But if you're eating more vegetables, if you eat more plant-based diet, then you typically have a lower F to B ratio. And we've seen that that at least changes fairly well. And I think a lot of these others do as well. Veillonella, for example. Your Veillonella is off the charts. Do you know why? Veillonella eats lactic acid. So, all that interval training that you're doing, the Veillonella in your gut is actually buffering the lactic acid. And there's been studies that have shown that people with higher Veillonella levels are actually better athletes, and they perform better under high-intensity programs because the Veillonella itself is actually buffering lactic acid–and eating, not buffering, really eating lactic acid. So, it's reducing it so your liver doesn't have to do all the work.

Ben:  Yeah. It's interesting. Some company, I think it's called Kraft, they just sent me probiotics that are fashioned after the exact bacterial strain found in the gut of professional athletes, hypothesizing that if you take the probiotics that contain the same bacteria found in the gut of pro-athletes, you could somehow increase your exercise performance. The bottle sits unopened in my pantry, but at some point, I plan on opening it and seeing if I notice anything in terms of exercise performance by, I guess, turning myself into a pro-athlete by taking a capsule, which I'm pretty sure is a fast track to getting into the Olympics.

Matt:  Probably so. Now, in all honesty, I'm a little dubious of a lot of the claims that these companies make. So, I think there is certainly an incredible–there's something really big here with the microbiome, but I think we're just scratching the surface and getting there. I'm really excited about companies like Onegevity, who were not only measuring this and reporting it, but doing some really cool science into what we can affect and what were the benefits are. So, I think we're just getting started with the microbiome, but I do think there are a lot of dubious claims out there right now.

Ben:  Yeah, yeah. It's all over the map, I think. Again, paying attention to how you personally look, feel, and perform with a certain gut protocol is in my opinion, just at the top of the totem pole still. As simple and stupid as that is, I just think we're still in our infancy with a lot of these gut tests and the results that they give.

Now, how about cardiovascular disease? It looks like cardiovascular disease and chronic disease are the next components that are jumped into. It looks like cardiovascular disease, dementia, insulin resistance, and inflammation. So, these are more parameters based on how likely I am to have an increased risk for mortality, it looks like. So, what are we looking at there?

Mike:  So, for cardiovascular disease, we start off with a couple different risk scores. The first one is basically MESA. So, MESA is a large study that was published several years ago. It looks at sort of your 10-year cardiovascular risk. And in order to plug your numbers into this, Ben, you have to be 45 years old. So, I had to fudge and say that you were 45. And if you were 45, your 10-year risk of having MI or cardiac event prior to 55 would be 1.4%. So, you're looking really good there. We also look at something called a genetic cardiovascular disease risk score, and that uses the 27 different genes on this right-hand side over here that you can see are colored in different shades to assess how you compare to the rest of the Wild Health population. So, you're in the light green on that. So, you're doing pretty good when it comes to genetic cardiovascular disease risk.

These two things help us create an initial understanding of what risk this person has sitting in front of us. And then, we can use some of these biomarkers down here to help assess that risk. And for the most part, as we've mentioned already, your biomarkers look really good. Like, we look at some more specific things like LP little a, for example, which was 14, which is great. Your triglycerides were excellent, as mentioned. Your ratio of your HDL triglycerides was two, which is excellent. So, your HDL is twice as much as your triglycerides. And then, if I look at your LDL particle number, this is actually sort of old data. So, the 859 was from, I think, a couple of years ago. You even had one recently, but it looked excellent, Ben. It was 859.

And then, your inflammatory markers we look at omega-3 here, your CRP, as well as your Lp-PLA2. Lp-PLA2 is an inflammatory marker that comes from inside the vessel walls. So, as your inflammatory cells are basically eating cholesterol, they release this marker Lp-PLA2. So, it can be kind of like an immediate marker of, is there plaque being developed right now inside your arteries? And 128 is totally normal. So, looking at all of these in my comfort level with your cardiovascular risk is very high right now.

Ben:  Yeah. And what's interesting, I had emailed you about this a couple of weeks ago. I had a client with high Lp-PLA2 and was investigating whether high-dose niacin would be an appropriate tactic for him because that's often something that's mentioned as a treatment for Lp-PLA2. And then, looking at the research, and this is why [01:09:09] _____ you guys, it appears that some people's genetics dictate that their Lp-PLA2 goes up when they take niacin. And in other people, it goes down. And so, as we're getting into the realm where we can more and more look at personalized genetics, it turns out that that's definitely something to pay attention to, especially when you're, say, taking a certain supplement to get a certain function. It may shift you up when you were trying to go down, or down when you're trying to go up. And I just thought that was super interesting. I wasn't even aware that niacin could actually increase vascular inflammation in some cases and decrease it in others, and all that was based on genetics.

Mike:  Yeah. Niacin is a nasty drug and we have to watch really closely with all these markers anytime we put somebody on it, which I'm doing less and less these days. And one thing I will say is that these biomarkers are easily repeatable and something that we should be doing on a regular basis on our patients to get an idea for how they're responding to diet, exercise, any medications or supplements that we put them on because you'll see pretty broad changes with these even in a matter of weeks.

Ben:  Yeah, yeah. Interesting. Okay. So, then it looks like towards the end of the report, you get into longevity. And I assume what we're looking at there are things like telomere length, things along those lines.

Mike:  Yeah, exactly. So, we have an epigenetic age on you, which we plotted up here as your biological age versus your chronological age. I think I gave you a couple years on chronological age just to make you look a little better, Ben. We've got each one of your genes for all these different areas that we think play very highly into longevity. Like, for example, oxidative stress, telomeres, dementia risk, your metabolic issues, and then cancer risk. Of course, your cancer genes look great so far. Telomeres are the only place that you're really having some difficulty, Ben. And then, of course, we look at our longevity labs here that are a good marker for how you're reacting to your genes. And looking at those, your DHEA level, which has been found to be one of the best biomarkers for aging, actually. It was great at 277.

Your IGF was right in the middle of things, which is about where you want to be. It's a U-shaped curve. So, you want to be there. And then, one thing that was interesting is your TSH was a little bit higher this time than it has been on past labs, Ben. Did you notice that on your most recent lab test?

Ben:  Mm-hmm. Yeah. When I finished racing Ironman, my TSH were like up in the sixes and that's not uncommon in endurance athletes, especially endurance athletes who–like I was at the time really mitigating carbohydrate consumption. I see that over and over again. I had a physician actually put me on Armour Thyroid, which I took for several years, and it seems to allow my TSH to normalize. And as I cleaned things up and decided that I'm not doing a lot of heavy endurance racing, I'm not doing like this strict ketogenic thing, I should just stop taking thyroid support since I doubt I need it. And I did, and I notice my TSH did climb up a little bit. But at the same time, I don't have like cold hands, cold feet, brittle nails, hair, and skin issues, anything that from a symptomatic standpoint would indicate thyroid issues. And so, I'm using a wait and see approach because I think over the next couple of years as I get farther and farther from beating myself up with excess endurance combined with inadequate nutrient or caloric intake that my thyroid should normalize. But I suspect that's the reason is that I was on thyroid replacement and then stopped.

Matt:  Yeah. And we try not to jump immediately on things like this. I mean, you could say, “Hey, this is how it's put on some Armour Thyroid.” However, we find that as you start to optimize everything else, individual markers like this just get better. So, in this case, we would usually probably just say, “Hey, what's going on? Talk through all the things you were talking about. Do you have any symptoms?” And then, let's just recheck it in a month or two and see where you're going because I think this is a problem. A lot of times, people get put on medications or things and they get better. They may have gotten better anyway, but they'll never know, and then they end up taking that for the rest of their lives. So, we try to be a little slower reaching for the prescription pad. We'll use medications if we need to, but we'd like to take a slightly more conservative approach and go a little slower before you add things like that.

Ben:  Interesting. And when it comes to telomeres, you noted that some of my telomere status is subpar, but this is based on genes like TERT and SIRT1 that would affect telomere length. So, it's not a direct measurement of telomeres, which I don't place a ton of faith in anyways. It's more my own genetic risk for the potential for telomere shortening, thus dictating some of the recommendations on things like using NAD, or resveratrol, or some of these things that if someone has a genetic risk for shorter telomere length may benefit them. So, this wasn't an actual blood analysis of telomeres. This is more of a genetic analysis of telomere shortening risk, right?

Mike:  Exactly, yeah. I didn't design the report to actually input any telomere data into it just because I, like you, I'm not very confident in that data. We do use epigenetic testing like DNA methylation, as well as age bio. So, biomarker measurements of aging for biological age. So, those are the two things that we can input into the program as actual data points.

Ben:  Gotcha.

Mike:  But in telomeres, I'm not so confident.

Ben:  Okay. Got it. Wow! And then, I guess that's the end of the report there after it gets through longevity. So, there's a lot on this thing. Now, have you guys just using this as a guinea pig, or did you already–could someone go get this test?

Matt:  They can, yeah, if you go to wildhealth.com. It is not a report that you can just get without seeing someone because again, I mean, we hit on this over and over and over. This has to be contextualized. When you're to increase risk for something, how much? If we can decrease [01:14:43] _____ risk, at what cost? Like, this is really important for that provider-patient relationship. So, right now, you can get this report, but it's through us and with us. I mean, there are quite a few of us providers who are doing this, but we're also training more. So, if a medical provider wanted to learn how to use this and get access to it, then we're training people. So, at wildhealth.com, we also have a fellowship program. But yes, you can get this report, but it's important that it's in the context of a physician relationship.

Ben:  Yeah. I think the biggest takeaway for me after going through all this with you and getting a chance to look at my report this morning prior to our call is that once again, like you need someone who's actually able to look objectively at this, that goes beyond just a computer and someone who can ask you questions like, how do you exercise leading into this test? What are you currently training for? Sure, your recommendation says higher fiber and higher carb, but how's your gut do with higher fiber or higher carb? And a lot of these factors that I think are still like the subtle nuances that you need a real live human being to be able to dig into with you. I just think that it's almost dangerous to take a report like this and just run with the recommendations willy-nilly without actually thinking about some of the–especially the environmental and activity factors.

Matt:  Hundred percent agree. And if you don't, if you're a provider or you want to learn more about this and you don't want to do the whole fellowship or something like that, we also were super excited about it and we're going to be doing some more courses next spring. I think you're going to come out and join us in the springtime. We will do some more education on this, but also actually really dig into some of the more wild side. So, we're doing a lot of wildcrafting and things. So, we'd love to meet people, too, if they want to come and talk more about this and learn more about it in person.

Ben:  Yeah, yeah. And do we have any kind of–I should ask you guys this before the podcast, but we'll just open the kimono and do it right now for the listeners. Are we going to include any kind of like a discount code or anything like that for people to be able to try this test out for themselves?

Matt:  We haven't really talked about [01:16:46] _____ approval from anybody else, but sure, Ben.

Ben:  You guys are the bosses. What we'll do is we'll chat afterwards and work something out. And what I can do for all my listeners is if Mike and Matt give me some kind of a code for you guys to–what's the test cost right now, guys?

Matt:  So, the test itself just comes with being our patient. So, there's not an actual cost to this test. So, when you sign up as one of our patients, we just use this, we run it, and we run it over and over. It's designed to be able to follow you over time so we can–I mean, we could re-input sleep data now and get a different report for you, or we can do new labs tomorrow. So, this is just part of the whole relationship that you get. But we will certainly have a discount code at wildhealth.com, whether you're talking about the conference that we'll do next year, whether you're talking about being a patient and all of that. You could put [01:17:31] _____, talk about how much of a discount we can do.

Ben:  Okay. Cool. We'll work that out later. What I'll do for those of you listening in is once we get that worked out, if you just go to BenGreenfieldFitness.com/clarity, I'll make sure in the shownotes I include any kind of special link or code that you could use that would give you VIP status with Wild Health. So, we'll throw something in there for my listeners if you go to BenGreenfieldFitness.com/clarity, which is where I'll also link to the other three episodes I've done that are super interesting with Mike and with Matt.

Guys, this is fascinating stuff. Thanks for coming on the show and sharing all of this with my listeners and putting up with my nitpicky questions.

Matt:  Now, we've already fired our spell checker. So, we'll get that fixed for you. And yeah, this report is a living report. We're updating it daily as we learn more and as more science come down. So, we're really excited to share it with the world.

Ben:  Awesome, awesome. I dig it. Well, folks, I hope you enjoyed this show. And we did a screenshot overview as well. And I'm also making it so you can download the PDF of my report if you just want to see what it looks like. And again, all that's going to be at BenGreenfieldFitness.com/clarity. And I'm sure you'll be hearing more from the good folks at Wild Health. Like Matt mentioned, I'll probably be in spring of 2021 taking part in another event down there at their fantastic castle in Kentucky, kind of like the Wild health headquarters down there. So, if you pay attention to my calendar, or my newsletter, or my podcast, I'll let you guys know if any of that stuff is open to the public because if you get a chance to go down there, they actually got a really cool thing going on in Lexington with their castle and their whole set up down there. So, stay tuned for more on that. And in the meantime, grab all the shownotes at BenGreenfieldFitness.com/clarity. Until next time. I'm Ben Greenfield along with Doctors Matt Dawson and Mike Mallin signing out from BenGreenfieldFitness.com. Have an amazing week.

Well, thanks for listening to today's show. You can grab all the shownotes, the resources, pretty much everything that I mentioned over at BenGreenfieldFitness.com, along with plenty of other goodies from me, including the highly helpful “Ben Recommends” page, which is a list of pretty much everything that I've ever recommended for hormone, sleep, digestion, fat loss, performance, and plenty more. Please, also, know that all the links, all the promo codes, that I mentioned during this and every episode, helped to make this podcast happen and to generate income that enables me to keep bringing you this content every single week. When you listen in, be sure to use the links in the shownotes, use the promo codes that I generate, because that helps to float this thing and keep it coming to you each and every week.

 

 

Drs. Matt Dawson and Mike Mallin are multi-time repeat podcast guests on my show and the lead physicians at Wild Health, a genomics-based personalized medicine clinic with locations and physicians all across the United States. I first interviewed these guys in the episode “How To Use Precision Medicine To Enhance Athletic Performance, Defy Aging, Balance Hormones, Fix The Heart & Much More.,” then again in “Why Your DNA Is Worthless (& What You Need To Focus On Instead),” and finally, a few months ago, in the episode “Biohacking Your Brain With Precision Medicine, Genomics, Psychedelics, Advanced Nutritional Strategies & Much More!.”

In this episode, they're back to reveal a brand new, impressively comprehensive biomarkers test that they've had a team of MDs, PhDs, data scientists, and software developers working on for over a year. It takes into account genetics, the epigenome, microbiome, environment, and more, and they call it “Wild Health Clarity.”

Dr. Dawson is a precision medicine physician in Lexington, KY, co-host of the Wild Health Podcast, and has been obsessed with performance optimization for as long as he can remember. He received scholarships to play two sports in college even with “minimal talent” because of his voracious reading and implementation of any fitness or nutritional techniques that would give him an edge. Dr. Dawson continued that obsession in medical school, and as a physician, he has won national awards for education, innovation, and leadership. He has lectured in over 20 countries and trained thousands of other physicians through live lectures, online education, two textbooks, and an educational app. Dr. Dawson combines his training in genomics and functional medicine to give personalized, precise medical guidance. His obsession with performance optimization has morphed from, initially athletic, to now mental performance and longevity.

Whether you're a professional athlete or a grandparent optimizing your mental clarity and mobility to keep up with your grandkids, Dr. Dawson is passionate about helping you perform at your absolute peak.

Dr. Mallin is a physician in Bend, OR who is obsessed with health performance and precision medicine and is co-founder of the Wild Health Podcast. He completed medical school in South Carolina and trained in emergency medicine in Salt Lake City, UT. There, he competed in several ultramarathons and found his love for the mountains and performance. Mike currently practices in Bend, OR and Lexington, KY in his precision medicine clinics. He is also co-founder of the Ultrasound Podcast, an educational podcast that has taught thousands of physicians all over the world how to use ultrasound.

**I reference a video portion of this episode in the audio. However, that video file is not available for the episode. Sorry for any confusion. However, below is my Health Report Summary and a PDF of my entire Personalized Health Report to help you follow along.

Health Report Summary

Personalized Health Report

Page 1 / 51

Zoom 100%

During this discussion, you'll discover:

-How Matt and Mike's report is different from all the other reports out there…09:45

  • Obsessed with precision medicine
  • Single nucleotide polymorphisms (SNPs) give incomplete genetic info
  • Multi-omics(blood biomarkers, microbiome data) are difficult to quantify thoroughly
  • One single report to optimize health and maximize healthspan

-How the report is utilized—from doctor to patient…14:30

  • Overall assessment (tree of life)
  • Begin with an overall objective score (91 out of 100)
  • Get the number, then discuss how to raise the score (contextually discussed with patient)
  • Epigenetic age: 43
  • Chronic disease risk calculator
  • Longevity genes

-Sleep and circadian genetics…18:25

  • The only thing in Ben's report that could be improved was sleep
  • Oura Ringdata is used as a reference
    • Wearables don't pick-up everything; do not factor in afternoon naps
  • Deep, REM, total amount of sleep were slightly lacking
  • An afternoon nap or meditation session may help alleviate sleep issues
  • How do you feel when you wake up; do you use an alarm to wake up
  • Certain gene SNPs affect circadian rhythm
  • Examine multiple SNPs simultaneously
  • Resting heart rate elevation during first half of the night indicates eating too late
  • Subjective feedback from the patient about food intake and sleep (data from the Oura ring) is important

-Diet and nutrition…27:00

  • Begin with macronutrients: carbs, fat, saturated fat, protein; proceed to micronutrients and methylation
  • Carb intolerance score is primarily from genetics
  • Gives an idea of what the body is best for converting into energy
  • Higher LDL increases risk of cardiovascular disease (but take data into context)
  • The report isn't meant to stand on its own; it's a reference point to practice precision medicine
  • Begin with general recommendations to account for conflicts in the report due to multiple labs giving data
  • Recommendations are editable by the physician

-Methylation…40:35

-Vitamins and micronutrients…46:20

-Balancing gut reactions vs. genetic pathways to superfoods…49:45

  • What do you like? What have you tried in the past
  • Very few set in stone guidelines; lots of room for experimentation
  • Know how to pursue a particular diet like the carnivore diet
  • Other things to contextualize like SIBO or microbiome problems

-Exercise and recovery…52:10

  • Most important factors: genetics and preferences
  • DNAfittest
  • Plan is for a beginner looking for where to start; make recommendations on existing plans for established athletes
  • Plans for powerlifters, runners, cyclists
  • Sex hormone-binding globulin (SHBG) tends to be high in active individuals eating a high fat, low carb diet
  • DUTCHtest

-Neural behavioral…1:00:15

  • FAAH gene determines how you use CBD
  • BDNF: take lion's mane, use sauna
  • Tips and tricks to “hack” neurological function

-Microbiome…1:01:55

  • Viometest results added to the Wild Health results (use code GREENFIELD to save 5%)
  • Diversity is high; inflammation is low (ideal scenario)
  • Berberinecan help with proteobacteria
  • Onegevity
  • Probioticsare difficult to change gut bacteria
  • Lifestyle and diet are important

-Cardiovascular disease…1:06:40

  • Two risk scores:
    • MESA– 10 year cardiovascular disease risk: 1.4%
    • Genetic cardiovascular risk score

-Longevity…1:10:05

  • DHEA is one of the best biomarkers of aging
  • Proceed with caution when it comes to prescriptions and medications
  • Medication should be delayed to see if individual markers get better without medication
  • Telomere lengths; data is shaky
  • Ben's epigenetic age: 43
  • Biological vs. chronological age; rate of aging=1.2

-How to take the Wild Health Clarity report…1:14:20

-And much more!

Resources from this episode:

– Wild Health:

– Food & Supplements:

– Other resources:

Episode sponsors:

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One thought on “[Transcript] – One Comprehensive Health Test To Rule Them All? How To Get An At-A-Glance “Clarity” Report Of Your Genetic Age, Death Risk, Gut Health, Ideal Diet, Exercise, Sleep & Much More.

  1. Mike C says:

    Why no talk of the testosterone/lh/fsh readings…?

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