The Future of Longevity Medicine Starts with Prevention | Christa Elza, NP

What actually creates long-term health?

In this episode, Christa Elza, NP joins us to discuss the future of functional medicine, preventative healthcare, longevity, cardiovascular prevention, metabolic health, GLP-1s, genetics and why personalized medicine is changing the way practitioners approach disease.

Christa shares her own journey from emergency medicine into functional medicine, why root-cause healthcare matters and how early testing, lifestyle interventions, genomics and preventative strategies can dramatically improve healthspan.

We also discuss:

• The foundations of longevity medicine
• Why prevention matters more than treatment
• Functional medicine vs conventional care
• The truth about GLP-1 medications
• Cardiovascular disease prevention
• Genetics & personalized healthcare
• Stress, nervous system regulation & chronic disease
• How practitioners can better support patients
• The importance of muscle, movement & metabolic health
• Healthspan vs lifespan

🔗 Dr. Alex Carrasco, MD

https://nourishmedicine.com/

https://www.instagram.com/dralexcarrasco/

🔗 Christa Elza, NP

https://elive-health.com/teams/christa-elza/

https://www.instagram.com/christaelza/

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Transcript

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people want a quick fix. And these are just cherries on top, like you can't out peptide and you can't out supplement a poor lifestyle if you're just sitting all day at your desk, it's that you can't. I mean, that's just not going to work. If you're eating terrible, you're drinking way too much alcohol. I mean, there's just it is the unsexy foundations is what I call them, and it's sexy, but they are so powerful. I think the most powerful. hi Krista, thank you so much and thank you for having me. I'm excited to be here. Really wonderful for you to be here with us in the studio. And let's kind of get into it. I would love to hear about how you got to where you are, because I feel that most of us in functional medicine and longevity medicine have a story. Yes, that's what makes us figure out what works. Yeah. Typically teach people and help people in the same way. Yeah. Let's hear you. So I knew from itty-bitty that I wanted to be in medicine. Like, I just never had a doubt in my mind what I wanted to do. I ended up becoming an RN, and I went directly into emergency medicine. And I really loved emergency medicine. Because you find a problem, you figure out how to solve it and then you treat them right. So I would never imagine like that I would be here. Never in a million years that I would be like in a clinic where there's not trauma going on. But when I went back to school, I became a nurse practitioner with family practice. I realized this. You don't have enough time to really solve the problems. And, you know, I find it fascinating to understand the human body, what drives disease. And I think working in the E.R., you see the end result of disease oftentimes. And where did that start? And so my mind really wanted to understand why why, why. And so when I realized that there was something called functional medicine that I could get trained in, I started training in that way. And it just opened up a whole world of understanding. Yeah. I feel like when I, I remember when I went to the very first the coursework, I felt like the ceiling shattered and I was like, oh my gosh, a bit of this bubble. And now I can really understand all these different connections in a way that, you know, they never actually do. At least in medical school. I mean, I just find it so much more interesting to understand the why disease begins, how to really solve a problem instead of masking it. And I think it also gives you a deep appreciation for how magnificent the human body really is. It's miraculous. It's so wild, I love it. It just keeps me so stimulated, you know, mentally to dig into these concepts and I think it's a really cool space that we're in right now where we're just the it's just building on itself what we get to learn. And it's really cool. Yeah. I think that the kind of the world of integrative functional medicine has changed so much in the last 15 years, and I love where we are because it's becoming common knowledge. People are engaged and interested in it. And then with the advent of AI and just how fast science is moving, we're seeing a lot of that translational gap. I think change in a way where before, you know, if you like, I think still in standardized care, maybe it'll be, you know, 20 years until something is discovered in the scientific literature and then it's actually implemented into a standardized practice. But I think the gap is closing, and I think people are so increasingly engaged. I, I agree, I it's sometimes it's hard for me to say, okay, is this just my algorithm that all of these, all of these things are coming up and everyone's talking about it? But I do think in general people want more. And I think especially with the way the government has shifted in terms of like health talks over the past couple of years, people are definitely more aware. People definitely want more. They want more than what they they anticipate. They want to work with somebody who wants to dig deeper now. Well, and to your point, yesterday came out that person health is now being accepted by insurers in this country. I saw that and I actually, I think it was James Maskell that posted it and I, I messaged actually, I was like, okay, so how is insurance actually covering the amount of time that we spent? I'm really curious because I would love to offer that. I think what keeps me from I am a cash pay practice, and what keeps me from offering insurance really is just that. I want to be able to spend more time with my patients. I want to see 5 or 6 a day. I don't want to see 20. It's hard when you're in that compressed model. Yeah, I think that the public wants more, which is exciting. Payers are looking at it, the model now. Yeah. It will ever fully shake out because I do think it is a time. It is a model where you do really have to spend a lot of time and I don't know. Yeah. It's tricky because it's not procedure based you know. Right. It's just sitting with someone learning about their history, their story and then connecting the dots. I would love to see how it works, because if they've figured out a way, I'm on board. I mean, I'm not anti insurance paying for people. It's just I'm anti the restrictions that it kind of puts on us. So yeah. So where are you now in your journey. So you have a practice. Tell us about that and tell us what you're interested in us. And I think that you kind of sit at the forefront of longevity. Optimizing health and health span. So tell us a little bit about all those things. Yeah. So I launched out on my own 2019 I did work at a clinic where it was primarily focused on hormone replacement, but it really was kind of based on quick fixes. Still. And so once I started educating myself more, I decided to launch out on my own. Initially, I only did virtual and then I decided I really like being in person with people. And so I still offer virtual, but I have a home base in New Braunfels, Texas, which is close to Austin. And, started that about two and a half years ago in a brick and mortar. And so my focus is to look at thorough lab work. I always say your primary care is going to look at about five pieces to a 20 piece puzzle. So let's get all the pieces out, put those together and really look at what's going on. And then do a really deep family history, personal medical history, spend time with them, really go over foundations. My focus is on preventative care, which again, I think my old self would have thought how boring I want to see things actually happen. But it's really fascinating to look at preventative care because you have to understand the pathophysiology of why something happens and how to put pieces together early enough, and then spend enough time to create trust with your patient in front of you that they'll take to heart what you're saying. Because I think prevention is hard sometimes for people to take seriously. Because if you don't currently have a pain point, what's the motivation? So a lot of it is creating that trust and that communication with someone and saying, okay, you came in to me, you came to me because you want to peptide. Let me tell you what's actually driving this first before we put the cherry on top. Yeah. So I am really passionate about cardiovascular prevention because we are so much you know personally my dad has a lot of heavy plaque burden and you know his lifestyle for years with being an airline pilot, being more sedentary. Circadian rhythm is being off. You're eating out a lot. You know, I see that and I can rewind and say, gosh, if you only knew in your 30s, then we wouldn't be doing so much now. We could have prevented some of the fear and some of the procedures that might have to happen now. So I'm really passionate about that, partly because I think there's just a huge gap in educating people. I know for myself, I wasn't looking at this a decade ago. Yeah, I think that it was very, very, very kind of cutting edge, like very, very small amount of doctors looking at, you know. It wasn't the conversation. Right? Right. That's exciting. It is exciting. And I think it's really interesting. It's it's interesting to see the different conversation around the guidelines and how some people stand on the soapbox of, oh, this is just completely pharmaceutically driven and I hear you. But also there is so much data, there's so much black and white and cardiovascular research that to me, it's a no brainer. Yes, they're finally catching up to the standards that I hold for my patients now. And so I see it completely as a good thing. And and I think in terms of pharmaceuticals, I very much am integrative. I think it's very, you know, again, some people stand on the anti statin soapbox and all of that. And I just look at it as like, that's a really dangerous voice to be spreading because it's not true for everyone. And there's a time and place there absolutely is. To your point, I feel like I, I live in a bridge between two worlds. Yeah, medical worlds, kind of the holistic world. And I always feel like we use all the tools because everyone's different. There isn't an emotional, like, you know, component to whether you take the medicine or you take an herb. It's like what works for the patient works for their life. It's going to increase their quality of life and improve their health span. Absolutely. I think another thing that I have integrated is when the patient is willing to do this is looking at DNA, I love it, it gives us so much information. Because looking at genomics is the game changer. It's like a one time blueprint that you can use for the rest of your life. Yeah, I love it. And I think it really helps the patient understand why we need to be more aggressive, or we can let things slide, or it gives kind of context to how aggressive we need to be. And do we need a pharmaceutical or do we not. It really kind of plays a role in that. And so I love it. I think when patients are willing to pay and do it, I'm like, yes, this is going to give us so much more information and we'll see. Like, you know, I like to cast a really broad net initially so that I can throw things in and things out. And that doesn't mean that every time you get tested, you've got a passenger, right? Net. But it does allow us to understand, you know, what we're looking at as far as, you know, obviously serum markers, but then also specialty testing, looking at genetics, looking at, you know, toxins, looking at gut health with all of that helps really understand the full picture of the patient. Yeah. If you have that information that you can, you know, really robust treatment plan and also just a prevention plan and see where, you know, where are the challenges within that patient's, story and history. Yeah. Yeah, I love it. More data is great. And I think yeah. Just really taking a personalized approach because what might be right for one person isn't necessary for the next. And I think, you know, you can look at two people with the same set of labs, and one has a really poor lifestyle. And that's why. And so we have a whole other conversation, and then we have another person with a really great lifestyle, but they've got some genetics, family history, etc. that is creating more of an issue. We need more support, with pharmaceuticals or more aggressive supplement support. Just kind of depends. Right. So yeah, right. Pivot I'm also huge on early screenings. Early testing. I think, you know, maybe I'll just dive in now to my own personal story, but, I consider myself a pretty healthy person. I eat pretty well, I exercise every day. Sleep really well. You know, I just consider myself following. I practice what I preach, and, my mom had been diagnosed with breast cancer at age in her 50s, ductal cancer. And she was able to catch it really early. For years I had, you know, dense breast tissue. I always had to come back for the diagnostic. All the things some women can completely relate to that. And I just really had an internal feeling that I just wanted to stay on top of it. And, you know, again, going back to some people are very anti mammograms and anti those things. And I will say that we need to take advantage sometimes of like modern technology. And I was able to catch my own ductal cancer early last March. So about a year ago and it was through mammography. You can't pick up on early breast cancer with an ultrasound. It's just the technology's different. I don't think people quite understand that, mammography can pick up on calcifications much earlier, and it just gave me many more options. And so, you know, going through that myself, it it helped me to iterate to my patients that like, don't be afraid of all of the things I mean, when we have an earlier notification of something, we have so many more options than if you wait. Yeah. And like I said, with my dad and cardiovascular disease, when you wait, I mean, you have a much bigger plaque build up and you don't have as many options as when you are early on and you detect something. So same with things like breast cancer. It was a big wakeup call to me, I think to to that I also when you get diagnosed with something like that, they run DNA and I saw that I did have a DNA marker. That put me at higher risk. So not brackets called check to put you at 40% chance versus bracket. And I had my sister check. And she also is positive for that gene. So it it kind of really solidified for me the power of genetics as well. Yeah. I think that's something that we can often overlook. And I think it's, you know, as far as, like things like scans and people, I think it's a double edged sword absolutely can save lives. I've seen it happen and seen people find, you know, stage one lesions and, you know, have a little amazing story, amazing success story. But again, then there's incidental findings. And that can be really scary. And then you have to go down those rabbit holes to. So you know it's like I agree, it's largely I agree. I think it is a double edged sword. I think that people can kind of fall into two buckets. They want to be really aggressive about looking at everything early. And then there's some people that they don't want to do anything. They don't want to know anything. They don't want to look at genes. They don't want to look at mammogram. They don't want to look at anything. And so I, I think but I think we just need to be educated on. Yeah. But if you find something early again, you have so many more options than if you wait. I don't know. I've thought about that too. I thought it would be so cool to like to have the whole MRI. But then you do. You have to. We can have incidental findings that lead to more testing that you may or may not actually need. Yeah. I think there's elements to also to just trusting in your body, trusting in your life and your life's purpose and being smart about it, being smart about lab values, being smart about being in tune with your body, but then also just trusting that you're you're okay. Your body body's okay in this moment and not live in fear, is what I'm saying. Because I think that that that is the other kind of side of it. That's the ugly side that people come from very obsessed almost about their health and they can take over. It's like, well it depends what you believe. But I believe that, I believe that that has it all figured out. Yeah. And the power of the mind honestly and like trusting that God has a purpose for your life and that your body can heal. When I think about you know with my diagnosis I opted to do a double mastectomy with reconstruction. It was a big thing right. And I think going into something like that, it's I can do this. I can get through this. My body. I mean, you if you've ever been pregnant, you know, it's just fascinating that you're the human body just knows how to to create. It's amazing. And so if our body can do that, our body knows how to heal. And so I think trusting in that really does help things along. Because your belief system about your body plays a huge role. And I think there's definitely been studies out about people do better with chronic disease, with a cancer diagnosis, with healing, what have you, based on how they feel and what they believe about their body? Yeah, I think optimism, you know, is very good for your health. For sure. It plays a role. Yeah. I remember when, when I had my first child, I had and I had to deliver early, and then I had a mom afterwards, so this is great. But then the reaction, you know, really, really kind of. Yeah. And I remember being pregnant with my second child and being really terrified about the birth as it was because I was leading up to maybe, maybe seconds. I was diagnosed with my daughter. And I just remember this moment where I thought, you know what? I was, I need to say thank you to my body like you did the best. with what it had and I was under stress, I was a resident. My diet was garbage. You know, there was also familial predisposition. My mother also had preclampsia. Yeah. And so I think in that moment I realized, you know what our bodies were adaptable. They're amazing. And this is this pregnancy I have done better. I have said it better. My stress is different and better. And, you know, I was like, I do this for for kids. But to your point, the body is not static and adaptable organism. It is in of the system and we can manipulate it and support it through many different inputs. Right. And going back to genetics, to you know, when I go through genetics, I'll tell my patients, these are the foundational supplements that you need because for whatever reason you need this, this and this and probably your whole life is, is how we're going to support the system. The other things that we're doing right now are temporary. It's just where you are. And, you know, combining bloodwork and DNA kind of shows those two worlds like this is who you were from beginning and how we support it. But then the body's so dynamic we can heal something we can. We don't always need to be in this one spot. And I think it's really cool that in one pregnancy, you had an issue. You shift your belief around it, you came in with different lifestyle. You you worked with your body a bit better, let's say, and had better outcomes. I mean, it's yeah, it's great. And I think people missed out on that opportunity somewhat with Covid, the fear, the mistrust in in your body and, yeah, I think you kind of had to go into that with I trust the resilience of my body. Right. And I think also Covid and let's say my breast cancer diagnosis taught me it's so important to manage your lifestyle. It's so important to focus on having a healthy body because you never know what you might be faced with, whether it's a car accident or a surgery. Yeah, right. Very fun. It's not what I just have to do. The same old, same thing over and out. And then some people might say boring. But at this point I love working out. Yeah, I put on my favorite, peloton instructor or a really great playlist and get to it. But you're right. I mean, necessarily it's not, you know, like in this world, we're always like scrolling or looking for the next piece of content or the next thing that is engaging with basic lifestyle, you know, care for our bodies is it's not that this is where doesn't necessarily give you the big dopamine, right? This is where I think the bucket of peptides and marketing for supplements come in. I use both. Yeah, I use both with my patients all the time. But I think there's a danger in that because people want a quick fix. And these are just cherries on top, like you can't out peptide and you can't out supplement a poor lifestyle if you're just sitting all day at your desk, it's that you can't. I mean, that's just not going to work. If you're eating terrible, you're drinking way too much alcohol. I mean, there's just it is the unsexy foundations is what I call them, and it's sexy, but they are so powerful. I think the most powerful. Yeah. How much are you? You know, I think if I can leave one piece of advice for everyone, it's move your body 30 minutes every single day. And I tell my busy people will do 15 minutes in the morning and 15 minutes after work. I mean, walk two times because you're sitting the rest of the day. There's a trend right now, and in it it's like, no, no, Maxine, or like grandma, like Maxine. You know, what is grandma it instead of, instead of a hot girl. Summer. Yeah. Like grandma, like a summer. Because, you know. No, no. As well as. Yeah, you know, there are these things that they do that are so foundational for health. So it's like, you know, some of you have time with community, you garden and you knit. all the things, you know, cook nourishing food and you live a slow life. And I think foundationally those are a lot of the things that yeah that is actually true. And I think even as a provider you have to remind yourself of like wait, you don't always have to be on you know and I'm very consistent with exercise. But you also need downtime. You need rest and simple things that I tell my real high achievers, the ones that are like, I don't know, I'm tired all the time. What peptide do I need? What? And I'm like, you know what you need to do? You need to breathe more during the day. And by that I mean breathe for kind of four n hold it for a second and breathe for an eight count out. And you just remind your brain that you are safe throughout the day because you're just running, running, running. And that just has a downstream effect in terms of hormones and cortisol and and why you feel the way that you feel. Yeah, that sympathetic overload is really, really hard. I think I've told this story before, but I remember I spoke with someone who was a terrific high powered lawyer, like in the 90s, and just kind of thinking back on his career. And I said, well, is it worse now? And this is maybe in 2015? And or was it worse then, you know, there's a scene where he's like, well, you know, it's always been a lot of work to be an attorney, and there's a lot of pressure, right? Especially for a litigator. But in the 90s, you had a fax, everything over. And so you would, you know, send information via an email and so then you have to wait for like an hour or two to get a response, like now with email and internet, everything is, oh yeah, all the time. And so then you turn these things around, you don't get that downtime right. And then you're getting constant information all the time. You know, it's like you're always on, you're always on there, always feeling like you have to respond. Yeah, absolutely. Social media pressures. I mean, there's always something. Yeah, there's a lot we could not sleep at all and have things that we should or could be doing. I tell my husband I wish it was 30 hour days. I could sleep eight hours and then work it out and just like, chill or do some things for the other hours, right? Yeah, it would probably that we would, I think, finding the balance is hard for some people. But when you look at the way they feel, you look at lab values, the solutions, sometimes it's not what people want to hear. But also once you kind of get in the routine, I think changing habits is the hardest part. And then once it become a habit, my routine right now and it changes like when, when am I getting my workouts in? I'm just not an early morning worker outer. I don't like it. Everything feels harder for me. I'm the kind of person that says I would rather get more sleep. Yes, make myself wake up, you know, for my kids, right? The extent of what I'll do before I get to the office is maybe go outside and walk for a mile. Okay, so it's about 15 minutes. Let's say it's not even a it's not even a run. It's a it's a brisk walk. But so that leaves after work. And so a lot of times my workouts are around five and I would say half and half. I really don't feel like it, but because it's such a routine now, I just do it. And once I'm in it, it's fine. So part of it's just changing the habits and getting in a routine and then some of the stuff that you don't love, you do anyway because it's just part of your day, it's part of what you do. And, you know, I mean, it's it's I think first is the awareness because some people are completely unaware of the, the extent of the impact of not drinking enough water all day, you know, six hours a night of sleep. So awareness and then some guidance and accountability and then eventually it just kind of becomes who you are. And it's just not right. It can feel overwhelming the first time. It can feel overwhelming. I mean, there's still things I, I recently just hired a trainer because yes, I know I need to be lifting weights, I know that, but I would squeeze in maybe 20 minutes. And now I'm like, let me pay you to make me do it for an hour. And it's just setting myself up for accountability. It's just do what you know that you need in an area that you really need accountability, and it's worth it. It is worth it. So yeah, for me, like lifting weights has been one of the biggest in great stories for me. I was probably like, so, you know, I play the cello. I was a fifth year and, you know, I didn't, you know, I was like, oh, I love that. Yeah. But I never lifted. And then I there's a period of time I that but we looked at weights amazing. And I was Potomac Gardens between like and she does like that I think I you're doing because I promise you in your life when you're 45. You know, be so thankful that you did it. And then you put this on your body and it's been really you know, I'm really proud of what I have been able to do and how strong I've gotten. But there's really not a late time to start with people for 70 for eating. Right. There's always benefit. But if there's a young person like you, let's just start lifting, please. And you know, our parents generation was not raised with that, especially the women. So I mean, I remember my mom just doing calisthenics with Jane Fonda. I mean, I'm serious and there was no weights. And I think with such a acknowledgment of the power of muscle and how well it helps regulate our metabolism and our insulin regulation combined with proper use of GLP ones, I think we'll see a trend of people metabolically healthier. I hope so, at least I really hope so. Because we don't have we don't have any excuses right now. We have a lot of information. It's information. It's more about the action. I think it really is have a perspective like how you use your you once you feel like you know how sends them in a pathway with you for your patients. I know probably vary by individual. You know, is there a point where you're like, now I'm going to start using them or to use this for. Yeah. I think I probably started my own journey with GLP one is about two and a half years ago. I'm only five feet tall. So I mean, and in your 40s you're like, maybe I'll try this. So I went in at first and I said, okay, I'm going to eat the right amount of protein. I'm going to lift weights consistently. And I really don't feel like I lost muscle mass, like it really did hang on there, but I prioritize and I didn't go too high in the dosing, so I took that information. And now I really share my personal story with patients of like, we can put you on this, but you have to be able to eat and I'll know. I'll know because we'll look at your labs if your iron is plummeting, if your hair is falling out, I can see it. And so I hold my patients to that accountability piece and really track them in that. But I have found miraculous shifts in cardiovascular risk factors without a statin, without anything. It's like, let's just start here. Yeah. Or have a little bit more fat than they want on their bodies. Did this oh it keep your current lifestyle change I see a big change to triglycerides LDL APB all go down. Blood pressure meds all of that same metabolically so much healthier. And are you seeing that at standardized dosing or is I. It really depends on where the patient starts. You know, because I've had some patients there A1 C was 6.2, right? I mean they were already well on their way. But I see a variety of it. Me personally, I've seen much better insulin resistance or insulin sensitivity. And I only do a microdose. So it just kind of depends. Some people really have a threshold where they don't see a lot of weight loss until they hit kind of the mid level dosing, and then we'll hold them there and then slowly taper back down, or I'll have them spread out the amount of time between injections. So maybe not every week every ten days. But it really does vary. But I see really great progress with just microdosing too. Yeah. Really exciting. I think it's great. I think just like anything you have to have responsibility with it. You need to nail down those foundations. But what I tell them too is this really helps kind of take the white knuckling out of making those changes because everybody's brain and we see this in studies where some brains really light up with sugar and carbohydrates, whereas others just don't. And we all know those friends that just are like, oh, okay, I don't need to eat. And they say skinny. And the other people like, I can't stop looking at it. Yeah. The people that go to the break room five times for a bite, I don't. Yeah. So everybody's brains are a little bit different. So I think it really helps people whose brains are wired for that dopamine hit of dessert and overeating. It helps them make the changes that they've been wanting for so long. Their brains are just wired to have a difficult time with it. And I put both my parents on it, actually, and I think that's played a huge role. Going again, back to my dad's case of stabilizing his plaque because he's so much more metabolically healthy by being on that. And he's lost 50 pounds. It's just, so, you know, kind of combined therapy. But that's part of the part of the therapy. And are you ever seeing patients that are, you know, using that super step. You see that I do I've got a couple. Yeah. But it still can happen and it can be hard because it's like the pacifier. They don't want the I'm like no you can't have it but I want it. There are some people that I've seen lose 60 pounds and still feel like they don't look good, still feel like, they they don't. They're ugly or their bodies gross. And I'm like, this is deeper now. We've got you healthier, but mentally we need to have some work there. So I don't think it's without risk, especially given sometimes you don't know that someone has a tendency for an eating disorder or body dysmorphia. Yeah. So that's where I kind of call on my therapy friends to say, hey, I've got this patient who's not physically healthy, but they need some work and support there. And that's kind of out of my scope. And so I'll send them to people who understand that element of it. Yeah, I think that's really great you so much. I want to talk to you more about longevity. So I think that your I know obviously cardiovascular health I think, I think that part of like the bigger conversation. But I want to talk about health span. Yeah. You know what is healthy. Yeah. Tell me, tell me all about it and how you're looking at it in your practice. Yeah. Healthspan to me is just being able to do the things that you want to do for a longer period of time. I recently traveled last week, and my suitcase was pretty heavy. And, you know, it took a lot to push it up there. And I do think about those things. I know that that example has been shared with other people as well. You know, I've heard other people say that, but it is true. If I want to be able to travel independently for 30 years or more years, lift up a fairly heavy piece of, you know, luggage that requires work now. And so health to me, for me personally is going to be able to have cognitive, you know, cognitive clarity. So I can have conversations. I can still learn and share my information. I can still travel on my own. I can still be active and have that high of working out. So all of that matters to me. And I think that what matters to each individual is different. But think about the things that you really care about right now that give you that feeling of life that usually requires physical health to be able to do those things. And so when you take note of those things, you think, can I imagine an 80 year old doing these things? Do I imagine my body doing those things? And so then we have to rewind and say, well, then in order to do those things, I need to be cardiovascular healthy. I need to be able to oxygenate well. I need to take care of my brain. I need to have muscle strength. So that's how I look at it. And I tend to be a procrastinator by nature. And it's really a shift in like weight. I gotta think way ahead. You got to reverse engineer it. Yeah. You can't be a procrastinator. That's for it really is. It is. But again, it comes back to really educating your patients. Really, understanding processes of disease and then reversing it back to say, okay, we know we know a lot of what drives that. And ultimately it comes down to metabolic health, I think is the foundation for all of it. Because if we and this is partly why I love cardiovascular prevention, because if we look at that, what does it require? It requires other elements that keep you from being more resistant to cancer, more resistant to depression and anxiety. I mean, all of those things that are required for a healthy cardiovascular system kind of bleed out into everything else, pun intended. But I mean, it really does, right? Because that requires you to be metabolically healthy. And that's kind of really foundational to what drives Alzheimer's. In some cases, diabetes, which then is a slippery slope. Right? So yeah, I would say that because everything is so we're connected with us and we forget about it sometimes. In silos, because everything is so connected with this information and visually. We've done a really amazing job. Yeah. Well I think too when we look at the interconnectedness it can be really complicated and fascinating to me. But that's kind of the behind the scenes work for us to do. Because when I try to and I've had to learn this, you know, I think as an early practitioner, I wanted to not not tell them all the things because I wanted them to know how smart I was, but a element of me wanted to explain it also that they knew that I knew what I was talking about. Right? But then it ends up overwhelming them because our bodies very complicated. But the solutions are very simple. And so sometimes when I'm going over DNA to and I say, well, you've got this cardiovascular risk and you got this detox risk, and then you've got inefficiency with vitamin D, they're like, oh my God, everything's broken. I'm like, not really. We just need to take this supplement and you need to lift weights and eat. Great. Right? So the solutions usually are simple. And so I've learned to like, do more of my work behind the scenes and then present it as we just need to focus on these things because this is where your body needs the support. Yeah. Yeah. I think kind of when we think about Healthspan, that's often where we're talking about the way that I like to explain to my patients. It's it's like trying to compress morbidity. So, what is the amount of time that you end up being sick in your life? Because sometimes just when we see a lot of our aging population, you're like, can be you. And so I think that healthspan is also the idea of, you know, as healthy as you can be in giving your life, you know, purpose and joy in being able to live your life as long as possible, but also really trying to compress the disease. I love that because you're right. And I think, yeah, women with osteoporosis, with many, many things cognition, women tend to be a little bit more in that bucket, of long term kind of decline. And you're right, it is like shortening that window. I mean, most of us aren't going to just be alive one day and then the next. And for me, I mean, most of us are going to have a slight decline, but like, let's compress that amount of time. How much for the right compression? And I've seen graphs too, where when we focus on healthspan, our longevity may or may not extend, so we might still diet. Let's say let's give us 95. We may still die at 95, but we're going to feel amazing between, you know, up to 94 and maybe the last year. There's some decline rather than feeling horrible from 85 to 95. So it's not necessarily the goal to live to be 150. It's more like, let's live life really amazing for the same amount of time, you know? And I do think that we will extend longevity in doing that and focusing on that, but maybe maybe not. But but I think it's worth it either way. If you're in, if you if you feel good, as long as your life is, you know, you have a small decline and then you go and that's probably. Yeah. That's a blessing. Absolutely. Yeah I think a lot of us have probably seen our grandparents struggle, our parents as well. So it's what can we do. How do we educate people so that they you know don't have too much. There's going to be some things that happen accidents or things like that. But I do think that we're in this era where we can really change. Looking back I was really close to my grandmother and you know she had a lot of trauma and loss that I think caused and created a lot of stress that led to diabetes right. High cortisol led to high insulin led to diabetes. And you know she was diagnosed I don't know, in the 80s. We didn't have as many tools as we do now. But watching that and looking back on that is kind of hard to see. Knowing like if I were who I am now and with the tools I had now, her life could have been healthier. It wouldn't have been such a struggle. Right. Yeah. And I think watching that, being close to her and watching that, you know, in my younger years really was foundational to, to my interest in surely doesn't have to be this way. Like how can we how can we stop this. You know, I think it's yeah, there's got to be other solutions. And there are and I think that if people pay attention and they're willing to work with patients, you know, providers like you and I, even if it means they can't use their insurance, you're going to use your insurance less long term. It's a good ROI on my my grade. So do you have any kind of like, kind of foundational recommendations for anyone that's watching, the show or shows? A lot of, a lot of people that are interested in moments but also like clinicians. What do you recommend to folks that maybe are starting out on the wellness journey. What were the top three things between people. Heavy hitters. And then also just to add more complexity to this question, what do you recommend clinicians do that are in this phase to kind of learn more. There's a lot of people are still learning. Yeah. So when I first meet with a patient I look at you know a ton of lab markers. But then I sit down with them and I go over kind of the five foundational things. How well are you exercising. What are you doing. And then we'll tweak it on there. The minimal needs to be 30 minutes a day and weights three times a week. And then I ask them about hydration. I think people don't ask that question. We just assume you're drinking water. 90oz at least. Right. Figure that out. Habit stack to get there. I talk a lot about, the diet. Like what? What kind of diet are you doing? I asked them to log. What are we eating for breakfast, lunch and dinner? Because people who can't lose weight sometimes aren't even eating enough to raise that metabolism. And so it's not only what they're eating, it's how much they're eating. So going through that. I talk about sleep. How many hours do you wake up all night? Do you have solid sleep? If that's what you're. If that's a problem, that's that's a tricky one. There's that. That's a whole whole podcast on sleep. But, but we address sleep. And then with that we talk about stress on a scale of 0 to 5, five being the most zero is nothing. A Marguerite on the beach. Where do you hang out most days? And also tell me, really, are you used to this level of stress? Or like what is your perceived level? And then we kind of go through those quick tools, breath work, that kind of thing. So I address all of those things first and then from there kind of say, okay, based on this, in your lab work, these are some kind of foundational supplemental support that you need to do where I learned a lot of this, I think you can get so much from podcasts like this. I mean, you can learn so much that doesn't cost a thing. Just be intentional about it. I have a 30 minute drive, to and from my. That's when I do my best. Yes. On the way back in, when I go to pick up my kids at some point were like, mom, why are you always listening to this stuff about mitochondria? What even is that? Like, okay, maybe I'll play music when you're in the car and then I'll switch. But yeah, I just started using my time a little bit differently to learn. And you never stop learning, right? I mean, you never. I still listen to podcasts to and from because it's such a good use of time and you'll always pick up on things and you create your own opinion. I think too, because your own special sauce. As a provider, you need to know multiple views, multiple studies to kind of create what you and then, you know, over time you see more and more patients and you say, I see this trend, this is how I want to tackle it. Right. And so podcasts are great. I personally use School of Applied Functional Medicine. SFM they're a great resource. They're really cost effective too. You can kind of go at your own pace. They have a good community. I know a lot of people do it from a forum, has really great courses. So there's there's a lot of resources that you can do while you're working and seeing patients, because you can kind of do the courses on your own time and then just dig into what you love, the area that you love. You know, I think it's important to understand the foundations, the interconnectedness of metabolic health. Gut health is a huge one to understand how that drives inflammation and then testing like you guys. Right? I know the testing. They usually have great resources too. Webinars. Yeah. You learn so much about what that tests actually mean because the tests themselves can be overwhelming, but they're so valuable once you learn how to use them. And because sometimes blood work doesn't show the whole picture, especially with gut health. And people will ask me all the time like, well, my gut health, how do I find out with blood work? Well, we'll see inflammatory markers, but if we want to know exactly what we're targeting, we can either do the this is probably what's going to help are we can look and see exactly what's going to help. And so having those and having the resources to learn how to read them really powerful. And so there's so many free resources I think to to become an empowered practitioner and offer your patients more value and real solutions. Yeah. I think vibrant has a lot of native tests, but I think you want to get somewhere. So I ran that on myself this year a horrifying horrifying I and the reason I ran it, this is a good example of why it's important and why I still have my finger on the pulse of completely insurance driven care. I remember I had a big surgery a year ago. That's a big stressor. I launched one kid to college. That's a big mama stressor. I just purchased a new building for my facility. A big stressor. And all of a sudden, a few months ago, I started with, like, eczema patches. I've never had a skin issue in my life. I didn't even know what it was at the beginning. So I went to a dermatologist, didn't ask me a thing, just was like, let's do a biopsy. We'll see what it is that is just responding to a symptom. But it's not at all looking at the sign that my body is giving as to something underlying. So of course, me, I don't just settle for that. Yes, I want a biopsy because I want to know what we're looking at. But immediately I went to there's got to be something going on with my my nervous system and my gut. And, you know, when you have surgery, you have a lot of antibiotics. You don't sleep as well for a while. And then stress has a huge impact on your body. So my body's not broken. My body's amazing, but it's showing a sign and it's having a reaction. And something has kind of some light switch has turned on. And so I did the gut tumor. Horrifying. I'm like, oh, well, we've got some work to do. But now I know what to do. And honestly, things have simmer down. I can tolerate some things food wise that I couldn't before. And it's because when you look at that data you can see like, okay, I need to remove these things. I need to add these things. So yeah, I still see the missing the gaps, I think, in my own life when I have to go see somebody because I can't biopsy myself. And there's, there's a place for it. We need some of that. But, like, why didn't he ask me some, some really targeted questions to get to the why my body just randomly did this? I think it's just back to that silo mentality where it's like, well, this is just the one organ system that you take care of and that's it. Yeah. Yeah. Right. Yeah. But it just, you know, I almost like to see those things because I'm like, this is why I do what I do. This is my fuel to continue learning, to continue to show up and spend more time with my patients so that they don't end up, you know, their body just coping, coping, coping and breaking down right. And they just need to be educated and have thorough testing. We need more information and more integration. And then I think, yeah, well, this. Yes, you let everyone know how to find it. Absolutely. My clinic is e live l Ivy health. So l5-health.com is our website. I am on Instagram, Facebook and under that or Krista Elson, my first and last name on Instagram. I would love to see if you have questions DM me and yeah, love to continue the conversation with you if you need help. Yeah. Thank you.