Nick Sterling, MD, PhD

Clear Decision-Making Under Pressure

In this episode, we cover a practical system ER doctors use to lead through high-pressure, high-stakes moments. I walk through a high-pressure scenario and break it into repeatable steps: checking your own pulse, clearing cognitive load, committing, prioritizing with the Eisenhower Matrix, executing safely (“slow is smooth, smooth is fast”), and cycling back to reevaluate and verify. We also talk about avoiding the “rise to the occasion” myth, delegating effectively, handling shifting priorities, and closing the loop to continually improve. Clear your mental bandwidth, commit to lead, prioritize what truly matters, execute safely, and reevaluate. Simple, repeatable steps you can use anywhere chaos shows up.#EmergencyMedicine #Leadership #HighPressure #EisenhowerMatrix #Teamwork #optimizeperformance #thepittChapters00:00 — Learn to lead under pressure00:38 — High-pressure & decision making02:06 — The “rise to the occasion” myth02:36 — Check your own pulse03:56 — Commit05:27 — Prioritizing with the Eisenhower Matrix07:13 — Execute and delegate07:33 — “Slow is smooth, smooth is fast”08:18 — Reevaluate, trust-but-verify, debriefSpotify Channel:https://podcasters.spotify.com/pod/show/sterlingmdphd/Social & Website:Instagram - https://www.instagram.com/sterlingmdphdX - https://x.com/sterlingmdphdFacebook - / sterlingmdphdNewsletter - http://eepurl.com/hQpdqTApple Podcasts: https://apple.co/3y438C9References & Show Notes:http://www.nicksterling.com/This content is not medical advice, is for general information purposes only,and does not constitute the practice of medicine or any other healthcare professional services. No doctor-patient relationship is formed. This content is not a substitute for medical evaluation or treatment and does not take precedence over information provided to you by your healthcare provider or official public health sources. Please visit http://nicksterling.com/terms for full Terms of Use.

10 Key Tests to Level-Up Your Heart Health - Add Healthy Years & Lower Heart Attack & Stroke Risk

In this episode, we cover why early atherosclerosis is essentially universal by young adulthood and tests that tell us about cardiovascular risk—beyond a standard lipid panel. We walk through ApoB (and why it can outperform LDL-C in some circumstances), Lp(a) and the case for checking it at least once, inflammation markers like hs-CRP and GlycA, the triglyceride–HDL relationship and TG/HDL ratio, omega-3:omega-6 balance (including an important atrial fibrillation caveat), blood pressure and endothelial stress, plus quick thoughts on homocysteine and coronary calcium scoring.Chapters:00:00 — Why almost everyone has early plaque00:01:01 — ApoB explained 00:02:12 — ApoB vs LDL-C: discordance00:02:38 — Lp(a)00:04:34 — Inflammation: hs-CRP & GlycA00:05:44 — Triglycerides & HDL00:07:19 — Omega-3:6 ratio & Atrial Fibrillation caution00:08:14 — Blood pressure & endothelial stress00:10:03 — Homocysteine & CACSpotify Channel:https://podcasters.spotify.com/pod/show/sterlingmdphd/Social & Website:Instagram - https://www.instagram.com/sterlingmdphdX - https://x.com/sterlingmdphdFacebook - / sterlingmdphdNewsletter - http://eepurl.com/hQpdqTApple Podcasts: https://apple.co/3y438C9References & Show Notes:http://www.nicksterling.com/This content is not medical advice, is for general information purposes only and does not constitute the practice of medicine or any other healthcare professional services. No doctor-patient relationship is formed. This content is not a substitute for medical evaluation or treatment and does not take precedence over information provided to you by your healthcare provider or official public health sources. Please visit http://nicksterling.com/terms for full Terms of Use.

How to Find Metabolic Dysfunction EARLY - Longevity & Healthspan

Spotting Metabolic Dysfunction Early: LP-IR, Waist-to-Hip, Uric Acid & More. In this episode, we cover practical ways to spot early metabolic dysfunction. We walk through the LP-IR (lipoprotein insulin resistance) index and what changing lipid particle patterns reveal, then show how to measure waist-to-hip ratio correctly and interpret risk thresholds. We also touch on where magnesium fits (and its small effects on blood pressure), how to read kidney function more accurately by pairing creatinine with cystatin C, what rising uric acid can signal (including ties to fructose intake and blood pressure), and simple lab/imaging clues of hepatic steatosis/NAFLD.HighlightsLP-IR flags insulin resistance before glucose markers shift.Waist-to-hip ratio is a strong visceral fat proxy.Creatinine + cystatin C improves eGFR accuracy.Uric acid links fructose intake to higher blood pressure.Chapter Markers00:00 Intro: avoid health “icebergs”00:00:41 Metabolic dysfunction 10100:01:26 LP-IR (lipoprotein insulin resistance) explained00:02:22 Triglycerides, VLDL & HDL in insulin resistance00:03:28 Small dense LDL & LP-IR00:04:51 Waist-to-hip ratio: measure & cutoffs00:06:14 Magnesium: insulin sensitivity & small BP effects00:06:47 Kidney function: creatinine + cystatin C (combined eGFR)00:09:06 Uric acid, fructose & blood pressure00:11:08 Liver fat (NAFLD): labs & imagingSpotify Channel:https://podcasters.spotify.com/pod/show/sterlingmdphd/Social & Website:Instagram - https://www.instagram.com/sterlingmdphdX - https://x.com/sterlingmdphdFacebook - / sterlingmdphdNewsletter - http://eepurl.com/hQpdqTApple Podcasts: https://apple.co/3y438C9References & Show Notes:http://www.nicksterling.com/This content is not medical advice, is for general information purposes only,and does not constitute the practice of medicine or any other healthcare professional services. No doctor-patient relationship is formed. This content is not a substitute for medical evaluation or treatment and does not take precedence over information provided to you by your healthcare provider or official public health sources. Please visit http://nicksterling.com/terms for full Terms of Use.

How to Catch Insulin Resistance Early - High-Yield Tests Part 1

In this episode, we cover the highest-yield lab tests to spot insulin resistance early—often years before routine screening would. I walk through how insulin works, why insulin resistance can be silent for a decade, and which metrics actually move the needle for long-term metabolic health.We dig into fasting glucose and A1C, fasting insulin, and combined indices like HOMA-IR and QUICKI. I also explain when an oral glucose tolerance test or a continuous glucose monitor can add value, the limitations of single time-point labs, and why calibration matters for CGMs. Finally, I preview how lipid test — particularly triglyceride-to-HDL ratio—can flag insulin resistance.Chapter Markers00:00 — Intro00:28 — Insulin resistance as a foundation01:11 — Common causes of mortality in U.S.02:07 — What insulin does (and what goes wrong)02:57 — Glucose tests: fasting glucose & A1C basics04:20 — Early signal: fasting insulin (typical ranges)05:16 — Combined indices: HOMA-IR & QUICKI (cutoffs & caveats)06:18 — OGTT & CGM07:31 — Continuous glucose monitor caveats09:10 — TG/HDL ratio for insulin resistanceHOMA-IR Calculatorhttps://www.mdcalc.com/calc/3120/homa-ir-homeostatic-model-assessment-insulin-resistanceQUICKI Calculatorhttps://www.mdapp.co/insulin-sensitivity-quicki-calculator-324/Quick Referencehttps://nicksterling.com/2025/09/18/quick-reference-guide-tests-for-insulin-resistance-part-1/Spotify Channel:https://podcasters.spotify.com/pod/show/sterlingmdphd/Social & Website:Instagram - https://www.instagram.com/sterlingmdphdX - https://x.com/sterlingmdphdNewsletter - http://eepurl.com/hQpdqTApple Podcasts: https://apple.co/3y438C9This content is not medical advice, is for general information purposes only,and does not constitute the practice of medicine or any other healthcare professional services. No doctor-patient relationship is formed. This content is not a substitute for medical evaluation or treatment and does not take precedence over information provided to you by your healthcare provider or official public health sources. Please visit http://nicksterling.com/terms for full Terms of Use.

How Bacteria in Your Gut Control Metabolic Health - Akkermansia & GLP-1 - Colleen Cutcliffe, PhD

Scientific knowledge of the gut microbiome has increased exponentially over the last decade. Recently, several studies have suggested that specific strains of bacteria, including Akkermansia muciniphila, are key to supporting the environmental conditions required for other related bacterial strains that facilitate healthy metabolic health. In this video, Colleen Cutcliffe, PhD, co-founder and CEO of Pendulum discusses groundbreaking research around Akkermansia mucinophila, the role of short-chain fatty acids (SCFAs) in stimulating GLP-1 pathways, implications for diabetes management, and how gut bacteria influence inflammation, gut integrity, and overall metabolic health. They also explore how diet, antibiotics, and stress impact the microbiome, potential roles of probiotics in inflammatory bowel disease (IBD), pediatric gut health, and exciting emerging research on the gut-brain axis and neurological conditions like Parkinson's disease. Colleen highlights Pendulum's rigorous scientific approach, including clinical trials and innovative manufacturing practices that ensure product viability and effectiveness. Promotional code STERLING20 can be applied for 20% off of first membership purchases (https://pendulumlife.com). Please note that Dr. Sterling has no financial affiliation with Pendulum. This code is provided only as a discount to listeners and does not constitute a clinical recommendation or medical advice. Chapters: - 00:00 Intro: Gut Microbiome Essentials - 02:03 Pendulum's Biotech Innovation - 06:15 GLP-1 & Metabolic Health - 09:59 Probiotic Industry Insights - 17:17 Importance of Akkermansia - 24:17 Clinical Results for Diabetes - 29:28 Manufacturing Challenges - 39:13 Diet's Impact on Microbiome - 43:35 Gut-Brain Connection - 46:50 Next Steps & Resources Spotify Channel: https://podcasters.spotify.com/pod/show/sterlingmdphd/ Social & Website: Instagram -   https://www.instagram.com/sterlingmdphd X -   https://x.com/sterlingmdphd Newsletter - http://eepurl.com/hQpdqT Apple Podcasts: https://apple.co/3y438C9 References & Show Notes: http://www.nicksterling.com/ This content is not medical advice, is for general information purposes only and does not constitute the practice of medicine or any other healthcare professional services.  No doctor-patient relationship is formed. This content is not a substitute for medical evaluation or treatment and does not take precedence over information provided to you by your healthcare provider or official public health sources. Please visit http://nicksterling.com/terms for full Terms of Use.