Blood Labs, Clear Answers

Most lab reports end with a shrug: “You’re fine.” At Redefine Fitness and on The Anthony Amen Show (formerly Health & Fitness Redefined), we believe you deserve better than “fine.” In this episode, Brent from Sage Healthspan joins us to break down how to read your blood work with confidence, track trends over time, and turn numbers into clear, doable action steps that actually move your health forward.

We unpack why “normal” lab ranges aren’t the gold standard—especially in a population where metabolic dysfunction is common. Brent explains how Sage uses a closed-data AI system to protect your privacy while translating raw biomarkers into insights you can understand. We explore the overlooked markers that genuinely change prevention plans:
• ApoB for cardiovascular risk (far more predictive than total cholesterol)
• Lp(a) for spotting hidden genetic risk
• PSA as an early, frictionless lifesaver for men
• Full female hormone panels that reveal what piecemeal testing often misses

We also dig into composite markers, key ratios, and biological age—not as verdicts, but as guideposts that help you choose your next right step.

Then we connect labs to real life. Sleep, training load, sunlight, season, fasting, stress, and even your environment all shape your numbers. Wearables like Oura help you decide when to push or pull back. Vitamin D fluctuates with the weather. Testosterone changes with fasting and sleep. Context matters as much as the score itself.

Brent walks through how Sage Healthspan centralizes historical labs, normalizes units, explains biomarkers in plain English, and even generates a smart question list you can email directly to your doctor so every appointment is productive. The goal is simple: reduce friction, increase clarity, and build health literacy that compounds over time.

If you’re ready to go from “okay” to optimal—and want a framework that aligns with the Redefine Fitness philosophy that fitness is medicine—this episode will show you how to take ownership of your data, fill the gaps in your panels affordably, and make better daily decisions backed by evidence.

Subscribe, share with a friend who’s ready to take control of their health, and leave a review to help more listeners discover the show and understand their biology with confidence.

Chapters

• 0:00 Host’s Injury And Recovery Lessons
• 1:30 Meet Brent And His Engineering Lens
• 3:00 The Doctor Visit That Sparked Sage
• 6:30 Building The Sage App And Privacy
• 9:20 Closed-Data LLM And “Optimal” Ranges
• 13:00 Biomarkers As A Symphony Over Time
• 16:30 Testosterone, Context, And Trends
• 20:00 Health Agency And Demystifying Labs
• 23:30 Wearables, Urine, And Environment Data
• 27:00 What Panels Miss: PSA, Lp(a), ApoB
• 31:00 Women’s Hormones And Complete Panels
• 34:00 Frequency, Seasonality, And Vitamin D
• 37:00 Access And Cost: Filling Lab Gaps
• 40:00 Beyond Total Cholesterol: Ratios And ApoB
• 43:00 Biological Age As A Composite Tool
• 46:00 At-Home Testing And Reducing Friction
• 50:00 Culture, Education, And Compounding Habits

Transcript

SPEAKER_00: 0:03

This is Health and Fitness Redefined, brought to you by Redefined Fitness. Hello and welcome to Health and Fitness Redefined. I'm your host, Anthony Amen, and today we got another great episode for all of you today. Little life updates, like always. Last week, you know, I kind of dropped the news. If you haven't listened to that episode, I totally ripped my chest in half. So eagle lifting, as we know, not the way to go. Something I preach on the show all the time, and yet sometimes you just get in your own way. But it's alright. It's it showed me that, you know, even the mighty can fall, and the best way to recovery is to stay active, keep moving. Uh we're like 20 or 40 days post-op at this point. I'm sleeping pain free. I've been pain free for two weeks already, and uh I'm supposed to only get like a five percent flexion on my shoulder, and I'm at 40% active. So I'm totally frozen through this. And a lot of the a lot of lessons I've relearned along the way and really solidified to myself that fitness is truly a form of medicine, and instead of hearing people tell you that you shouldn't work out, you actually should work out, even though it goes against uh conflicting theories, it makes you feel better, it helps you move better, and overall our our bodies are just meant to uh heal in motion. So that kind of ties into today's show anyway. So without further ado, let's welcome to today's show. Brent Brent, it's a pleasure to have you today.

SPEAKER_01: 1:31

It's good to be here. Thanks. I mean, it's an amazing testament to your resilience uh resilience that we're we're having this this uh this discussion, even right. So I'm I'm glad that you're able to recover quickly and and we're able to talk.

SPEAKER_00: 1:44

Yeah, me too. I I analytics my favorite thing in the entire world. Blood work, my favorite thing in the entire world. So this is gonna be right up my alley, and we really haven't had anyone with an engineering background talk about a little of this before. So this would be really cool to see how that all plays a role. We've heard it more from the physician side of it and more from the gym side of it than the engineering side. So without further ado, tell us a little bit about your background in engineering and how that got you to Sage Health.

SPEAKER_01: 2:15

Yeah, totally. Um, I mean, listen, there's a couple different versions of this story, and it's like anything, right? It's like uh a bunch of different factors in your life coalesce around one thing, and this one thing has really just become sage over the past couple years. I would say, you know, I've been running businesses sort of at the intersection of health and technology and nutrition for the last 25 years. So I've certainly seen what's going on in the universe and and how this whole, the, the whole, the whole world works from the from the business perspective and the health perspective. Um, you know, even you know, for eight years running a company called Metagenics, serving serving healthcare practitioners that are that do this for a living. Um, but but really what drove me to this was going to see my doctor a couple years ago, like we all do, and uh, you know, having my blood drawn during the visit. And I was leaving, the doctor, you know, said, Hey, listen, I'll call you if something's wrong. And I just remember like the uncomfortable feeling um that I had when when he said that. Uh, because I'm not looking, well, certainly I want to know if something's wrong, uh, but that's not, you know, that's not the driving force between, you know, behind sort of the interaction I want to have with my with my doctor, with my healthcare professional. I want to talk about you know how I can live my best life for as long as possible. Um, and really we just didn't have the time for that conversation. And and so yeah, I walked away. He said, I'll call you if something's wrong. So obviously we didn't have a chance to review my blood work. A few weeks went by, I didn't get a phone call. So, you know, you're sitting home going, okay, I guess everything's okay. Um, but it's like, all right, I'll just find out. So I I uh picked up the phone, called the practice, got the person at the front desk, and I said, All right, did my blood work come in? She said, Yeah, it's been in for a few weeks. And I said, Well, what's it say? She goes, Well, there's no notes here, so I guess everything's okay. I'm like, Did did somebody even review it? Um, she's like, Oh, I'm sure somebody did. Uh, you know, so there's just a lot of ambiguity there. Uh, you know, fortunately, she sent me uh a copy of the results and and uh there wasn't anything wrong, which is great. Um, but you know, there was there were a few things that weren't right. There were a few things that weren't perfect. Um, I certainly, you know, I'm about to be 50 years old, my birthday's in a couple weeks, which is exciting. Uh, I certainly don't feel like I did when I was 40 or 30. Um, you know, get into the gyms a little bit harder than than it was before. And uh, you know, certain things in my body, you know, continue to work, but maybe not as well as they could. And so, you know, I was curious at what was really going on. So I spent, you know, a couple days uh asking Dr. Google, so to speak, about my blood work and you know, throwing stuff into AI. And I realized, okay, well, there's a business opportunity here. There's a problem to solve. Let's help people really deeply understand their blood lab results. Let's help people understand um uh what all these different biomarkers are, because I do think it's a little bit of a black box, right? Uh we tend to look at things in isolation. You'll only look at something if it's sort of abnormal. Um, but there's a lot of things in there that that change over time. So what's actually really fun is you can um, you know, the tool that we built, you can take any blood lab you've ever done. And, you know, I've been doing blood labs. I'm gonna be 50 this year, so I've probably got 20 different uh labs in my in my history and various EMRs around the world. And I was able to take it and put it together and put it into one place and look at these trends over time. And what you notice is sure, there's a lot of things that are normal, but there's a lot of things that aren't the same as they were uh 20 odd years ago. And I think a lot of those are just opportunities to go after. So you have to understand, okay, what is a neutrophil? What is a basophil? Uh, what are all the different types of cholesterol that that I'm looking at? Um, you know, I certainly asked myself the question too, did the did the blood panel that my doctor ordered, was it the right blood panel for me? Was it comprehensive enough? Um, because there were certain things that were missing too. Like I didn't see PSA. Um, I think I listened to some radio program with with Ben Stiller talking about prostate cancer, and he's a a big advocate for um you know early testing for prostate, uh PSA testing. I I'd never had one. I'd never had a PSA test. So there were certainly gaps. Uh so you know, you you connect all these things together. How do you understand your blood labs? How do you think about optimizing yourself over time? How do you make sure you're getting the blood panels? And out of that, you know, we we we built Sage HealthSpan. Uh so Sage, you know, in its simplest form, is uh is an app uh on your iPhone, and you can either upload or scan in any blood lab you've ever had. And we use on-device AI, so we're never sending your data to the cloud. We use on-device AI to take all that data, pull it off the page, or pull it out of the PDF, or pull it out of the picture, or whatever, put it in a consolidated form, normalize it over the years. So if you've had blood panels that were done at different labs, sometimes they use different um, you know, metrics, you know, millimoles per deciliter or grams per liter or whatever it may be. We normalize it, we look at it over time, and then in really plain English, we help you understand what it is. Uh so what are the different biomarkers? What do they mean? What does high mean? What does low mean? And what are some ideas of things that you can do about it? So hopefully it's really clear to understand it. We do have some more advanced features, like if you've done the right things, we'll automatically calculate your biological age. We think that's really fun uh and interesting. Um, you know, it's a nice composite market that marker that tells you sort of if you're on track or off track on a lot of different uh important accesses. And then we also have our own proprietary LLM that we will send your data to completely anonymously and completely privately, where we've actually taken some of our favorite functional medicine doctors and got them to build this massive data set dissecting blood panels. So, what does low mean? What is high mean? What are some best practices? What is optimal? Um and so we we we apply your date your data to that database and use an LLM to come up with a quick summary using AI of how to best understand your health markers. And one of the most fun things is it'll give you 10 questions that you can ask your doctor, and with a click of a button, you can actually just email those questions to your doctor. So next time you're sitting in front of your doctor looking at your blood panel, you can have that meaningful conversation that I didn't get to have. Um, because really what we're looking to do is help build those great relationships with your doctor so that you can live your best life. That was a lot of talking, but um, hopefully that's a brief enough summary for what we're trying to do.

SPEAKER_00: 8:07

No, it's a good overarching view of what I'm looking for. And I now I want to get a little more specific. And I think the first question that comes to mind, maybe it's because I'm addicted, is to AI itself and what training level has that AI undergone to really give recommendations and track. So how do you program it to make sure it's accurate as opposed to uploading to Chat GPT, for example?

SPEAKER_01: 8:36

100%. So the first thing is we're really applying, we're really using our proprietary LLM on a closed data set. So the the LLM is not going out there in the ether and pulling God knows what data and and trying to apply that information to you. It's pulling really only the best recommendations that we've got from our favorite functional medicine doctors. Uh so we got a bunch of doctors around, we built this massive data set, we know the data is perfectly accurate, and so we're applying the AI, we're applying your data to that data set, and the AI can't go outside of that walled garden, for lack of a better way to put it. Um, and you know, to your point, we're training all the time. So uh, you know, one of the ways we think about it is sort of every person that participates in Sage and gives us some of their data, uh, you know, we certainly anonymize it, but each piece of data helps the entire data set get better, um, right? Because we're trying to understand that uh in a in a meaningful way. And I would say that's kind of, you know, there's there's a lot of nuance and subtlety here too, right? Because we can get into the debate between what's a normal level, what's an optimal level. Um, you know, that's a really big discussion. I mean, what is it, 68% of America today uh has some sort of metabolic dysfunction. And when you know you're looking at sort of what's a normal biomarker, well, they're just gonna take a normalized curve and say, okay, the middle of that curve is what normal is. Well, if 68% of America is metabolically not optimal, let's just say that, uh, that means normal is nowhere near optimal, right? Normal includes that that 68% of America. And so, you know, we've spent a lot of time talking with our favorite functional medicine doctors and thinking through, okay, what actually is optimal? And so when our AI is giving you recommendations, it's actually thinking through those recommendations based on what is the optimal place to be for so many of these biomarkers. Uh so I you know, I would say our AI is is as good as as can as as we can have at this point right now, uh, but certainly it's always getting better, right? Because what gets interesting, especially with with biomarkers, is I think we're so used to in medicine today looking at them in isolation. So you're looking at them as a snapshot instead of looking at them over time. And I think you know what these AIs have the power to do, and and we're in the early days of this, right? But it'll get better and better, is really see those subtle changes that have happened over time and understand that in a more profound way than you know most doctors would even have the time to notice on your on your bio on your you know on your lab. I also think there's a ton of interplay, which is interesting, between biomarkers, right? So, you know, what is the interplay between your cholesterol and your glucose levels? Uh, what is the interplay between this hormone and that hormone? You know, we kind of like to think about it, we spend so much time thinking about uh, you know, biomarkers in isolation. This biomarker itself is not normal while the others are. But it's more subtle than that, right? We like to think, okay, when you listen to a symphony, you're not just listening to one instrument, you're listening to how all these instruments come together. And certainly the complexity of our biology, I think, requires us to look with that level of nuance at our biomarkers if we're really ever going to think about optimizing. And so it's really Sage starts to open up the door to be able to do that, um, which is pretty exciting for us.

SPEAKER_00: 11:39

Yeah, there's a lot of stuff like you mentioned, like recommended and optimal, just to give like quick specific examples, vitamins, for example. There's an RDA recommended daily allowance, and there's an optimal daily allowance, and they're putting two totally completely different numbers. And then my favorite, I think the most misunderstood is body temperature. Like the like an average body temperature of a being is 98.6. But I've remember as a kid, I if you take my temperature right now, it's 97.4, me being healthy. So when my body temperature went to 99, I had a fever, but the nurse would say if it's not over 100, you don't have a fever, it's like, but I'm dying. Like I feel like shit.

SPEAKER_01: 12:15

Yeah. So and I mean, and there's so many examples of that. Like, I mean, I probably get more personal than you want to hear, but like, you know, I'm getting into 50 and I go to CrossFit every day, and all my CrossFit buddies that are also 50-ish, right? We're all sitting around going, okay, is it time to start thinking about testosterone? Like it's a little bit harder to, you know, uh grow our muscle than it was, you know, earlier on. And, you know, maybe the the little bit of fat I carry around my midsection is, you know, a little bit a little bit harder to uh to keep to keep at bay, so to speak. Um, so okay, is is is now the right time to for testosterone. I mean, one of the fortunate things is I do have 25 years of data. And so I've actually never been a person with super high testosterone. My testosterone is usually in the low 400s, but today it's actually still in the low 400s. So probably I'm not a great candidate for TRT. And and um, you know, I think that comes out of, okay, if I were to just look at my testosterone today, I can say I'm very much on the low side of normal. Maybe it's time to start thinking about options. Um, but if I, you know, if I can look at my history and I can look at the changes over time, I've been between, let's call it, 412 and 420 for 25 years. Um, so that's also one of the very fortunate things um, you know, when you have all this data and you can see it, you know, continuously over time.

SPEAKER_00: 13:27

Yeah, testosterone is another example because there's such a wide range of where men sit. And then you're taking a snapshot, like you said, up to someone's test levels, and that could be a lot lower than what they used to be. And that's what that person feels drowsy, lethargic, and is a good candidate for tea or testosterone.

SPEAKER_01: 13:42

Or, you know, and have they been fasting, right? Like if you're fasting and all your testosterone's bound, like of course your your free testosterone is going to look awful, right? So all of these nuances are so important to understand, right? Uh as you're looking at your blood work. Um, and and we think like none of this is is rocket science. Like we think, you know, every person out there has the right to understand this. I think for so many years, we've just kind of decided that it's too complex and let this black box exist in medicine. But I mean, I'm sure you've, you know, you have the same experience, right? You bounce up against medicine, little by little you realize, okay, my health is actually not something that I'm just blessed with or not blessed with. It's something that I can actually try to improve over time. It's a skill I can learn, understanding my health, understanding these biomarkers. These are all skills I can learn. Uh, I may not get it all right the first time, but it's it's like any journey that we're on with, with, with, you know, whether it be fitness or in business or or learning, um, the skill of health is something we can all get much better at uh if we apply ourselves to it and we you know feel some agency and control over our health trajectory. Um, and so I think that's something that's really really critical for folks to understand. And I don't think biomarkers are are the exception. I think they're they're inside the realm of what everybody should have a good feeling of. Like, you know, I'm not saying we should all sit at the bar and and uh and and you know know our cholesterol numbers and and you know be able to tell our friends about it. But you know, I can't tell you since I've been at Sage and it's it's it's one of those things. I can't tell you when you start talking to anybody that you meet um about what I'm doing here at Sage, every one of them has a story to be like, well, you know, my AST and my ALT last time I was at the doctor was a little bit high, uh, but I don't know what that means. Well, why? Why live with that uncertainty? Let's figure it out, let's help you put it together. Um, and and I think everybody's got a little bit of a story like that around some of their biomarkers.

SPEAKER_00: 15:31

Yeah, and you're starting to see more and more people track more biomarkers. Me, for example, personally, I just went ahead and bought an aura ring, right?

SPEAKER_01: 15:38

So great. I mean I oh actually not wearing mine, but it's charging because I I just woke up. Uh but I'm I you know I've been using aura for for 10 years. It's awesome, right?

SPEAKER_00: 15:48

It's I it's three weeks in. I wanted to track my sleep. I literally bought right before we took my chest. So but I was always like, let me figure out how to take my sleep into my own hands because I've always been someone who struggles with sleep happening. And obviously my mind's not being overweight, it's just something I've had my entire life, and it's how can I learn different behaviors to enhance my sleep and make myself better. And there's a bunch of the stuff on there that I love about being in control. And then you take your blood work and you're being in control. And I think the way where AI is headed is it will know a complete picture of somebody and then be able to take all the biomarkers from all these devices and then spit out exactly what's recommended for you, even on a deeper level, which is when you add in genetics to the that component. So what what are my genes uh showing that other people's genes aren't showing, whether that's uh sex or ethnicity, because we all have different biomarkers even inside of that of what's important and what's not important. So it's pretty interesting to look at and how we can uh take everything all together at once. I mean, my idea for even the personal training side of it is we are building a new app. I mean, I was thinking 10 years from now, but you're already ahead of it is taking an AI like yours, taking an AI like Aura, plugging that into all the exercises we're doing with people, and having a person just say, Hey, what do I need to do today to optimize everything based upon my markers? And then it's out a workout program for us, it picks out nutrition for them based upon that specific individual and what they're doing. Hey, how am I trending over the last uh seven days from all this activity and stuff I've been doing? And it can give them pretty close to accurate data.

SPEAKER_01: 17:30

Yeah, and it's not just what's best for me, but it's also like what's best for me today. Because what's best for me today could be different than what's best for me a week from now. Like I we're big fans of or at Sage. Um, like I said, I've been using it for years, and it just keeps on getting better and better. It's so interesting to look at, you know, sort of correlate, okay, what am I having great workouts to um, you know, what was my heart rate last night? Was my heart rate elevated? What is my recovery score? Um, you know, a lot of that stuff becomes really interesting to think about internally and correlating that. You know, at Sage, one of the things that that we we deeply believe in is that we have all this data around us, and so much of it is underutilized. Uh, and so you know, it is on our roadmap to add a lot more than just blood to what we're doing at Sage. We're gonna actually roll out urine tests uh in the next few weeks. We think there's a lot we can tell by looking at your hair, skin, and nails over time, how those things are changing and evolving based on the season. There's a ton of environmental data we can pull. Like I know where your phone knows where you are, which means your phone knows your pollen count every day. It knows the level of pollution in the air every day, it knows a lot of things about what's happening environmentally around you. I can absorb that and understand that. And then certainly we can connect with things like Apple Health or Google Fit or whatever it may be and any other wearable that you're using, we can ingest that data and again apply that thinking to what's happening inside, you know, inside Sage. We we kind of think the future is a little bit of a, it's a kind of a an oxymoron of a concept, but sort of self-administered concierge medicine, where um, you know, you your phone should be the center of your health life and and have all of your health data and be able to see the interconnections and patterns in your health data in meaningful ways that really only some of your best doctors can get.

SPEAKER_00: 19:12

Yeah, I I I couldn't agree more. I think you're kind of right on the right path with that, is to give everything all in one specific place and really track everything as you're as you're going along. And I think that's so cool that you're headed into the urine part of it, you're headed into the skin part of it. It really adds more of a bigger picture to it. I mean, I think it would be really cool if like to say you partnered with aura, you partnered with Ancestry, and now you're getting all of that data up on the route and really give a person's like an individual journey of where they should be and what they should be going on as a person. And even just breaking down simple but I want to get to like a little more specific of like what exactly markers and stuff we're looking for inside of blood work. Because I don't I think a lot of people don't understand. Let me phrase that. I know a lot of people don't understand blood work because I always say, Hey, let's bring a blood work and let me look at it for you. And they go, You can read that. I was like, Do I know absolutely everything on there? No. Do I know 80% of it? Absolutely. Can I give you good recommendations? Absolutely, and we can help integrate this in because, like you said, doctors don't like discussing it. I think it's a timed issue more than anything. Like I'm always ripping on doctors, but I'm really not. They just don't have time.

SPEAKER_01: 20:26

So you know, it's it's you know, yeah, it it's it's easy to sort of it it's the system, right? The system's the problem, not the individuals. I've I've exactly have so many great friends that are amazing doctors, and you know, not one of them got into medicine to only see people for five minutes at a time and miss a bunch of stuff in their labs and uh you know have this this sort of awful experience um that they're enabling. But the system doesn't make it easy, right? You know, you wish, you know, the the system was was almost developed in the days when we all lived in small towns and there was a doctor that was the same doctor from sort of birth to death of everybody in the town and knew what was going on and you know understood how our social lives and behavior in the town and how our parents interacted with us and what our parents you know had or whatever. Like they were able to practice comprehensive medicine just by being part of the same community that we lived in. And you know, today it's just impossible for doctors to have that level of access to what's going on so that they're you know, the the instincts that they train and you know when they study medicine uh are able to really empower you as an individual to live your best life.

SPEAKER_00: 21:26

So I want to ask you specifically, what's one or two uh uh uh biomarkers you're looking for inside of blood work? What do you recommend people to say, hey, these are the top one, two, or three uh results I want you to look at, I don't want you to track. Because I mean, our stand-up blood panel is huge for most people, it's like three and a half pages long. So what are specific ones you're looking at or telling people to look at?

SPEAKER_01: 21:47

So I I would say in two ways. Like what, like the the if I just think about what are the things that that sage users, what has been the most illuminating for them that you know we get feedback to say, oh my God, this is happening. Um, one, and then two, like what do we see as most missed by sort of just your annual physical when you're getting, I don't know, somewhere between 22 and 32 biomarkers measured. Um, the the three big ones for a man is this the first is PSA. I think every man over 35 should get their their PSA tested every couple of years. Um, nobody should die from prostate cancer. The fact that there's still upwards of 40,000 men a year dying from prostate cancer is just an unbelievable tragedy. If you know your PSA and you can stay ahead of it, no one should ever die from that. Uh so that's a big one uh for men. I would say for men and women, uh, one of the ones that's been very illuminating for a lot of folks is LP little A. Uh so your LP little A, it's a it's a genetic thing. Yeah, if you have high LP little A, likely you have you know high genetic, genetically of high, you're gonna have high cholesterol. Uh, and you're not gonna be able to see it just at looking at your overall cholesterol numbers. Uh so that's also been super illuminating for folks where they'll get a they'll get their LPA tested and realize, okay, I'm pretty high. I need to go out and get my calcium score checked. In almost every case where that's happened, the calcium score has been way higher than folks had expected it to be. Uh, and they've been able to get on a therapeutic program to optimize them. So LP little A, I think is an important one. It's one of those you don't have to get tested regularly. You kind of need to get it tested once just so you know, are you genetically uh sensitive to that? Are you not genetically sensitive to that? Um, and then you know, another interesting one we think around cholesterol is is your AP is your uh APOB. Uh understanding where that sits, that's probably the best um the best biomarker we can say we can look at for where are you in that that journey of you know acquiring atherosclerosis. We're all gonna get a little bit uh the longer we live, right? Um, but where are you on that journey? And I think your APOB is probably your best, your best uh biomarker to look at for that. It's not an expensive thing to check. Um and and um you know, we'll will give you some great insight into where you are. Um and it's actually not common to get. I would say those are three big ones. On the women's side, I would say, you know, the a little bit of the tragedy that we think uh we're seeing, especially as women are getting into sort of their middle ages, um, you know, late 30s, 40s, is really just looking, they're only looking at one or two uh hormones and they're looking at them in isolation. So they'll maybe get an incomplete thyroid panel, or they'll maybe just look at their estrogen without checking their progesterone and testosterone and everything else. So we think you know what's critical for most folks is to get comprehensive hormone panels, and especially women as they're getting into their 40s need to be need to be monitoring that very closely so that they can sort of see how that's modulating over time. Those are, I would say, are some of the most important ones that folks should be uh looking at. And those are some of the the gaps that we see most often in just your standard annual physical blood test. And I think that's a little bit of the interesting thing about developing health agency as well, is really saying, okay, my doctor is recommending this panel to me, but I'm actually not even sure why he or she are recommending are recommending that panel to me. Are they giving me that panel because that's the panel they give everybody? And do they give it to everybody all the time? Is that the panel that they think is just the most often reimbursed by insurance, and they don't want to have to deal with a call in six weeks that says, my insurance doesn't cover this, so why did you test it? I mean, why do doctors pick the panels that they pick? I think more often than not, it has to do with some of those things. It's just the basic standard that they do, and it's what's most often reimbursed so that they don't have to deal with an upset consumer, an upset patient uh somewhere down the road that they had to cash pay something. Um, so so you know that's what we think is important. I also think testing frequency is important. I do think most of us need a very comprehensive panel at least once a year. And if and if things aren't in the optimal range, maybe more than once a year. Um, so I do think that's the other thing to be checking on is hey, are you getting your annual checkup? I mean, we all go twice a year to the dentist. Uh, we probably go once or twice a year to the to the optometrist. Um, if we're not getting a comprehensive blood panel at least annually, I think there's a big miss there.

SPEAKER_00: 25:58

I would even throw it in the same time of year annually, because I just think of silly examples like vitamin D3, right? Your vitamin D levels are gonna be way higher in the summer than they are in the winter. So testing that exposure on an annual basis will be huge. You might be more active in one season over the other as well.

SPEAKER_01: 26:15

So I'm absolutely I mean, and you know, I've never seen anybody north of the Mason Dixon line that doesn't need to supplement vitamin D. I mean, it's just it's just it's just gonna be the case, right? That uh uh, you know, that's just the way it's gonna go.

SPEAKER_00: 26:27

Yeah, I I totally agree. I'm lucky enough in the summer I don't need to. I literally live outside. I'm just like I get as much sun as possible in the winter, it's impossible. Oh, totally, totally. It's zero degrees outside, you look at it, you go, no. Yeah, not happening.

SPEAKER_01: 26:42

Not happening. Or you know, or you're just too covered up, right? I mean, you're wearing long sleeves or or whatever it may be, right? So um, yeah, yeah, it's I you know, I think I I think just being aware of of all these things is so important. Um uh and it's you know, it's it's certainly something Sage can help you stay ahead of. You know, we're we're happy to sell you comprehensive panels if you ever want to uh uh buy them. Um or you know, we'll we'll analyze where you have gaps in your in your blood work and we'll just sell you the things that you're missing as well. So, you know, we're happy to to make sure that you have the complete picture.

SPEAKER_00: 27:14

Yeah, and uh to your point about asking physicians, I have to ask all the time for specific blood work because they don't they want to give you a standard blood panel and like you said, that's what they're gonna get reimbursed on, but that's what they're just doing for everybody because they don't want to get a call later. So I always ask, well, can we do this, can we do this, can we do this? And then sometimes they get no, but a lot of people also don't know. You can actually go out to those labs directly and pay out of pocket and it's dirty. You gotta send a blood panel to get through request, which is a local lab by us, for like ten bucks. So that might even be more uh practical for people if they want to do that every six months or they want to do it every quarter because your insurance might only cover a once-a-year annual, so you get the opportunity of really being on track of it for not a lot of money to follow through. Total insurance company is a lot higher than you're paying out of pocket for them.

SPEAKER_01: 28:03

Well, and yeah, you know, half the battle is knowing what you're missing, first of all, right? Um so that you're getting something comprehensive, and then two is being able to go out and procure it and get it done. Uh, you know, that is one of the things we do at Sage, so we're happy if you just get your annual blood lab done at your doctor and you want to upload that, we'll just tell you where the gaps are that you need to go fill. If you want to do the comprehensive panel through us too, like we offer way reasonable prices. We we're actually Quest is one of our partners. Um, so you know, we'll give you better pricing through Sage and you'd get directly with Quest.

SPEAKER_00: 28:30

Yeah, I I love that. I think it's so important. People keep an eye on exactly what's going on and really truly understand. I mean, cholesterol is in itself, I I know I bring this up a lot, but I think it's just so important. You look at total cholesterol levels, it's not a good number. And it's something everyone always looks at. My cholesterol is above 200, like I'm unhealthy. And it just doesn't mean anything. Okay. And it's hard to explain to people like your total cholesterol is so vague. Like do you have is it actually causing any damage to your arteries? Is it is your LDL uh HDL ratio super off? Like who cares about a total cholesterol number? I really want to know what's going on with the other markers to see if it's actually an issue for me as opposed to just one little basic screenshot of, oh, this is where you're at. So I don't know if that's something you you've seen as far as like data coming back, that total cholesterol really doesn't matter. It's more important for uh the wire markers you mentioned, plus LDL to HDL ratios.

SPEAKER_01: 29:32

Yeah, listen, so much of this is in the nuance and in the details, right? I can certainly think of examples that we've had with with consumers using Sage where they have a high cholesterol, but they have no issue. I can also think of a bunch of examples on the con, you know, the contrary, they have low cholesterol, but they actually have a pretty big issue that they're not dealing with. Right. So you can always think of those things. There's certainly, you know, so much of medicine is like, okay, let's for the first 90% of people that we're seeing, like, what is the minimum required thing that? That you need to understand. That's certainly a piece of information, but it's it's just such an incomplete piece of information. So I'm like, how do we take the next step and the next step and the next step? And certainly the older you get, um, and you know, if there's any other risk factors involved, uh, the more detail you have, the more nuance you can understand from your from your biomarkers, the better off you'll be. You know, you were mentioning ratios. We're a big fan of a bunch of composite markers. That's actually one of the things we do really nicely in Sage as well, is we'll take the data you have, and if there's any composite markers that we can help you evaluate and help you understand, we'll do that math for you and we'll show you which of the connections you should be looking at to look at these different ratios in these different ways together. I mean, biological age, you can sit around and debate all day long. Is bioage a meaningful tool, a not a meaningful tool? It's certainly something that everybody's curious about. Okay, where do I stand versus my actual age? Am I younger than my actual age? Am I older than my actual age? Uh, you know, what is the meaning there? What we think is listen, if it gets people to dig into their blood work and understand it, we're thrilled. Uh if it's something they that, you know, they're gonna care about and they're gonna care about in such a way that they're gonna understand the details of it, we're thrilled. We kind of just see it as a yet another composite marker, like one of these ratios that's looking at a bunch of different things, comparing them and contrasting them mathematically, and then you're able to say, okay, if my bioage isn't, I don't know, 10 years below my actual age, why not? Uh if my bioage is over my actual age, okay, why or why not? And then there's usually a handful of things in your in your blood work that you can see really aren't optimal. And if that's the if that's the journey you go on to find that, I'm thrilled. I don't actually care how people get to the get to the destination as long as they're getting to the destination. They're getting involved in their blood work and they care about what they're doing.

SPEAKER_00: 31:37

What do you think the next step uh of this is for one us as a society and two just for you guys in general?

SPEAKER_01: 31:44

Yeah, I think that's a really good question. I think we kind of talked about it earlier. You know, a lot of this is really um, you know, the more we're getting our data centralized into one place, and the easier that we can use these AI tools to activate against multiple pieces of data and compare and contrast them in meaningful ways, um, the better off we'll be. I also think we can make the whole lab testing process so much simpler. We're gonna we're gonna come out later this year with an at-home test process so that folks can actually just buy a little kit, uh, draw themselves a little tiny vial of blood painlessly out of their arm, send it into their lab and not have to leave the comfort of their home. You know, certainly you you may have a great experience at your local Quest. I don't mean to dis on Quest, but um, I've had a multitude of experiences at Quest. Some of them have been wonderful, some of them have been atrocious. I do think uh the service model at a lot of these labs is is is not ideal. And I do think like, yeah, half the battle is getting people to just get the test done, right? Like, let's get the data out of you, let's understand it. Like that's usually the first hurdle to overcome. I imagine it's a little bit for you too. It's like, how do I just get people into the gym? If I can get them into the gym, I can get them to take that first step, I can get them to go somewhere else. So I think there's a lot of uh a lot of parallels to that. I mean, I don't know what percent of people in America today are actually regular gym users. I think it's got to be probably a low single-digit number, right? So, how do you get that number? I mean, if exercise is the best longevity drug out there, how are we gonna get more and more people into the gym is a big question. And I think we're asking ourselves the same question about biomarkers and blood work. Like, how do we get more and more people engaged in their blood work? How do we get more and more people doing these sorts of things regularly? Because there's so many things that people are sick from or dying from today in America that if they were ahead of this uh in the right way, uh, you know, wouldn't be the pro they wouldn't have the problems that they're having. Uh and with so many of these things, like, okay, there may not be that many points of no return. There certainly are points of no return that if you get to them, you can't go backwards. But so many of these things, the earlier you start identifying issues or weaknesses, the easier it is to modulate your behavior so that you can control that over time, right? Like so much, so many things in the world, the effect of compounding is astounding. Whether it's your level of a fitness, it's it's also true in your biomarkers. Compounding is astounding. And that goes in both directions. You can compound towards the worse and you can compound towards the better. Um, and so it's you know, showing up every day, starting early, and sticking with it for the long term. And that's really what's gonna change the trajectory of health, I think, uh, you know, in this country.

SPEAKER_00: 34:11

I think what's interesting to even look at stats, like you mentioned before, it's rarer to have a six-pack than it is to be a millionaire. Like, think about that for for a second. You know, Legion 30, you're easy easier to be a millionaire than just to have a six pack. One is definitely easier than the other. I think the six pack's easier than the millionaire, but it just shows how little people even try for it. I mean, take that to what's gonna be in the next 10 or 15 years, it's probably gonna be rarer to like even be a normal blood worker, like a blood panel, or just be your biological age. It's just the way trends are are are going. It's pretty astounding that people just don't more people are joining Jin's, but we're getting less healthier, and it's something has to fix it. I think that really comes to the education component, which is why I'm a big believer in one of this show, one of the things you're doing, and what we're doing as a company as a self is educating people with what to do. I I love all the pushes that's going on politically, but that's uh coming even on a local level where people are just getting more involved and understanding what I need to do, how I need to do it, what do these certain things mean? Instead of blindly trusting people that aren't an authority in their field, uh just silly examples like a doctor. I still just this bothers me so much as I keep bringing it up. But it feels like every week I have a client telling me the doctor said it's not working out. And it's just like why? And it just they just give you the reason. It's just like, no, actually, research shows is the exact opposite, you should be working out. So as a doctor, I feel like at least some they're so afraid of getting sued, or they just don't have enough time to really work with the people. They just say, Oh, just he's everything and it's sad what's what's going on. I I just had a woman today that has uh uh lymphedemia and her doctor said quit your gym but go do PT. And he's just assuming I guess we're just this dirty gross gym, and it's like, no, like we're doing way more than physical therapy does in-house and training and education, and just that's the first thought is just quit your gym. No, like it's so hard for this woman to get here. Now she's gonna put her quit, and it's gonna take her three and a half years to get back, so you're just doing her a disservice. Or I had another client even three days ago who told us that uh we were recommending she eat, I think it was like 1700 1800 calories a day. And she's like, Well, I asked my doctor, he said he only eat 500 calories a day. And I was like, 500 calories a day is anorexia. Like that's not healthy in any way, shape, or form. Yeah, but my doctor knows more than you. It's like, yeah, maybe about like other things, but not this, right? Like, I'm not gonna tell you that the best cure for cancer is this essential oil. I'm gonna go say, like, nope, go to an oncologist, like, get chemo, do whatever the hell they say. Like, that's the avenue to go. So it's really just understanding who you're talking to and gathering information, taking an AI which is totally unbiased, right? And having it dive through your blood panels and giving you specific recommendations and markers for an individual. It's just gonna empower the person with more education to really make those right choices because it'll start seeing those trends, like, oh, what I'm doing is right. So now we got the positive reinforcement factor back in. Hey, I'm doing this, I'm getting healthier, I'm doing this, I'm getting healthier. And hopefully that spirals us into a push to really now make the average person super healthy, lower all of our biological aids, take the obesity rate from 67% to back when it was like 45 years ago to 5, 10%. So I think information is power more than anything in the entire world.

SPEAKER_01: 37:53

Yeah. I the way we always talk about it at stage two is like um we can't succeed, and it's true of kind of everybody in healthcare, we can't succeed unless people feel a sense of health agency, feel like they can control their health trajectory and realize it's like all things. It's it's it's not something you have and you don't have, and it's it there's also not a lot of quick wins. You kind of got to put in the hard work here. Um, so it's it's not something you can fix overnight. Compounding matters. Like compounding is probably the most important skill I think anybody can learn, whether it's finance, fitness, health, you name it. Um, it's how to get yourself on the right trajectory, how to make those little decisions every single day that over time build into great health. Um, and so I think the the language we use internally and God only knows if it's right. Um, but how do you create a sense of health agency? How do you help people feel like they have control over their health future? They have that health essency, that's a huge first step. I do think like we we had a culture and we have still probably a predominant culture where health is something you either have or you don't have. And we sort of outsource monitoring that that I don't know, that switch to a doctor. And the reality is it's it's a continuum. Health is something that you can improve over time. Uh, you can improve how healthy you are by learning new health skills. Uh, one of the critical health skills we think is understanding your data. Uh, and so, you know, uh you bring up education, right? That's how you that's how you acquire those skills. You acquire those skills through great education uh and through thinking about things in the right way. We think there's, you know, it's it's like so many things, right? If the world just got eight hours of great sleep, went to the gym four or five times a week, kept themselves into calorie balance, had healthy relationships, and kind of stayed away from all the bad crap, um, you know, the whole health trajectory of the world would be would be radically different. And so, you know, we're focused on those core five things. We're focused on helping people feel a sense of agency over each one of those pillars. Um, and if they do, we think they're gonna be on the right path for the long term. They're gonna be on the path where, okay, they're starting to make the right little decisions every day that lead to the great health outcomes over the long term. Uh and so I think if people can get that mindset shift, uh, think about health as a skill, think about learning and building those skills over time and really stick with it for the long term, understand sort of what is the minimum viable uh amount of effort they need to put in to get on the path and stay on the path. Uh I mean, it's, you know, again, to use the the dumb finance quote, sort of the biggest sins in the world, right, is when you get, you interfere with compounding. It's kind of what annoys me about some of the stories you tell about doctors saying to the to their patient, you know, don't go to the gym. Well, you just got in the way of compounding. They actually were already on a journey that was starting. And anything that interferes with compounding, that interferes with the trajectory, the positive health trajectory that you may be on, is just, you know, it's one of the sacrileges of the of the industry that you see, unfortunately.

SPEAKER_00: 40:40

I really, really couldn't agree more. It just everyone has to get on the same page, and that's why I am a huge component, as scary as it may be, and maybe this is Terminator, but like you have an AI that knows everything about who you are, what you do, all your blood work, all compounded, and then you have someone to just ask, hey, give me what uh make a fish today, and it just spits everything out or run this for me, and it runs that for you. And it's just easy to have all that information together. Now I go to the doctor and I say, Hey, pull up all my blood work for the last 20 years, show specific trends. I'm having pain, ABC, there's any correlation. And then the AI just shows the doctor absolutely everything about who you are, an individual. And then the doctor can ask the AI specific questions about you because it's like the funny example of when we get uh physical therapy clients coming over, and it's like, what are you doing at PT? You know, the thing. And it's like, okay, cool. Like that's so unhelpful. So it's just being able to talk to someone who really understands like the language of the doctor wants to hear, so the AI can do that for the person because it knows everything about them. And going back, maybe that'll be the end of humanity if it learns all that, but or maybe it will be the best thing in the entire world. Yeah, who knows?

SPEAKER_01: 42:01

I mean, it's it's to me, it's like the, you know, uh, again, we we think about it as sort of the power of personalization, right? It's like if I can dial in the best plan for you, you know, I'm gonna hopefully make it easier than it would have otherwise been for you to get on that journey and stay on that journey. And that's really what it's all about. Like whether it's, you know, I don't know what it what a silly example would be, but um, you know, the the more that we can personalize your program, the more that we can personalize what's right for you and help you understand why that's the case, we think the easier it is to make the right decisions or the better decisions and be on the better trajectory. Uh I'm I mean, I guess like the dumb example, right, is that you can think about, I don't know. Well, I don't want to go down that road, but there's so many different examples where like if I can understand a few things about your genetic profile, a few things about your biomarkers, and a few things about your current set of daily habits, you know, I think it's a lot easier for me to bake in those moments in your day where you can actually start that process of compounding uh and developing those health skills and and getting on that trajectory that's gonna learn those health skills.

SPEAKER_00: 43:04

Um would be a meta party. Hey, can I eat this piece of cake or is it gonna screw my blood work up? And it goes, okay, you've been, you've hit ABCD, you're doing great, you can afford to eat that piece of cake, it's fine.

SPEAKER_01: 43:16

So I mean, listen, you know, I I you know, I don't, I the example I was gonna give is like, okay, let's say you're uh, I don't know, you're you're of Eastern European descent, so you have a genetic profile of of folks that spent most of their life in sort of, I don't know, the north or whatever, uh, versus somebody that you know has the genetic profile of someone that was in the in the Mediterranean. So why is somebody from the north overweight? Well, maybe it's because they're eating like a Mediterranean rather than eating like a, I don't know, a Viking. I mean, I don't know what the what the example might be. But those things are nice because I think what what they do is, and if you can understand and personise to that, okay, why am I struggling with my diet? I'm struggling with my diet because I'm not making the decisions that are ideal for my body type. If folks don't understand that, I think they feel really helpless about um, you know, well, I didn't realize I was making the wrong decision and I didn't, I don't know how to make a better decision. Um, and if you're in that moment of helplessness, if you're the victim to your genetics, if you're the victim to the system for whatever that may be, you're not gonna be on that path towards a healthier and a and a better journey. That was kind of it's a s again, it's a it's a little bit of a silly example, but I think it's it's meaningful in the sense that, yeah, it's it's about that empowerment and that engagement. I think, you know, it would be nice if my phone kicked me every time I, you know, my my friends decided to buy me a uh a beer. Um, that's one way to go. I think that's maybe where the terminator would go. I think the other way to go is okay, how well do I metabolize alcohol? What are the pros and cons of of having one or two drinks a week or not with my friends? Does the social benefit outweigh the physical um uh you know issues that could come from trying to metabolize alcohol? Like help me sort of weigh the pros and cons in that and help me understand, okay, what is the best decision for me? Maybe I can metabolize a couple of drinks a week, and that's actually better for me, for my overall health and function to have those social moments with my colleagues than avoiding it, uh, you know, than the benefit I would get from not having those couple of drinks. I don't know the answer to that question, but I think that's the level of subtlety and nuance that if we can start uncovering that, you know, it's fine.

SPEAKER_00: 45:15

Because like Asian genetics, as an example, don't metabolize alcohol well, which is why they're most likely to get alcohol poisoning. It's just genetic in and of its nature. While you look at people from uh Western European, like Ireland, for example, really good at metabolizing alcohol, but on the flip side of that also have super high addiction issues. So it's you're you're weighing in different pros and cons of how our genes play. Uh uh, the example you're using about food, fiber, for example, is the best way to keep your blood sugar in check, eating high amounts of fiber. And it's something I've been preaching for years. But what I've learned with my own personal body and how I metabolize food is the more fiber I had, the more my IBS flared, the more it was painful to go into the bathroom in the morning, like severe pain. So I took my diet and I went on a low fiber diet and I started only really consuming meat products, uh, tied in with some minor fruits and vegetables just to get some pre-probiotics in my gut, and the pain went away. I've had normal bowel movements. It's like that general knowledge for the general population of focusing on eating high fiber is great, but there's certain individuals that don't digest fiber that well, whether that's insoluble or soluble fiber, and therefore should eat lower amounts of it, even though it might be healthier to eat higher amounts of fiber. Yeah.

SPEAKER_01: 46:31

And it you know, and a lot of it too is understanding sort of how that fits into your overall health picture, right? So fiber is a really fun one. I'm I'm certainly not a fiber expert, but I can imagine a bunch of things, right? Where it's like, okay, are you taking fiber because you actually want it to absorb some cholesterol in your GI tract before it gets to your bloodstream? So it's about it's about cholesterol reduction. Great. I'm sure there's the right type of fiber for it. I think you brought it up. Is it soluble? Is it insoluble? Are you just trying to be regular? Are there other things that can be doing to be regular? Like if I'm am I just trying to maintain a healthy microbiome ecology in my system, right? I mean, can I do that with a few resistance starches rather than going down some of the hardcore fiber routes, right? So I think like how you help individuals make those decisions, they can certainly do it by feeling, right? You can certainly go on an elimination diet and add little things back in and then which makes you feel the best. I think that's probably more onerous than most individuals are willing to go down.

SPEAKER_00: 47:19

Diet for that is the most miserable thing to do in the entire world. And I've failed almost every time I've tried to do it, and so most people. So being able to get an exact genetic marker of what to do prior is the right decision.

SPEAKER_01: 47:31

100%. And you know, a lot of it too is okay, like it does it change based on the seasons? Does it change based on other things? Like, should my diet be following, I don't know, like wherever my genetics that I should be from? What are the fruit and vegetables? What is in season when? Like, is that what my ideal diet should be? Again, I don't think we know the answer to any of these questions. I there isn't a perfect diet. I think the perfect diet is the one that makes you feel great that you can stay on for the long term and that keeps you in calorie balance, right? That's certainly what we think the best diet is. I'm not a I'm not an advocate for one type of diet over another, but I think the the most meaningful thing is like, how can I find the diet that's best for you? How can I find the diet that suits your genetic profile, your biomarkers, that's helping you achieve achieve your optimization goals that you can actually stick with every day. If we get if we can get all those components put together, I think we have a win. Um and so those are the types of things we think about over over time.

SPEAKER_00: 48:20

Yeah, I I really couldn't agree more. I think it's so important to get an idea of how your body moves, functions, works, how you digest certain things. And I think what makes this harder is being an American, right? Because you have now genetic markers from all over the place. Like I have half my family is Sicilian and the other half is English. It's like talk about two polar opposite genetic profiles and just trying to figure out okay, what can I digest? My body's just totally confused.

SPEAKER_01: 48:44

Well, you just get to drink all the beer you want and eat all the pasta you want. Isn't that what that means? You get the best of both.

SPEAKER_00: 48:49

Hey man, I do great with carbs, let me tell you.

SPEAKER_01: 48:53

Anyhow. Uh but no, I mean, listen, it's fun to imagine where we can go with all this too. But but yeah, I think you know, the deeper that we can personalize this, uh, the more that we can make it just easier on folks to stay with for the long term, the better off they're all going to be for sure.

SPEAKER_00: 49:07

Yeah, I agree. But Brent, I do want to wrap this show up. So I'm gonna ask you the final two questions I ask everybody. The first one is if you were to summarize this episode in one or two sentences, what would be your take-home message?

SPEAKER_01: 49:17

Compounding matters, right? Get make the little decisions every day for your health trajectory that makes sense and and and get a sense of health agency uh from wherever you can. We certainly hope Sage provides some of that for individuals. So the more that you can feel a sense that you're in control of your health trajectory, that you understand your biomarkers, that you understand what's happening inside your body, uh, we certainly think you're on the best chance of having a long, healthy life.

SPEAKER_00: 49:43

Love that. And the second question how can people find you get a hold of you and learn more about Sage?

SPEAKER_01: 49:48

Yeah, I mean, the easiest we're Sage Healthspan everywhere. It's online at SageHealthspan.com, uh, all of our social media at SageHealthspan. Download the app, try it out. Uh, we'd love your feedback. We're in the early days of where we are as a business. So we'd love your feedback. If there's certain things you see that you love, let us know. If there's certain things you see you don't love, let us know. Um, you know, we're trying to make it right for folks. Uh, it's free to get started. You can upload 100 labs for nothing, and we'll give you a free analysis of everything, everything that you have. Uh, and then if you want to go further on the journey with us, uh, you know, we'd be thrilled to go down it with you.

SPEAKER_00: 50:19

Brent, thank you so much for coming on. Thank you guys for listening to this week's episode of Healthy Fitness Redefend. Don't forget, subscribe. It's the only way the show grows. We really appreciate it. As you know, we don't run ads or anything else like that. So share with the friend. And if you're not following, please hit that follow button. It means the world on the analytics. And don't forget fitness in medicine. Until next time. Thank you guys for listening to this week's episode of Help to Fitness Redefind. Please don't forget to subscribe and share the show with a friend, with a loved one, with those that need to hear it. And ultimately, don't forget Fitness in Medicine. I'll see you next time.