Recognize that sleep deprivation causes the quickest and most severe health decline. Prioritize getting sufficient, high-quality sleep as it has the most immediate impact on your overall well-being.
Set your bedroom temperature to be as cold as humanly possible, aiming for a level where you feel incredibly uncomfortable when first getting under the covers, for optimal sleep quality.
Refrain from consuming carb-heavy or ‘shitty’ meals close to bedtime, as this can increase your respiratory rate and diminish sleep quality and recovery.
Dedicate as much effort and emphasis to managing your health as you would to any other deeply cared-for pursuit, such as a hobby or investment, to achieve meaningful results.
Thoroughly understand your lab results and actively participate in your healthcare discussions, as engaged patients extract the most value from their healthcare team.
Be highly skeptical of nutritional epidemiology studies, especially those relying on food frequency questionnaires, due to their inherent limitations and often low hazard ratios, which can lead to misleading conclusions.
When evaluating health claims or study results, always consider both relative and absolute risk, along with the study duration, as relative risk alone can be highly misleading.
Utilize a Continuous Glucose Monitor (CGM) as a powerful behavioral tool to avoid unhealthy food choices by making glucose spikes visible and undesirable, thereby motivating healthier eating habits.
Employ CGM data to empirically calibrate how different activity levels, periods of nutrient deprivation, and consumption of treats affect your glucose levels, allowing you to minimize metabolic damage.
Monitor your glucose standard deviation via CGM and strive for low glucose variability, as this serves as a good proxy for maintaining low insulin levels and better overall metabolic health.
Instead of consistently maintaining low IGF-1, aim to cycle your IGF-1 levels between high and low, potentially through strategies like fasting and refeeding, to promote tissue regeneration and rejuvenation.
Aim to keep your triglycerides below 100 mg/dL, and ideally lower than your HDL cholesterol (when both are measured in mg/dL), as a more stringent goal than typical lab ranges.
Strive to keep your LDL particle number (LDL-P) below 1000 nmol/L, which is approximately the 20th percentile, to significantly reduce your risk of atherosclerotic disease, the most common cause of death.
Aim to keep your small LDLP below 500 nmol/L, targeting the 25th percentile for improved cardiovascular health.
Aim for oxidized LDL levels below 40, a more stringent criterion than the typical lab ‘reasonable’ level of 60, to further mitigate cardiovascular risk.
Strive to keep your C-reactive protein (CRP) below 1, which is a more aggressive target than most labs’ ‘reasonable’ level of 2, to indicate lower systemic inflammation.
Aim to keep your uric acid levels below 5.0, a stricter goal than typical lab ’normal’ ranges of 6 or 7, to potentially avoid other health consequences beyond gout.
Target ALT and AST levels below 20, which is considerably lower than the typical lab upper limits of 40-44, for optimal liver health.
Strive to keep your fasting glucose below 90 mg/dL as a key indicator of good metabolic health.
Target a fasting insulin level below 6 to indicate healthy insulin sensitivity.
Following a 75-gram glucola challenge, aim for 1-hour glucose below 120-130 mg/dL and insulin below 20-30, with 2-hour glucose returning below 100 mg/dL and insulin ideally below 20 or 2x the 1-hour glucose.
Aim for TSH between 0.5 and 2.0, free T3 above 3.0, and reverse T3 below 12 for biochemically optimal thyroid function, even if symptoms suggest otherwise.
Strive for an EPA/DHA index above 8.5%, and potentially up to 10-12% if no adverse effects like nosebleeds, to optimize fatty acid balance for neurodegenerative and atherosclerotic axes.
If taking statins, monitor desmosterol levels and aim to keep them above 0.5 to avoid overly suppressing cholesterol synthesis, exercising caution at the individual level.
If a woman is trying to get pregnant, exercise caution with nutritional ketosis, as calorie restriction and elevated ketones can suppress reproductive hormones (FSH and LH).
The speaker is not convinced that deliberate ketosis is the optimal nutritional strategy for women during pregnancy, despite its ancestral prevalence.
A foundational nutritional strategy is to eliminate junk food, sugar, and highly refined carbohydrates from your diet.
If considering medicine, study something you genuinely love and are obsessed with mastering in college, rather than just pre-med, as medical school will cover the foundational science in depth.
When feeling unhappy or overwhelmed in demanding situations like medical training, find someone who aspires to be in your position and help them, as this can rekindle your enthusiasm and perspective.
During intense periods like medical school or residency, consciously allocate time (e.g., 15% of your non-sleep hours) to replenishing activities like exercise, pleasure reading, or socializing to prevent burnout.
Frequently interact with patients during medical school to remember the unique privilege and awe of the patient-doctor relationship, which can be a powerful motivator against the challenges of medicine.
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Aim for a higher heart rate variability (HRV) as it indicates greater parasympathetic nervous system activity, reflecting a state of rest and recovery.
Be aware that overtraining, alcohol consumption, and poor food choices close to bedtime can significantly lower your HRV and increase your resting heart rate, negatively impacting recovery.
Use daily HRV data from wearables (like the Aura Ring) to empirically adjust lifestyle factors such as alcohol intake, meal timing, and room temperature, to find your optimal recovery state.
Utilize a wearable’s readiness score as an indicator of your body’s recovery, especially after intense cardio workouts, and adjust your training intensity or prioritize rest accordingly.
Taking low-dose lithium (10-20 mg, over-the-counter) may offer potential mood stabilization benefits with low risk, but its value is considered low-reward and should be discussed with a physician.
Never take high-dose lithium (e.g., 600 mg/day) without extremely careful medical supervision, including constant blood level monitoring, due to significant risks of side effects and toxicity.
Berberine, a plant extract, can act as a weak AMPK activator to decrease hepatic glucose output and may weakly inhibit PCSK9, potentially lowering LDL in some individuals; try it to see if LDL improves.
Based on recent studies, if you are in a low-risk population for heart disease, re-evaluate the necessity of taking a baby aspirin, as the benefits may not outweigh the small risks.
Instead of relying on baby aspirin to prevent blood clots on long flights, prioritize getting up and walking around as much as possible, as data does not support aspirin for this purpose.
Be skeptical of oral nicotinamide riboside (NR) or nicotinamide mononucleotide (NMN) supplements, as current research suggests only the liver can effectively take them up and convert them to NAD, limiting systemic benefits.
Do not pursue NAD infusions, as cells cannot directly take up NAD; it must be synthesized intracellularly, rendering infusions ineffective for increasing cellular NAD.
For general supplements, rely on reputable brands like Jarrow and Pure Encapsulations. For EPA/DHA, consider Carlson’s or Nordic Naturals to ensure quality.
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