Why You Feel Tired, Disconnected and Burnt Out | Dr. Molly Maloof, MD

Why do so many people feel exhausted, disconnected, and unhealthy even when they’re doing everything “right”?

In this episode, Dr. Molly Maloof, MD & author of The Spark Factor, breaks down the real root causes of modern health issues. From metabolic dysfunction and hormone imbalance to loneliness and disconnection.

We cover:

• Why modern life is out of sync with human biology
• The role of metabolic health and mitochondria
• Why loneliness is one of the biggest health risks today
• The truth about hormones, perimenopause, and women’s health
• How stress, environment, and lifestyle impact your body
• Why most people are approaching longevity the wrong way
• The difference between healthspan vs lifespan

This conversation connects the dots between physical, emotional, and social health and explains why so many people feel off without clear answers.

🔗 Dr. Molly Maloof, MD

https://drmolly.co/

https://m3healthspan.com/

instagram.com/drmolly.co

🔗 Laurenn Cutshaw

Marketing Brand Director - Vibrant Wellness

https://www.linkedin.com/in/laurenncutshaw

https://www.instagram.com/activelaurenn/

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Transcript

0:00

human relationships are either our greatest source of health or our greatest source of disease, because they're either giving us life by giving us safety and helping our nervous system turn off the hypervigilance that is on by default loneliness is a deep, deep problem in society. 1 in 2 people are lonely and loneliness is worse for our health than smoking, drinking, sedentary behavior, and obesity. If it's that important, we need to talk about it. We need to understand why it's it's causing so many problems. Doctor Molly Maloof is a physician, educator, entrepreneur, and the author of The Spark Factor A Guide to Reclaiming Your Vitality Through Cutting Edge Science and Ancient Wisdom. She describes herself as an accidental organismal biologist, which I love because it means she looks at health, not through the lens of symptoms and disease, but through the lens of what life is actually trying to do. Doctor Molly, welcome. I'm so glad you're here. Thank you so much for having me. Absolutely. Let's start with the framework you've built around the biological imperative. You've said that biology doesn't care about your job, your ambitions or your plans. It only cares about two things surviving and reproducing. Walk us through that tension. Well, it's kind of like a hard thing to accept that, you know, as a, as, like a modern woman, right? We're told we should have these amazing careers and we should also be amazing families. And we should also, take care of our health and and do so much. And at the end of the day, when it really comes down to like how our bodies are programed, it's just two big things. One is, how do I secure resources to actually create energy in the body, to actually power my physiology? Like that is crucial. And so we've created these expansive monetary systems around accruing wealth to actually fundamentally be able to find the resources to eat, to bed a roof over our heads, to be able to buy water, to be able to do all these things, to actually just thrive and survive right, in modern life. But really, it's coming down to energy, right? So that's why I spent most of my first half my career on which was metabolic health, because I wanted to understand why does metabolic health matter so much to our longevity? Why is insulin resistance underneath so much heart disease, cancer, diabetes and dementia? And what is actually driving that insulin resistance, right. It's our modern lifestyles that are out of sync with our genetic design, because we're not really designed to live in cities, isolated, alone, drinking tap water, not being in nature, not having to be around us. We're not designed for that. We're designed for living in tribes. And that's how we evolved. Unfortunately, we're like very, very now we're in a very different world than we were many, you know, many hundreds of years ago, if not, thousands. And so we're we're struggling with our health as modern humans because we're not living in alignment. Right. And then the second big part, that big piece is the biological narrative I started discovering during the pandemic. So I had this, company I started called the Dharma Bioscience, and I was trying to understand signs of love very simply. And I thought that you could reverse engineer it and then package it in the form of pharmaceuticals. Like, I really thought that you could do that. And it turns out that you can create love drugs, but they are highly unethical. I was going to say, and, I learned that by being part of this major movement in psychedelic space and recognizing that even if you can do stuff like that, should you. So I started actually working with ethicists, and I started sitting down reading their books because there was a great book called Love Dogs written by this guy right here who, was in ethicist at, I think he was do. And when I read his book, he, he basically shows the pros and cons of, you know, the concept of love drugs. And I was actively working on one. So what an ethicist on my, on my advisory board. And it wasn't until there was this big scandal at maps, basically that kind of shut down the entire business of, and the basis of therapy. And I realized that, like, I needed to really understand love and I needed to understand why, why it's so important to our evolutionary biology. So during that, you know, company building journey, I actually brought on some advisors. Two of them were my mentors. Essentially, one was named Susie Carter, who is the wife of Stephen Fry. Guess who invented bagel theory? So he studies stress and she studies human bonding through oxytocin biology. So she pioneered that whole research. And then I also studied with, I basically got a lot of my research from this woman, Helen Fisher, who passed away last year, but she was the most cited woman on the science of love. And she studied romantic love in particular, and was actually responsible for analyzing the Match.com dataset. Oh, wow. Incredible woman. And so both of these women were my mentors, and they were teaching me about fundamentally organismal biology. And that's how I accidentally became one, because I was studying with these women, trying to understand why do we so desperately need connection as humans, and why are we struggling so hard in modern life, feeling so disconnected. So that's when I realized, hey, like finally, after studying all this, I was like, well, I gotta stop producing this. I can't possibly commercialize this drug. It's too dangerous. It's going to wreak havoc on society. And I was just like, I gotta put a pause on that. But I was still interested in the human connection because I realized it was all the work that I did and all the research, that it wasn't in vain because it was able I was able to transform it into new keynote talks and new ways to present how we can relate in in modern life and how we can reconnect in both communities and also in relationships. In a relational sense, and really bring this to the forefront of medicine because it's not talked about enough. And human relationships are either our greatest source of health or our greatest source of disease, because they're either giving us life and giving us safety and helping our nervous system turn off. The hypervigilance that is on by default is the way we are designed. It's actually I'll go into this later. But this single, the generalized safety theory of stress and essentially our nervous system is on stress mode unless it's on safe mode. And the thing that turns us into safe mode is safe relationships, safe people being in safe environments. And it's hard to get there when we're alone. So this is why it's so important to find meaningful work and having really healthy work environments. Why it's so important to find meaningful relationships. Even if you're not partner at having work. It's more that a community around you. And it's it's important to understand that loneliness is a deep, deep problem in society. One and two people are lonely and loneliness is worse for our health. And smoking and drinking behavior and obesity. If it's that important, we need to talk about it. We need to understand why it's it's causing some problems. Well, yes. And it seems to me that all of the most like important things in life for survival, for connection, for thriving are really not taught. We don't learn about how to care for our bodies in school. And you're sitting here talking about relationship, and I was thinking about you're talking about love. But there's also like the Gottman and Esther Perel and all these people who talk about generally the relationship between man and a woman or two partners. And is there a correlation between their work and your work? Well, I try to go beyond just the romantic relationship and really look at relationships themselves as healing or toxic. Okay, I really like your family relationships, right? There's we have record numbers of people that are just estranged from their families. I don't know what is causing this aside from, I think, potentially social media and the media just cycle is so divisive and it's just pulling us apart. And I think it's it's doing it because it's trying to to really get our attention and our and our attention is being captured by these, news cycles and by these social media clips that convince us so easily that, like, oh, this relationship is just terrible. So I think we're not you're not getting the skills to actually weather the storms in our relationships. We're not given the skills in school to help to understand what rupture and repair looks like. So there's a lot of relational rupture and not enough repair happening. And mostly because we're just not equipped with the knowledge. And I think, you know, look, there's there's a time there's definitely a there's definitely appropriate times where you may need to just say goodbye to our relationship. Right. Like they're totally you might have put enormous amount of effort into a relationship, only to find out that when you needed someone, they weren't there. That is an understandable reason to recognize, okay, this was an imbalance relationship. This person doesn't actually have my back. It's okay to walk away. But in general, what we should be leaning into is how can we build more sturdy, foundational friendships in our lives because relationships are going to come and go. The reality is romantic relationships. 50% of them don't last through marriage. But what does last is are communities. So like fundamentally, your foundation should be ideally your family and your community. And if you don't have a family, then like a good solid social network is really important and it should be seen as important and it shouldn't be kind of like thrown to the wayside. I mean, I think there's I think romantic relationships get the most attention because they are the most primary of our existence. But I don't I don't I don't give enough credit to the value of just having a strong social network of in-person connections. Yes, in person for sure. And I think what's so interesting about what you're talking about now, like the rupture or the repair, there's so much polarity in life and in our bodies. So I want to just go back in time for a moment or not back in time. But, humans are unusual and that women often live decades after their reproductive years in evolutionary biologists propose we did this to ensure the survival of the next generation. And from what I understand, it's called the grandmother hypothesis. So what does that tell us about the role women have historically played in survival? And and this is where the polarity piece comes back in is modern longevity medicine supporting that biology or is it really modern life but also longevity medicine? Is it supporting our biology or fighting against it? Oh my gosh, this is so many questions. Let's start. Yes. The first is the grandmother hypothesis is essentially a theory that we evolve longer lifespans so that we could continue to care for the kin and ideally perpetuate the species. Right. So if a healthy family is multigenerational and is taking care of each other, this is something that we really could learn a lot from China and India. And like other other cultures in the world, like America, has somehow become a very individualistic culture where we're forgetting the value of that multi-generational connection. But it is very protective and protective for many reasons, and your children are more likely to take care of you, but you're also more likely to care for that stable psychological foundation that creates a level of safety and trust that that like, it's just really difficult to replicate outside of a family. So I really believe deeply in the role of women, in particular in maintaining the family bonds. I don't know if humans are patriarchal or matrilineal or egalitarian. It's unclear based on human history, but humans have in multiple cultures demonstrated different ways of relating in terms of sex differences. And right now we live in a fairly patriarchal world, but it hasn't always been the case. And I'm not here to, like, preach that. I think that there's one good way or another way. But I am here to say that women have had a variety of roles in human history in terms of how they relate to, society. And if you look at early human, you know, if you look at like, there's this places in, Mesopotamia where there's definitely evidence that there were major lineal societies that worshiped fertility and worshiped women and worshiped femininity at large and, worshiped female gods and goddesses, female goddesses. Like, it's not this isn't that. This is very old knowledge. If you look at the animal kingdom or as an elk or two of my favorite animals, because they're matrilineal and like the females, the oldest female is the leader of the pack. So there's a lot of evidence that, like female leadership can provide a very strong survival advantage. The fascinating thing about elk is that the female, the oldest female elk is one leading the pack. And the males, if there's a hunter that comes in the females will all surround the males to protect the men because they want to make sure that they can survive, their species can actually be passed on. So it's a really fascinating thing to think about, like why we have kind of undervalued the role of femininity and longevity. But it turns out that modern longevity science is actually leaning deeply into extending ovarian aging, reversing ovarian aging and extending the life of the ovaries. Because ovarian aging is one of the things that keeps us from living a long and healthy life as women, we actually have lower healthspan the men because we have this unfortunate ticking time bomb of our ovaries in our bodies. And it's basically like running out of time because we're running out of eggs. And that happens through our 40s, through the lovely experience of perimenopause. And what's that? Tell me more. No kidding. This is like a wonderful thing that happens to you as women that a lot of women aren't even aware about, which is that your hormones don't just slowly decline, they go through this massive up and down just really sinusoidal waves of really jagged up and down estrogen and both high and low estrogen cycles, which makes you feel like you're losing your mind and you don't feel like yourself and you feel like, you know, you are doing everything right when it comes to your lifestyle, but your body is just doing whatever it's it's doing things that you can't even see. So, God, we're living in an age where we have technology and we have lab testing. I am so grateful I started working the way I did when I did, because I've had like a little bit of a, advantage over the average human because I've been doing the quantified self work since 2014. So I started doing a lot of labs and a lot of wearable tech, early in my 30s. And so I was able to actually catch early low progesterone in my late 30s, way before I took it to the doctor, where I've caught it. But, you know, the first sign of perimenopause is typically a low progesterone phase deficiency, which does impair fertility, which is why you see a lot of women who are they try to get pregnant, use progesterone suppositories. But then there's also all the other hormones and the symphony of hormones that are changing. So it's really crucial to look at your cortisol, to look at your progesterone, your pregnant alone, your DHEA, your testosterone, your free testosterone, your sexual body globulin, pretty much everything that you guys can measure on most vibrant testing, especially your hormone panel. Just getting those those hormone panels and really knowing what's going on in your body. And then using companies like mirror for home testing in between. Because, like, you may not be able to do a vibrant test like every month. But I would say if you're really struggling with very like every quarter, just see what's going on and tune because things are changing and, there's really no better investment than in health. And we actually have more tools that any generation has ever had as women. So I actually think that we are way ahead of like we are, we're literally light years ahead of where our parents were because they didn't start you on hormone replacement therapy until you went through menopause. We're now learning that you actually need to start this much earlier. Well, we also had that black box for me, but I want to put a pin in this just for a minute, because I was thinking about what you said about the generations and families caring for each other, all living together. And I thought about attachment theory. And is there any data out there that would point to some of these? I don't know the right word for it, like insecure attachment. I guess the less desirable attachments were non-existent back then. Like do we have any clue? So what we know from all these work, which was the pioneer of attachment theory, is that essentially what he did was he studied orphans who had no touch early in their life and discovered that they were profoundly impaired as adults. They were severely impaired, right? They did not have the same capacity to bond. They did not have the same capacity to even interact as normal adults. And he wanted to understand why. So we started studying attachment, and then he started studying monkeys, and he started running experiments and started discovering that the early way that we we related to our parents, the way that they responded to us when we were in need, did definitively would shape how adults would relate. And an attachment can be impaired not just in early childhood. You can have a traumatic experience as a high as a teenager, and it can affect your attachment. I would say even in your early 20s, I think, I think any form of human trauma can disrupt attachment. I don't know if that's as well studied, but that's just what I've seen in the field, because there are plenty of people who have to wonderful parents and still have attachment dysfunction. And I think it does come from, any, any relationship that creates the conditions of humans are unsafe as a message that gets stuck in your head and that can come from trauma or sexual trauma. Losing a parent can be really, really traumatic. Especially if you lose, like early in life. So I think that there's a lot of things that can affect attachment, but I don't know if we have enough data on human attachment because it's a new it's such a new theory that it's it's not been around that long. And I don't think, we even have enough. I don't think we have enough records. Yeah. I wouldn't think so. But it just would make sense to me because we've lost that, like, tribal way of living and that community, especially in the US. Right? This really community focused way of living, so I want to come back to something we discussed just a few minutes ago before I got on air, about the idea of reproduction and how you are expanding that beyond the creation of another human being to things like art and company is and leaving a legacy. Tell us about that. Think that this whole drive to reproduce is very much based on, like this concept of fidelity, right? Like the fidelity of our of our genes, the fidelity of us as an imprint of a human that existed at a point in time in history. And I think this, this genetic, this desire to pass on genetics is one form of that concept of fidelity. But it's also it's really comes down to this, this fear of being fully forgotten. And I think a lot of people are realizing that, like, well, we have a lot of people on this earth, and not everybody wants to bring life into the earth, into this world, because it feels quite crazy for a lot of people, and they're overwhelmed. And frankly, the cost of bringing children into the world has gone up so high that a lot of parents just don't feel like they're financially capable. But there are people who produce things beyond children, things. There's people who produce works of art. There's people who produce and contribute to the building of important technologies and who build companies and who leave a legacy in different ways. Right. Like maybe they felt, maybe they like I mean, I was reading about a man who, restored forests, you know, and that's a way to leave a legacy. So, like, I think the concept of, of being able to make an impact on the world goes far beyond just producing children. And I think because life has become so much more than child rearing for so many people, the real thing that we're all searching for is meaning and purpose. Yes, that's what's underneath a lot of like, what is there, what is your reason for being? And I think even beyond the not wanting to be forgotten or having fidelity beyond this one existence, it's like we're all searching for truth and for for purpose and for having a meaningful existence in this one beautiful life that we're living, and that we get a lot of meaning from meaningful work. We get a lot of meaning from having a purpose. And this is something that also makes this all this technological change, particularly, dramatic right now because a lot of people are feeling the pressure of AI taking jobs. Right. And there's a big fear that if I take half the jobs, what are these? What are what are half, what's half the population going to do? And it's something that we really need to bring into the forefront of conversation. There's a new documentary coming out, on AI called how I Became an Optimist. It's going to hit theaters in like a month, and I really do encourage everyone listening to go see this documentary, because we need to have conversations about how technology is affecting our capacity as humans to remain human and to actually have that sense of humanity. And there's actually we at a very special moment where we can turn the tide of where things are going with AI in a positive direction. That's pro human. And that's not because right now what's really happening is there's like an anti-human drive to to produce more value without as many jobs. And actually there's a definitive way to create more jobs and create more value with humans involved. And I think that if we don't turn that tide, we will see a large number of diseases and diseases and deaths of despair. And that is something that is unfortunately already right, rising since the pandemic. And so we, we we need to this is about is is is a culture sooner than later I agree and I might be overly optimistic, but I do feel that while one yes, this is probably like the biggest change we've experienced more than the internet, more than the Industrial revolution. But there's a piece of me that really just and maybe it's daydreaming, but we've always figured it out. I do believe despite the loneliness, despite everything that's happening in the world, like we've always figured it out. And as you were talking about, I and we were talking about loneliness before, I was just thinking the first and foremost belonging that we need is to ourself. Right. And how do we create the relationship with ourself to then have a relationship with our kids, our husband or partner, our friends? And then when you think about and I'm, I'm kind of going back a little bit into that notion of reproduction, but and women in particular. Right. We tend to pour into the family. We're wanting to pour into our purpose for wanting to pour into our jobs. And a lot of us do it to the point of depletion, and then we are tired. And so you say you take the like the inherent tiredness. Plus what's happening in our body is at this time. And essentially it's like the perfect storm for hardest decade for women. Yeah, there's you're at the peak of your career, you are having kids. You or maybe you have kids that are in grade school. You have parents that are getting sick, and there's just a ton of pressure to maintain a healthy relationship on top of that. Right? So like for the women out there that are able to do all four of those things, congrats. I don't know how I, I actually don't know how so many women do it. Well, I, I think they have a tribe. They have that support. Yeah. Women in my practice and, one of the biggest challenges is letting them know that it's okay to slow down. It's okay to do less. It's okay to delegate more. It's okay not to do it all. Like there's so much opportunity to delegate that we don't delegate enough. And unfortunately, like, a lot of women feel like they have to do it all themselves. But, to kind of get back to the topic of health, I think the most important thing you can do as a woman is manage your health. Like you are not going to be a great partner, a great friend, a great mother, a great wife or a great businesswoman. If you do not have the foundation of your health and if I didn't have such intense health practices that maintained my capacity to work despite a lot of challenges that I've been faced with because of living in modern existence, having I got mercury poisoning from fish. I got cadmium poisoning from dark chocolate, I got mold poisoning from a from a washer. And the our environments are getting so poisonous that like, women think that like before you trip, before you blame anyone in your personal life for your problems, please go. Please go run a hormone zoomer. Please go write a gut zoomer. And just like, just run some labs because there is a if you have inflammation in the gut, you inflammation in the brain if you have a massive amount of toxic burden because, I mean, I remember I ran and told expert and after I'd been exposed to wildfire smoke and it was gnarly. I mean, the number of things that showed up, it was devastating. I was like, Holy crap. Because it wasn't just wildfires burning, it was farmland. I was inhaling glyphosate. I was inhaling all of these organic phosphates, but I wasn't eating. My food was pristine. So like, we are living in a very interesting time, but we have tools. We have, like I tell people all the time, like, what are you doing? Refinishing your powder room in your house, spending $100,000 on your powder room when your health you're like, you need to invest in your health, right? Like, not not to like to to like talk down to anyone who wants to do a huge renovation. But I do worry that, like there's a lot of women who are really doing well in business and they have ample funds to afford taking care of their health, but they're not doing it because like, oh, that's just expensive. And I'm like the most valuable thing that you can spend your money on is this body, because it's the only one you're going to get. And we're I mean, I'm just so grateful that we have so many tools now to be able to actually fix things and know what's wrong before other, because, like, there's a lot of women that like to start going through their 40s and they start having issues with their partners and their what's really going on is actually it's not their partner's changed, it's that their hormones are changing. And so I think, like before you go get a divorce, please just take a look at your hormones first because there's a lot that you can do physically to feel better before you have to make major life changes. Like I really tell a lot of a lot of women this like first look under the hood before you go do something dramatic in your life. Because there's just so much that we we're missing with regular labs. Most doctors are not looking at these things. No, they're not. And let's let's just give for the listeners. Let's give a couple practice practical tips and like where to start. So you said you have mitochondria is a big one. Yes. And I, I wrote a whole book on mitochondrial health for a reason because I was borderline pre-diabetic. After I went, I weighed myself out of all my early 30s because I had gone on a, during medical school and, and I was at it during residency and, I think it was a little misdiagnosed, to be entirely honest. I think I actually had I was just too sedentary in medical school. I just was studying too much. I wasn't, and I was losing muscle mass, and I wasn't maintaining a healthy blood sugar because I wasn't moving my body enough. So I think these stimulants really not necessary for me. I don't think I really had like maybe full blown ADHD, but I went off of those and my blood sugar had gone up because I was craving sugar, because I was because when you go off of, of of Adderall, you literally drop your dopamine levels pretty significantly. And so what do you do when you dropped off? I mean, you go and see, where do you get dope? Me from food. So I was eating a lot of I also went off gluten because I discovered I was celiac. So it's even though it's good free foods. And I was like, I was watching my blood sugar. Like I was asking about sugar, like right around 100, which is technically prediabetes. And I if I wasn't wearing a glucose monitor, and this is 2014. So I was way before the whole movement, I, I literally fixed my, my body and my blood sugar. And I started becoming obsessed with mitochondrial function because I realized if everyone took a look at their mitochondrial function, they would not have so many problems with other issues downstream. So. So one of the best ways to actually look at a control function is you're on a you're in organic acids and micronutrients because, well, like a way to see do you have this the substrates that are necessary to power your metabolism. Well so before we get into the test, let's talk about the mitochondrial function and specifically the Krebs cycle and then that relationship. And then we'll get into the testing when we eat food. And we breathe air, we burn oxygen to literally burn substrates into energy. We're literally like pulling apart molecules through digestion. We're like breaking things down, breaking things down. Break these down until we absorb substrates into our bloodstream, and that gets into our cells. And then our body, you know, basically powers this thing called the Krebs cycle, which is this thing that turns and literally helps us produce more substrates to power the electron transport chain. So the electron transport chain is what carries electrons that we generated through the TCA cycle. And essentially, electron transport chain powers an ATV turbine, which is essentially like a hydrogen turbine. And it makes the electrochemical gradient in the cell, which creates a capacitor, which is a charge differential between two plates and a battery, which is I literally like, charge differential between, between like a membrane. So battery is a capacitor. Basically you're running around with, with batteries, capacitors and all your cells, which if you studied physics at all, you've learned that like the one truth of existence is that if you understand physics, you understand life. So if you understand mitochondria, you can understand life because mitochondria are fundamentally operating from it, from from the essence of physics and biophysics. So if the citric acid cycle is thrown off because it's missing magnesium or it's got mercury that's throwing a wrench in it, so either you're not powering it or you're not allowing it to flow properly like the gears are stuck, then you're not going to be able to produce energy effectively. And so there's a lot of things that can throw off the TCA cycle. First and foremost is a block in the cycle from heavy metals or from toxins or from, lack of substrates like lack of B vitamins, lack of magnesium, or just eating the wrong foods. Like, you know, a lot of people are just eating really improper diets. And so they're creating a traffic jam before you can even get substrates into the mitochondria. There's a traffic jam to fat and carbs, and your cells are literally like, oh, crap, what do I even choose first to metabolize? Usually it chooses the carbs first, and then the fat backs up and unfortunately spills into your visceral cavity if you can't tell. So this is why overeating is so dangerous, and overeating high fat, high sugar foods is so problematic because there's only so much capacity that your mitochondria have to metabolize, and so it's going to metabolize what it can do effectively first. And whatever it can't metabolize leaks into your visceral cavity. It gets stored as fat. It gets stored. It literally has no choice but to get stored. Is this visceral fat or adipose happens when you start filling up your ectopic fat stores as you start filling up the peripheral fat stores. What's your, peripheral fat stores are filled in your in your, in musculoskeletal system, mostly your muscles. And then your glycogen stores are filled up and your muscles and your liver so that that starts versus glycogen. And then whatever's left over is in your, your personal fat stores, once those are all filled and then you keep overeating, that's when you have nowhere else to go but your visceral cavity. Okay. That's why there's a spillover effect. That's why insulin resistance causes visceral fat accumulation. So when I say I have an entire course dedicated to understanding resistance and all of this is in the course, it's free on my website. So if you want to learn about this, I go, you can download my course. But it's really took me a long time to actually see how this works, because I was trying to understand why do we become insulin resistant and why do we become feel the visceral fat? And it's literally the way that we metabolize food has limits. There's only so much that you can metabolize before your cells are saying, I gotta put the lock on the door. I gotta, I gotta like, really lock that door because there's no more room in the house for food. The other things that can cause insulin resistance are chronic stress. So it's like there's a lot of danger outside the house. You're gonna batten down the hatches, you're going to lock the doors. Right? So chronic stress is a huge driver based on resistance. Lack of movement is a big driver of insulin resistance levels. Don't know about that. Lack of macronutrients. Just not being able to to power the house because you don't have enough, you know, you don't have the things that can run the electricity. So there's a lot of things that cousins, the resistance that I talk about, that unfortunately, it hasn't really made it to the mainstream yet because everyone's really focused on nutrition. But you have to look at the big picture of what drives, this, this problem and this problem is really underneath all modern illness. Well, and I want to go back to what you said about nutrients and nutrition, too, because I have learned recently that there are it's like nutrients in your blood and then nutrients inside the cell, and they're not the same. No, because you have to be able to absorb them. And a lot of people have problems with absorption. I cannot tell you the number of people I deal with on a daily basis who have like you guys, it is. So it's almost all my clients who come and see me. Almost everybody has high level goals. It's wild and I'm like, what is going on? And I think it's just honestly the amount of stress that we're all under. And I think that the modern food that we're eating in America is so, problematic in so many ways that even if you try to be healthy, people are eating out all the time. And when you eat out, you're exposed. If, let's say you take something home, the food packaging is filled with toxins. The there's so many, seed oils that have been fried over and over again that become rancid. That's really where the problems with you all this comes in is the processing. And it really is just like the food that we're consuming is so problematic for gut health that it throws off the balance. And before you know it, people have like you got. And so like you got means that you have inflammation in the body and inflammation of the body means inflammation in the brain. And, I do see a lot of stress related that issues. So stress can affect digestion. It definitively has a role in digestion because the vagus nerve plays a major role in parasympathetic balance. So the vagus nerve is not able to turn on effectively and give you the rest of digest function. You're never going to fully digest, and then you're not going to release enough enzymes, which you can you can see all this on the house, like if you do a godsend where you can see as a person need more digestive enzymes, do they need more to support bile, fat metabolism? Which probiotic should they be taking? You can see a lot of this stuff when you test you can see are they hide inflammation. And thank God for the peptide movement because, my gosh, peptides are very effective at fixing gut health. Well, I want to for the woman who doesn't know where to start or when someone comes into your clinic and they're just complaining about all these, you know, symptoms, whether it's God or brain fog, like where does someone start? Because we do have so many tools and that too can be overwhelming or a source of stress. I would say it depends. It depends on your age and like what you're really dealing with. Let's let's like walk through the decades. Everyone, everyone needs to do a social setting. Like most mainstream doctors do not know how to interpret this. You do need a good functional doctor. It's really important not to go heavy duty on antimicrobials too quickly, because I have seen people, even on the natural antimicrobials, like if you're not careful, those can really wipe out the good bacteria. So you should be very careful with too many antimicrobials. But there's a lot that you can do to rebalance the gut from just nutrition and from lifestyle and supplements. So I would say gut health is primary because everything is I mean, if your gut isn't functioning properly, it's really hard to feel good. So I always start with the gut on everybody. And then I would say hormones is a big piece as well. Because hormone dysfunction is rampant in both the young and fertile and the preventive puzzle and the menopausal woman. There's just so much you can to support. But I would say if you do have common dysfunction, you really should know if you have a toxic burden. Because before you go, I just like cover up the symptoms with with replacement. Please look at what could be driving the hormonal dysfunction, because you might actually need to detox more than you need to replace, or more that you know more than need. You need to take a bunch of support supplements for the hormone imbalance. So it's kind of like those three things are really crucial. I think, you know, you, me and I talked about this on her podcast, but, you know, if you I would also say that like blood sugar is crucial for everybody. So like it's very easy to get a estilo, over the counter now, like when I was first practicing with blood sugar monitors in 2014, I was like a crazy person. At the time. People thought I was nuts. But nobody was healthy. I mean, everybody was having blood sugar issues. I'm like, wait, wait, wait, am I catching something? Am I catching some sort of epidemic that we're not even seeing? And it was actually validated by the CDC data, like somewhere around 88% of the countries dealing with metabolic health issues. If that's the case, and almost everybody should be putting a CGM on. And I went on right now if I don't use a CGM on a consistent basis, like I fall off the wagon, I'll start being like, oh, it's okay if I just have that one sugary drink, but that one sugary drink is causing like, real havoc on my blood vessels. And if you want to protect your vessels and your cell membranes, like the first thing you got to do is look at what you're eating and your CGM and you can't hide from what's going on. So you are you're so. I have not tried one yet. And I was thinking, okay, I'm gonna get one for a couple months, I'll know what's happening and then I'll be good. If they see that they're pretty healthy and like, you are very lean in your, you know, your great skin and you just probably are healthier than the average human. But if you like a sweet tooth, you have a real problem with sugar. You might actually need to use it for a lot longer than that, because it might take you a year to fully wean off your sugar, okay, and get metabolically flexible. But it sounds like it's really good for accountability and information. Okay, I would say I like to use my quarterly, but like I right now I'm using it probably two weeks in every month. Okay. But I also notice if I, you know, the the beauty of your CGM is you can see how it changes in your cycle. So during my little phase I have way higher blood sugars. During my follicular phase I we lower blood sugars. So I'm not seeing like it's very obvious that I need to be way more careful during my luteal phase, which is what I crave sugar more. So it's like, okay, it's helps me stay accountable and not fall off the wagon when I know I'm going to be like wanting more treats. And that's when I go and make healthy, healthy options for myself. Like I'll have like, you know, I'll take a date and I'll stop it with a nut butter and dark chocolate and have to have those in my fridge if I need a sweet something sweet, which I know is not for this, might me. Well, that sounds delicious. And yesterday I had a gluten free cranberry oatmeal cookie and it was amazing. Okay, look, I'm not I actually am not the kind of doctor who's like, so, obsessed with perfection that, like, I don't get myself treats. I definitely believe in being a human being and enjoying life, and I love dessert. But I also know that, like, it really is dependent on where you are at in your health journey. If you are dealing the more you're dealing with physiologically, the more you have to be more careful. I have celiac, I am way, way set up for more issues than the average person because of my ability for someone with autoimmunity has to be way more careful with their blood sugar than the average person. But everyone has to protect their heart, and we know that there is a relationship between blood sugar and heart health, and women are way more likely to end up with heart disease than we realize. And so, like, I got a test back called MDMA and it was borderline. It was like I was like I scored 100, which is right above normal. And it was like a reminder that, like, I got to really care for my blood vessels and how do you care for blood vessels? You try to reduce as much oxidative stress. You try to make sure your blood sugar is balanced. You try to avoid stress as much as you can. you know, there's a lot of insults on our bodies and taking care of our physical, physiological health. The foundation of it is our lifestyle. And that's why I like this. Huge. Because it shows you how your sleep, how your movement, how your environment, how your food, and how your relationships all affect your health. Because you can see it, you can see how stress affects your blood sugar. Do you know what's wild? My best friend, was super upset about her agency. It was like one under pre-diabetic. So she started wearing a CGM and she was like, I'm monitoring it and it's fine. Not saying her name, obviously her parents came to visit and it spiked her blood sugar. And so she called me and she was just like, okay, it's not what I'm eating. Because she went really went off the deep end about it. And it was stress from that do have perfect diet, I would say as perfect as you can get because they have chefs and I know what they're eating. I don't have to get them to stop eating oatmeal. But like, people don't realize that oatmeal is actually challenging for a lot of people's health. It works for some people. It doesn't work for everybody. You won't know what works for you until you put a CGM on, but I more than more often than not, I see stress being one of the biggest drivers of blood sugar dysregulation in my clients, and it's not their diet. It is definitively what they're doing outside of their meals. And it's it's the high powered people. You know, they're really busy. And, I can see if a person has high profile on their blood sugar and I can see that low, for example, butter, because I can see because your cortisol is a glucocorticoid. So if your blood sugar is chronically low, despite you eating whatever you want, like you have and you're feeling like crap, that's might that might be a signal that you need to get your hormones time because you might actually have low cortisol. That's overlooked a lot. Also, really importantly, you cannot overlook just regular blood vessels. So hemoglobin I was see is not perfectly accurate. So if someone's anemic it's going to be surreptitiously low. If they have high hemoglobin it's going to be sufficiently high. So things that can drive hemoglobin in one see I don't really take it as like an all be all test. It's a decent tool. I really like fasting insulin a lot more, because fasting insulin is going to really tell me how well your body is like adapted to your diet. So I see a, I see a CGM that looks pretty darn good, but the other insulin is like 15 and it's like, okay, your body's doing a really good job at increasing your insulin to maintain the blood sugar, but that doesn't mean that you're you're healthy. So that's like the kind of person I would see with like a borderline pre-diabetic, you know, going to I see normal looking CGM and then I see their insulin type and it's like the but it's an early sign that they're starting to move in the direction of insulin resistance. Okay. As a doctor, how do you distinguish the difference between early signs and compensation in the body, or are they one in the same? That's that's the thing that I try to explain in the course that I teach in the book that I've written, The Spa Factor and that's that. What is challenging about aging is we are stressed. We start losing our, our capacity to adapt and self-manage in the face of adversity. That is the definition of health. So we start with what does it mean to lose health? It means that you lose the ability to maintain stability with change. So the environment be like stress is like it is an insulin that can affect our ability to to basically maintain this is counter regulatory responses. So like blood pressure is a counter regulatory response. Heart rate is kind of a regulated response. Blood sugar is a kind of regulatory response. These are regulatory responses that are designed to help you adapt to demands. As we get older we get stiffer, our heart rate starts to rise. Unless we are fit, and then our HIV starts to drop because that's a reflection of our fitness or our fitness. And then our blood sugar starts to rise. And these are, these are just that, that drifting towards hypertension, that drifting towards, pre-diabetes. That is that's the thing that you wanted to keep tabs on because you that in that state of drifting towards those disease states or pre disease states, you can reverse almost anything in those states. That's why I'm so passionate about this topic because I'm like, if everybody knew that you could catch the stuff early and reverse it, we wouldn't have to end up with all these chronic illnesses. Like, it's really like I, I've actually reversed multiple autoimmune conditions that popped up after I got the Covid vaccine. Like I was able to reverse them like, on paper, they're gone. And that's the thing about autoimmunity as well, that people don't realize is that if you catch autoimmunity early enough, you can reverse it. There's different stages of auto immunity. There's first stages, just blood markers. I've got a friend who's a hatmaker. She's like, oh my God, Molly, I literally just tested positive for RNA and rheumatoid factor. And I'm like, give me symptoms. She's like, no, I'm like, awesome. You're in the earliest stages. We can reverse this next stage. You start having symptoms end stage and organ damage. So you want to move away from this idea that like, oh yeah, I'll deal with diabetes once I'm diabetic. That's how our health care system actually reimburses things. If you are in in the end stage of a disease, you were actually sick and you're actually diabetic, you're actually hypertensive, you're actually had a stroke. She's actually had a heart attack actually showing signs of dementia. That is too late. It is so much more difficult to fundamentally reverse a full blown illness once you've developed it. And that is how our health care system is designed to treat people once they are ultra sick and once they're showing all these disease states. The thing about the longevity movement is that the entire point of the longevity movement is to not get to this place in the first place. This is why there's an entire market for longevity medicine. This is why there's a market for healthspan extension. This is why there's a market for personalized precision medicine. Because it is actually easier to prevent than it is to treat. Now, the real question we're going to find out in the next two decades is whether or not these longevity interventions we're doing have actually worked, because we can try to tailor treatments to lengths. But at the end of the day, there's a lot of overtreatment happening in longevity medicine. There's a lot of people overdoing the peptides. There's a lot of young people that are that have no business using updates because they're perfectly healthy on paper and fortunately, there's this like, I think that we are actually we may be doing young people a disservice by having them believe that. Like if they start doing a lot of these heavy duty interventions when they're young, that they are somehow going to end up healthier when they're old. So I think that there's a really big question, like when it comes to growth hormone peptides, like, I just want I always want to bring back some real science. Like the super centenarians have low growth hormone levels. The people that live the longest are not high growth hormone people. So I'm not convinced that taking a bunch of growth hormone peptides is going to give you longevity. I think it's going to give you better health span because you're going to feel better. But I'm not. I would never sell a person that a growth hormone peptide is going to give them a longer life, because there's no evidence for that. And I would say the same thing about super physiologic, just the hormones that bodybuilders take. Like there's no evidence that bodybuilding to a level of such incredible bulk is going to give you a longer life. Now, maybe they feel like they have awesome quality of life while they're young, but that's not for long. So the thing that we need to really always be asking ourselves is what is actually the intention behind this treatment? Is this actually give me more years or give me more life to my year? Well, and I think that's where we have to be very careful with our words. Right? There's healthspan and there's longevity, and it already feels like the current state for the average American is very far from Healthspan. And then beyond Healthspan, we have longevity and some of these edge practices, and it's great because they bring attention to it. There's a lot of development, both treatments and devices in that area. But this is where I think for like the average American or someone who's just putting their toe in like the functional or healthspan space or someone who's like, actually, I am so sick and tired of not feeling well, which is most women. I think this is where we have to start shaping the conversation and setting expectations and explaining the difference between these words, because right now is just getting lumped into one. And that's why, like when we were talking a few minutes ago, I was like, where does she start? Is it her sleep? Is it her hormones? Is it just that the blood panel, is it? And that's that. In my biohacking journey, when I first started all of this over a decade ago, is like in my early 30s, I just started my practice. And I remember thinking to myself, I have got to get my sleep under control. Like, this is so personal. I know that I need to be safe. You better started studying sleep, and I really, I'd already started with a sleep doctor in medical school, so I knew a lot more about sleep and the average doctor. But I was like, I need to really get this circadian rhythm thing down. And so this was like way before people were talking about light and dark cycles, and I was living in a really dim, like a loft. It was a huge space, but it was really dim. I didn't have a lot of light. I had a light. Well. And so I remember wearing a wearable that measured my UV exposure, and it was like showing me that, like I was not getting enough light during the day. So I used to go on the roof of my building every morning to get sunlight, and I was giving myself, like, doses of sunlight. And and before I knew it, I was like, you know what? I probably should just move to a place that has light because, like, what am I doing in a place that's so dim? But getting your light dark cycles and your sleep wake cycles sync to what is natural for your body and for the environment is a very low hanging fruit that anybody can work on. It just requires some discipline. Like it requires not staring at your phone at night. And honestly, going camping for a week in nature is the best way to reset your circadian rhythms. You will naturally you know, harmonize to your environment and you'll natural harmonize to nature. And we all often forget that we are nature or part of nature. But if we're, living in modern lives with so much blue light in our days and watching TV late at night, like we're not wearing a blue blockers and they're not, you know, blocking the blue light on their phones or their computers, and they're just getting inundated with so much light. And so they're not getting that melatonin production. It's not giving the proper circadian rhythm. And I'd say, like if you're not sleeping well, do everything in your power to figure out that and also get tested. Yeah. My friend has this company called M.D. bio, and they have a home sleep test. Since they got that test. First, first thing you can do if you get diagnosed early, you can get an oral retainer. There's surgeries you can do. I have multiple friends of them. Oral surgery folks? Yeah. A lot of people that orthodontics have said as adults, and they don't even know that their mouths or the airways are impaired. And there's also CPAp, which not a lot would want to do, but it's definitely a possibility. So just getting airway, your airway fixed and, you know, your mouth taping is a cheap way to do it. Checking your nasal, you know, getting your getting an the appointment and looking if you have problems in nasal breathing, like making sure you have proper airways through your nose, like your nose is crucial for having a healthy nervous system and healthy, healthy sleep. So like that entire world of sleeping and breathing, that's like health 101 that is ignored by so many people and most dentists aren't even properly trained in airways. And so I would say like airway and sleep and circadian rhythms is so foundational, Well, just to wrap up, we've talked about a lot. We've talked insulin, we've talked hormones, we've talked tox the foundations. For me, I'm thinking personally after this conversation, really get my sleep under control, get a CGM and I'm going to say go to lunch with a friend, get into nature. And, just back to basics. Yeah, absolutely. And also, don't forget that, like when you when you invest in testing in your body, you're actually investing in your longevity. Like what the best thing you can do is actually have real knowledge about what is going on inside your physiology. Before you go make a ton of lifestyle changes. I think a lot of people are flying blind, and it's like getting taking your car in to get fixed, but only getting it detailed. It's like you're really just focusing on the outside, but what's on the inside is really what changes everything on the outside. So that's that's something I would say to all the women out there. Doctor Malik, thank you so much. I greatly appreciate this time together, and I'm sure all of our vibrant wellness listeners will as well. Awesome. Thanks.