Ep 28 | Advanced Thyroid Health with Dr. Dana Gibbs

Ep 28 | Advanced Thyroid Health with Dr. Dana Gibbs

Most people who struggle with hypothyroidism are told the same thing: their TSH is normal, so everything is fine. Dr. Dana Gibbs, board-certified ENT surgeon, thyroid and hormone specialist, makes a compelling case for why that's not good enough, and what patients and physicians should be doing instead. She explains the Total T3 to Reverse T3 ratio, why excess T4 can backfire, how undertreated thyroid dysfunction drives infertility and miscarriage, and what lifestyle factors silently sabotage treatment  Where to find our guests: Website - https://danagibbsmd.com/ [https://danagibbsmd.com/] YouTube - https://www.youtube.com/@danagibbsmd8190 [https://www.youtube.com/@danagibbsmd8190]  Podcast - https://podcasts.apple.com/us/podcast/beyond-the-thyroid/id1756413327 [https://podcasts.apple.com/us/podcast/beyond-the-thyroid/id1756413327]  Where to find us: Website [https://vitaveda.health/] | https://vitaveda.health Youtube [https://www.youtube.com/@vitavedahealth] | https://www.youtube.com/@vitavedahealth Twitter / X [https://x.com/drprilongevity] | https://x.com/drprilongevity Newsletter [https://substack.com/@vitavedahealth] | https://substack.com/@vitavedahealth Instagram [https://www.instagram.com/drprilongevity/] | https://www.instagram.com/drprilongevity/ [https://www.instagram.com/drprilongevity/] Timestamps 00:00:00 - Introduction: Dr. Dana Gibbs 00:01:17 - Dr. Gibbs' personal thyroid journey 00:05:18 - The diagnosis breakthrough 00:10:11 - Armour Thyroid vs. Levothyroxine 00:13:07 - Hashimoto's Disease: Triggers & prevalence 00:20:04 - The thyroid lab panel explained 00:36:32 - Thyroid, fertility & miscarriage 00:46:54 - Lifestyle factors that disrupt thyroid function 00:52:07 - Thyroid management in pregnancy 01:02:49 - Thyroid issues in men 01:13:01 - Cortisol, sleep & stress management 01:22:37 - Finding the right thyroid doctor The Core Thyroid Lab Panel (5 Tests) * Free T4 * Free T3 * Total T3 * Reverse T3 * TSH Ideal ranges Dr. Gibbs targets: * Free T3: 3.4–4.0 (lab reference range is 2.0–4.4, but she considers anything below 3.4 suboptimal in symptomatic patients) * TSH: 1.0–2.0 (lower half of normal); below 2.5 if trying to conceive * Total T3 : Reverse T3 ratio: 10:1 or higher (below 10 indicates the body is breaking down rather than building T3) When to also add antibodies (TPO + Thyroglobulin): * Abnormal results on the core 5 * Trying to conceive or history of miscarriage * Family history of Hashimoto's * Symptomatic male patients with low testosterone Symptoms That Warrant a Thyroid Workup Dr. Gibbs’s core list includes: * Fatigue, especially worse than peers or worsening over time * Difficulty getting out of bed in the morning * Poor sleep or frequent waking * Brain fog / difficulty concentrating or memorizing * Hair loss or thinning * Loss of outer third of eyebrows * Unexplained weight gain or difficulty maintaining weight * Cold hands and feet * Constipation * Recurrent illness / low immunity * Low libido (in men and women) * Menstrual irregularities or fertility problems Common Triggers for Hashimoto's Disease * Viral illness (e.g., mono, URI) * Extreme psychological stress * Pregnancy or delivery * Menopause * Any event that causes rapid hormonal fluctuation Lifestyle Factors That Raise Reverse T3 (and suppress thyroid function - fix these first) * Over-exercise / overtrained athlete syndrome - body interprets it as chronic stress * Caloric restriction below basal metabolic rate - body perceives starvation * Low protein intake - even in overweight patients * Nutrient deficiencies - especially iron, B vitamins, healthy fats * High insulin / insulin resistance - very common in Hashimoto's patients (double the general population rate of ~35%) * Chronic psychological stress and elevated cortisol * Circadian disruption (e.g., night shift work) * Rapid weight loss (including GLP-1 use without proper dietary support) GLP-1 / Weight Loss Considerations for Thyroid Patients * Rapid weight loss can raise Reverse T3 by signaling starvation * Must maintain adequate protein intake even when appetite is suppressed * Must continue resistance/strength training - not just cardio * Must maintain B vitamins, minerals, and healthy fats * Best candidates: people with high insulin resistance or uncontrollable sugar cravings * Concern: GLP-1 use in Hashimoto's patients without these safeguards may worsen the T3:rT3 ratio Sleep & Cortisol Management Strategies What has worked for Dr. Gibbs personally * Get thyroid optimized first - poor sleep is often a symptom, not the root cause * Split thyroid dose and take the first dose very early in the morning (even at a middle-of-the-night bathroom wake-up) to prime cortisol for proper morning rise * Adrenal glandular supplement - taken early morning and a small dose at bedtime to support the natural cortisol curve * Hot shower immediately before bed - helps with cold extremities and faster sleep onset * Yoga nidra meditation - for middle-of-the-night wakefulness; most effective within 15 minutes References:  * Dr. Dana Gibbs’s education website - http://www.thyroidclarity.com [http://www.thyroidclarity.com]  * Physician integrative hormone management class and discussion group - http://thyroidclarity.com/endo-optin [http://thyroidclarity.com/endo-optin]  * https://wlwt.com/article/doctors-screenings-colorectal-cancer-young-adults/70320212 [https://wlwt.com/article/doctors-screenings-colorectal-cancer-young-adults/70320212]  Disclaimer This audio and video podcast are for general informational purposes only and does not constitute a practice of medicine, nursing or other professional health care services including the giving of medical advice. No doctor patient relationship is formed. The use of this information and the materials linked to this podcast and video cast are at the user’s own risk. The content on this podcast and video cast are not intended to be a substitute for professional medical advice, diagnosis or treatment. Any listener or watcher of this information should not disregard or delay in obtaining medical advice from any medical condition they have and they should seek assistance of their healthcare professionals for any such conditions. We take all conflicts of interest very seriously. For all disclosures and companies we invest in or advise, please visit our website.

Ep 27 | The approach to habit change that works

I’ve seen people stay stuck for years with their habits because of small things. Once you fix those, everything else gets easier. Here are a few examples that actually worked. Examples of Behavioral Hacks for Longevity That Can Help You: Key Takeaways * Cold Showers for Mental Grit Start your shower warm and gradually make it cooler over time until you're on max cold. This builds mental resilience and the adrenaline boost carries you through the rest of your day. * The "Two's Protocol" for Strength Training If you're short on time or traveling, try two exercises, twice a week, two sets each. Push-ups and squats require no equipment and can be done anywhere. Consistency beats intensity, this simple routine can actually build strength over time. * The 10-Minute Interval Hack to Break a Plateau Set a 10-minute timer with a 1-minute counter. Each minute, do a small number of reps (about 25% of your max). Rest the remainder of the minute, then repeat. Over 10 minutes you'll accumulate far more total reps than a standard set! * Cool Your Feet to Sleep Better Your hands and feet act as temperature regulation vents for your body. If you're sleeping too hot, stick your feet out from under the covers and point a small fan at them. If you're too cold, keep your hands and feet covered and insulated. It's a free alternative to expensive sleep-cooling gadgets and works surprisingly well. Where to find us: Website | https://vitaveda.health Youtube | https://www.youtube.com/@Vitavedahealth Twitter / X | https://x.com/drprilongevity Newsletter | https://substack.com/@vitavedahealth Instagram | https://www.instagram.com/drprilongevity/ Disclaimer:  This audio and video podcast are for general informational purposes only and does not constitute a practice of medicine, nursing or other professional health care services including the giving of medical advice. It is not meant to be a substitute for professional medical advice, diagnosis, or treatment. No doctor patient relationship is formed. The use of this information and the materials linked to this podcast and video cast are at the user’s own risk.

Ep 26 | Crucial Physical Capacities for Aging

I sat down with Dr. Patrick Donovan, PT, DPT, founder of Heather Lane PT, to dig into physical capacity for Longevity. It is one of the biggest things people fear losing as they age, and yet most of us wait until something breaks before we do anything about it. We walk through his Capacity Compass framework covering the 6 domains of physical health everyone needs to proactively manage to ensure they can live the life they want well into their golden years.  Where to find our guest, Dr. Patrick Donovan, PT, DPT: Website | https://www.heatherlanept.com/ Instagram | https://www.instagram.com/drdonovan_healthspan/ Facebook: | https://www.facebook.com/people/Heather-Lane-Physical-Therapy-and-Wellness/61561488149188/ Where to find us: Website | https://vitaveda.health Youtube | https://www.youtube.com/@vitavedahealth Twitter / X | https://x.com/drprilongevity Newsletter | https://substack.com/@vitavedahealth Instagram | https://www.instagram.com/drprilongevity/  Timestamps 00:00:00 – Introduction to proactive physical therapy 00:14:37 – The Capacity Compass: 6 metrics that help extend health span 00:17:50 - Strength: Upper vs. lower body & real-world goals 00:24:03 - Mobility: Squats, lunges & joint range of motion 00:33:04 - Balance: What's at stake & how to test it 00:39:11 - Endurance & cardiorespiratory fitness 00:44:25 - Gait & walking speed 00:49:54 - Chronic condition management 00:59:47 - How often should you check in? 01:03:28 - Virtual Physical Therapy: Access and effectiveness The 6 Domains of the Capacity Compass 1. Strength * Definition * This is your capacity to get up from a chair, get off the floor, carry groceries, climb stairs, and move your own body weight through daily life without needing to hold on, compensate, or ask for help. * Importance for longevity * Required for nearly every daily functional demand like getting out of a car, picking something up off the floor, and walking up stairs with bags. When body strength declines and goes unaddressed, the downstream effects compound: gait slows, balance deteriorates, and activities get quietly dropped from life.  * Key tests:  * 5x Sit-to-Stand:  * Sit in a standard chair with arms crossed over your chest. Stand up fully and sit back down 5 times without using your hands.  * Floor Get-Up:  * Lower yourself all the way to the floor and stand back up without touching a wall, chair, or other surface.  * Other important info: * The goal is to work backward from what you want your 75 or 80-year-old life to look like and build enough reserve now that you never fall below that threshold.  * Strength gains take 8 to 16 weeks to establish, so the earlier you build the habit of maintaining it, the more buffer you have. * Upper body strength is relevant but secondary to lower body strength in the Capacity Compass unless you have specific overhead goals (competitive swimming, getting luggage into an overhead compartment). When it is tested, the progression is: counter pushup, chair pushup, floor pushup. * A common misconception is that strength training requires a gym. Most functional strength work can be done at home with bodyweight and household objects. 2. Mobility * Definition: * The ability to move your joints through their full range of motion, without load (unweighted) and under load (weighted).  * Mobility includes the control and stability you have throughout that range, particularly when force is applied. * Importance for Longevity * When mobility is lost the risk of injury dramatically increases, which may lead to irrecoverable loss of function. * Key tests:  * Goblet Squat:  * Hold a light weight (around 15 lbs) at chest height. Squat until your hips drop below your knees, butt toward heels.  * Inline Lunge:  * Step forward and lower your back knee toward the ground, ensuring there is no forward trunk lean or other deviations. * Other important info:  * Shoulder mobility deserves specific attention. Desk posture and prolonged sitting collapse this. The result is restricted shoulder range that most people attribute to the shoulder itself, not the spine. * When weight is added to mobility tests, compensations become immediately visible, so if they are too easy add light weight. 3. Balance * Definition: * The ability to maintain control of your body's position - both statically and dynamically  * Importance for Longevity: * Major risk factor for falls and injuries * Feeling unconfident here leads to psychological harm and avoidance of socializing  * Key tests: * Single-Leg Stand:  * Stand on one leg. Target for younger adults is 60 seconds.  * Single-Stair Hop:  * Hop up one step on one leg and land without using the railing. This tests power, reaction time, and dynamic stability all at once.  * Other important info:  * For young folks, try balance tests with your eyes closed * Make sure to test both static and dynamic balance - both are critical for injury prevention, and they don’t necessarily overlap * At higher fitness levels, balance and strength begin to overlap significantly. For example, a single-leg Romanian deadlift is simultaneously a strength exercise and a balance challenge. 4. Gait / Walking Speed * Definition: * How fast and efficiently you walk, * Measured in two ways: self-selected speed (comfortable, natural pace) and fast speed (urgent, maximum walking pace).  * Importance for Longevity: * There is a lot of evidence tying gait speed to lifespan * For healthspan your ability to walk confidently and comfortably is key for many enjoyable activities and socialization * Key tests: * Two-Pace Test:  * Walk at your "grocery store" pace - comfortable, like you're navigating a parking lot. Then walk at your "catch the bus" pace - fast, urgent. The difference between those two speeds is the main data point. * Other important info:  * If you are young, track it consistently so you notice any deviation right away 5. Cardiovascular Endurance * Definition: * The capacity of the heart, lungs, and circulatory system to sustain physical effort over time.  * Importance for Longevity: * VO2 max is the main metric that has a lot of data tying VO2 max levels to lifespan * From a functionality standpoint, higher cardiopulmonary endurance allows you to do more physical activities and sustain them for longer * Key tests: * Formal VO2 max testing * Done in a laboratory with a breath mask on a treadmill or a stationary bike * Stair Climb Test:  * Walk up flights of stairs at a steady pace and count how many you can complete before needing to stop and catch your breath. Most people have never done this deliberately.  * That number, wherever it is...

Ep 25 | How to build mental resilience for Longevity

Mental resilience is the most underrated factor in Longevity because it boosts your healthspan like no biomarker or peptide can. In this video I lay out how you can build in a simple, incremental way daily. Where to find us: Website | https://vitaveda.health Youtube | https://www.youtube.com/@Vitavedahealth Twitter / X | https://x.com/drprilongevity Newsletter | https://substack.com/@vitavedahealth Instagram | https://www.instagram.com/drprilongevity/ Time stamps: * 0:00 - Resilience helps you manage the complexity of longevity * 1:24 - More resilience, longer lifespan * 4:45 - Why reslience improves healthspan * 6:58 - 5 simple steps to building reslience 5 ways to build mental resilience 1. Start the day with something you don't want to do - Do it first thing in the morning (cold shower, push-ups, skipping a treat) 2. Do at least one uncomfortable thing daily - Make it a non-negotiable. Check in at night, and if it hasn't happened, do it then. 3. Don't let setbacks derail you - Missing a day or week is normal. Just get back to it. 4. Push past the governor - Count how many times you override the voice saying stop. Aim to do this once a day. 5. Keep an inspiration playlist - Create a go-to playlist/content that helps you push through harder moments. References: https://www.sciencedirect.com/science/article/pii/S0022399925000807 https://link.springer.com/article/10.1186/s12889-024-19558-8 Disclaimer: This audio and video podcast are for general informational purposes only and does not constitute a practice of medicine, nursing or other professional health care services including the giving of medical advice. It is not meant to be a substitute for professional medical advice, diagnosis, or treatment. No doctor patient relationship is formed. The use of this information and the materials linked to this podcast and video cast are at the user’s own risk.

Ep 24 | pTau 217 detects Alzheimer's 10 years before any other test

A new blood test called p-Tau 217 can detect Alzheimer’s disease years, sometimes decades before symptoms begin. Here’s how it works, why it matters, and what you can do if levels are rising. Where to find us: Website | https://vitaveda.health Youtube | https://www.youtube.com/@Vitavedahealth Twitter / X | https://x.com/drprilongevity Newsletter | https://substack.com/@vitavedahealth Instagram | https://www.instagram.com/drprilongevity/ References https://time.com/collections/best-inventions-2024/7094900/alzpath-ptau217-antibody/ https://jamanetwork.com/journals/jama/fullarticle/2768841 https://pubmed.ncbi.nlm.nih.gov/33068398/ https://www.nejm.org/doi/full/10.1056/NEJMoa2310168? https://www.aafp.org/pubs/afp/issues/2025/1200/suspected-dementia-evaluation.html https://pubmed.ncbi.nlm.nih.gov/40997839/ Disclaimer:  This audio and video podcast are for general informational purposes only and does not constitute a practice of medicine, nursing or other professional health care services including the giving of medical advice. It is not meant to be a substitute for professional medical advice, diagnosis, or treatment. No doctor patient relationship is formed. The use of this information and the materials linked to this podcast and video cast are at the user’s own risk.