Writing
Everything I've posted, in one place. Each post runs on LinkedIn first and lands here for good.
- Clinical practiceThe honeymoon phase ends after the first quarterEvery longevity program puts most of its energy into the first few weeks. In my experience, the honeymoon phase typically ends somewhere around the end of the first quarter — and most programs have nothing scheduled to catch it.
- Lifestyle & behaviorWalk outside when you canWalking doesn't get much attention in longevity medicine, probably because there's nothing to sell. The research behind it is strong, and for a lot of people it's the base everything else sits on.
- Testing & diagnostics"Should I be fasting?"Fasting has become close to a default recommendation. For some people it works well. For others, especially men who are training hard, eating too little or fasting too long can backfire on their hormones.
- Supplements & protocolsProgress lives in the relationshipReal progress can come from testing. The bigger progress comes from something slower — a continuous relationship with a team that knows the person, built over months and years.
- Testing & diagnosticsSee the plaque, not just the riskA blood test tells you about risk. It doesn't show what's actually happening in the arteries of the heart. Two people with the same ApoB can have very different scans.
- Clinical practiceClear roles. Room to work.Longevity medicine is moving toward care teams. That's the right direction, but it only works if information moves between them cleanly.
- Lifestyle & behaviorSleep has gotten more complicated than it needs to beMouth tape, magnesium, blue-light glasses, a cold bedroom, red light, a wind-down routine and a sleep score every morning. Some of it helps, but I don't think the gadgets are where most of the change happens.
- Testing & diagnosticsThe first question about imaging is what the indication isFull-body MRI usually runs $2,000–$3,000 and most people walk out with a list of findings. For a small group it can be extremely valuable. For most others it means more appointments and worry over something harmless.
- Supplements & protocolsSupplements should be held to the same standard as medicationsA lot of people are taking something without being sure of the dose, whether it works with what else they're taking, or whether they needed it in the first place.
- Science & physiologyVO2 max is a summary of how well the whole system worksVO2 max is one of the strongest predictors of how long people live. What gets lost is what it's actually measuring — how well the body takes in oxygen, moves it and uses it.
- Clinical practiceLongevity care needs one plan, not five separate onesSomeone might hear from a physician, a health coach, a nutritionist and a trainer in the same month. Every piece can be valuable on its own and still add up to something overwhelming.
- The basicsGrip strength is simple and gets overlookedIn large population studies it predicted outcomes better than blood pressure. Here's what I think it's really measuring.
- Questions I hear"My labs are normal, so why don't I feel right?"Normal means your number looks like most people who were tested. Plenty of those people aren't feeling great either.
- My takeOptimal ranges are often a best guessSome ranges are backed by good outcome data. Others started as one person's opinion and got repeated until they looked settled.
- The testApoB is one piece of the pictureApoB tells you how much traffic is on the road. Lp(a), Lp-PLA2, and imaging answer the questions it can't.
- Behind the scenesWhat happens after the results visitThe front end of longevity care has gotten really good. What happens after is where a lot of care quietly stops.
- The basicsFitness is the one thing that makes the biggest differenceThe research is about as strong as anything we have in this field. It also gets the least attention because there's no product to buy.
- Questions I hearA bigger lab panel isn't always a better onePast a certain point, more tests mostly create more things to explain. A shorter panel can be the more thoughtful one.
- My takeNobody walks in saying they want to live longerOur field talks about lifespan a lot more than our patients do. That gap matters for whether people actually stick with a plan.
- The testBiological age tests don't agree with each other yetSend the same blood to a few different companies and you can get answers that are years apart. Here's what I pay attention to instead.
- Behind the scenesWhy I'm starting to write hereA lot of what I see day to day never makes it into the podcasts or the headlines. That's the part I want to write about.