SPEAKER_02: 1:12

Danielle, how are you feeling today? Well, I could be a little bit better. I'm having a little pain in my back, but you know, nothing a good uh doctor can't help.

SPEAKER_01: 1:21

I know, and it's that time of year where all those bugs and things are going around and our kids are like petri dishes.

SPEAKER_02: 1:28

Yes, they are.

SPEAKER_01: 1:29

Bring home everything under the sun.

SPEAKER_02: 1:31

Yes, they do. And I'm gonna knock on wood because we haven't had much in our house. So we're knocking on wood because right now it is kind of okay right now at our house when it comes to all the colds and flus and different things that are going around. We have other issues, but you know.

SPEAKER_01: 1:47

Today we have Dr. Nick Gentry on, and he's here to kind of help us sort through all the ways that we can stay well and um take care of ourselves and our families during these cold months and the holiday season. Nick, how are you today?

SPEAKER_04: 2:04

I'm great. How are you guys? Good. Thanks for being on the show. Yeah, thanks for having me. I've actually so for the listeners, like Brock produces both of our podcasts, and he's like, You should go on their podcast. I'm like, okay.

SPEAKER_01: 2:15

Yeah, and he has a great podcast. I've listened to several episodes and sent them to my husband because a lot of them are are topics that I don't know. I don't know that all guys are seek out, you know, the different topics. Oh, they're men's. Yeah, thank you. And so I will send them and be like, hey, you should check this out. You should, you know, think about this, especially as we get into like middle age. And but anyway, we'll totally round back to that. But and we're happy because we've had to reschedule this since you know I had bronchitis and he was kind enough to send me some supplements that actually helped greatly. I so thank you.

SPEAKER_04: 2:49

I love them. And so, like we talked about, you know, bronchitis is unless you have underlying COPD, it's like 98% viral.

SPEAKER_01: 2:57

Yeah, and when he told me that, I don't know why I always had my head that you take antibiotics when you have bronchitis. Yeah. Maybe it's because I'm usually prescribed that. But it's good to know because like you don't want to become resistant, you don't want to like contribute to the resistance in bacteria.

SPEAKER_04: 3:12

So I actually just released an episode of acute viral illness supplements, and and one of the reasons that I did that is because when you take a round of antibiotics, it takes six to twelve months for your gut to recover.

SPEAKER_01: 3:24

Oh my gosh.

SPEAKER_04: 3:25

And most Americans take one to two rounds of antibiotics per year, which means your gut is in a constant state of dysfunction.

SPEAKER_01: 3:33

I didn't realize it took that long because I always think, oh, I'm taking probiotics. I'm probably gonna be fine right after.

SPEAKER_04: 3:39

Well, and that can help. The probiotics are great. Yeah. But you know, so the most common thing is a ZPAC, right? Well, azithromycin is a really, really broad spectrum antibiotic. So it's not only killing the bacteria that it's going after, it's also killing collateral damage of all of our good bacteria in our gut. But uh it just drives me insane because this time of year, especially, upper respiratory infections, so like your cold flu symptoms, cough, congestion, low-grade fever, sore throat, headaches, body aches, about 98% of them are viral.

SPEAKER_01: 4:12

Okay. Yeah, and there's so much going around it's hard to even pinpoint what they are sometimes.

SPEAKER_02: 4:17

You'll you know it's kind of like you just have to go through wait it out. Yeah, yeah.

SPEAKER_04: 4:22

My daughter just had something that I the flu so the flu test is not very good. It's um like if God himself said this person has the flu, the flu test is only positive like 60, 70% of the time.

SPEAKER_01: 4:32

Wow.

SPEAKER_04: 4:33

And depending on operator as well. But you know, my daughter's flu test was negative or COVID test was negative, but I'm like, this is flu. Really? Like I just yeah, sudden onset, super high feeders, like crying because her body hurts so much. I'm like, yeah, this is a lot of things. Sounds like the flux flu.

SPEAKER_01: 4:48

Yeah. So I wanted I have so many questions about these things and supplements. I kind of nerd out on supplements. I used to dive into the world of how they became unregulated and how people use them and how doctors integrate them. But before we go into that, we always like to ask how you came into the area because I know you went to university in Missouri.

SPEAKER_04: 5:10

That's where I went to med school, yeah.

SPEAKER_01: 5:12

Yeah.

SPEAKER_04: 5:12

So born and raised southern Missouri, undergrad at Southwest Missouri State University, med school at Missoo, and then I actually did my residency in emergency medicine in Richmond, Virginia. And I knew I liked emergency medicine because it was so broad, but even early on, I was like, you know, traditional medicine is super broken. And I started doing all this just research on my own and taking these courses, going to trainings about regenerative medicine and functional medicine and just complementary type things. And then finally in 2017, well, so you how I got to the area or how I got into the type of medicine I do.

SPEAKER_01: 5:50

Let's do both. Let's do how you got into this type of medicine and then how you came to Northwest Arkansas.

SPEAKER_04: 5:55

Okay, so the the medicine part, I just noticed that traditional medicine was super broken. I felt like it was doctors standing around a conveyor belt of patients and like slapping band-aids on and hoping that the band-aid held until they got to the next doctor. And we weren't fixing anything, we're just treating symptoms. You know, even in the emergency department, I mean, yeah, if you come in with a broken arm and I splint it and it heals or a dislocated shoulder and I pop it back in, like, okay, that's you're done. But for most things, it was like these acute flares of an underlying chronic condition. And traditional primary care doctors are spending on average six to eight minutes with their patients. That's really hard to do much. And it's not necessarily to their fault because you know, insurance reimbursement and just everything else, they have to see 40 or 50 people a day to make a living.

SPEAKER_01: 6:44

Yeah.

SPEAKER_04: 6:45

So I wanted to try to get into like root cause medicine. So, like I said, I started doing all this training. And then in 2017, I opened my own practice doing just that. And so we did some aesthetics, you know, some Botox filler, laser kind of stuff, but I did a lot of functional medicine, regenerative medicine, hormone replacement therapy, and I just loved it. And so we just grew. And then in 2018, I took a non-medical business partner and we formed rejuvenated medical spa for women. And medical spa is a bit of a misnomer because really only about 25% of our practice is actually probably more like 35% is aesthetic.

SPEAKER_01: 7:24

Okay.

SPEAKER_04: 7:24

The rest of it is hormone replacement, functional medicine, weight loss, regenerative medicine, that kind of stuff.

SPEAKER_03: 7:31

Okay.

SPEAKER_04: 7:31

And then we have a men's clinic called Maverick Mail Medical, where we do most of the same things for men. But as we talked about, men are not great about going to the doctor.

SPEAKER_02: 7:40

No, or taking medicine.

SPEAKER_04: 7:42

So, yeah, or anything, yeah. I can't tell you the number of times where like a guy will come in for low testosterone evaluation, and I'm like, Well, when's the last time you saw a doctor? He's like, Well, I think I had the flu about five years ago. I'm like, You're killing me, man. So true. And then how I got to the area is uh I met my wife in college and she's from Fort Smith, and so she was kind enough to follow me around throughout uh, you know, med school and residency. And then 2015, we were like, you know what? We want to go back closer to family. My mom's in southern Missouri, my brother's in Springfield. She has some family in Fort Smith, and then she has a sister here, and uh, so we moved back here, and then probably three or four years ago, her parents retired and moved here as well. So now we have like a core family.

SPEAKER_01: 8:29

Yeah, you guys are all like kind of in a hub, really close.

SPEAKER_04: 8:31

Yeah, my mom's about three and a half hours away, my brother's two and change, so it works out.

SPEAKER_01: 8:37

It's not bad. Yeah. Okay, so in Richmond, when you were in residency in the ER, I I like to ask doctors about this because to me, emergency room seems really intense.

SPEAKER_04: 8:50

Can be.

SPEAKER_01: 8:51

And I mean, it can be because I think a lot of times I've been to the ER and it's usually just like extreme illness or something, not necessarily trauma, but I imagine the trauma part was a lot to take in. Like, do you feel like med school prepared you for what you were gonna see?

SPEAKER_04: 9:06

No.

SPEAKER_01: 9:07

Okay, no.

SPEAKER_04: 9:08

So I did my residency at Virginia Commonwealth University, which is in downtown Richmond, and it is extremely high volume, high acuity, meaning super, super sick injured people. Richmond actually, not that well known, but it actually has a very large gang presence. And so we saw a tremendous amount of gunshot wounds. It also is very close, it's like a mile off of the intersection of Interstate 64 and Interstate 95. And so two things there is one is just a lot of high traffic want trauma from car accidents, but Interstate 95 is a well-known drug trafficking route from Miami up to New York. And so we saw just a tremendous amount of crime-related violence, so much so that the my second year of residency and then my chief residency year, I taught special operations combat medics. So there were only two hospitals in the United States that this the special operations, so like your Navy SEALs and Green Berets and that sort of stuff, they they sent their combat medics to us and another hospital in Tampa to train how to take care of trauma.

SPEAKER_01: 10:20

Wow. It's intense.

SPEAKER_04: 10:21

Yeah, it was intense.

SPEAKER_01: 10:23

I was not expecting that when you try to ask that question.

SPEAKER_02: 10:26

You're like, I was expecting just people getting in car accidents. Yeah, hearing about I mean, obviously, yeah, no, but I think like sometimes that's where our brain goes when we think of ER is we think of trauma from an accident. Um or people doing stupid things, but here we are hearing about your practice a little more peaceful in terms of your clientele.

SPEAKER_04: 10:49

A bit so, yeah. Mine's mine's a little more, a little calmer. And then it also is in in downtown Richmond, so it's a very impoverished population. And so very, very high incidence of sickle cell anemia, in-stage renal disease, and stuff like that. And so we had a Larry, a very high trauma, but also a very just sick population with lack of access to healthcare. If you want to go into emergency medicine, VCU is a great place to train. Because when I left there, I did feel like I could literally do anything.

SPEAKER_02: 11:17

Sounds like it. There's a great, I mean, my my niece is in the nursing program at the University of Arkansas, and she wants to work in the ER. And I kind of laugh at that because I'm like, you think you can handle that? Because I don't know that I don't know. I don't she she probably can. Not she probably will surprise all of us that she can totally handle it. But I think it takes a very special and unique person to handle that much blood and guts and sickness and and it's not just that, but it's from one, it's shift work, and so you're working days, nights, holidays, weekends.

SPEAKER_04: 11:49

But the I'd say the one of the hardest parts about it is emotional.

SPEAKER_02: 11:53

Oh, yeah.

SPEAKER_04: 11:53

Um, because you have to think about it, like you run into somebody who's having a bad day, right? Like, oh, okay, like that was a a stressor to your day. When you're working in the emergency department, everybody is having a terrible day.

SPEAKER_01: 12:05

Right.

SPEAKER_04: 12:06

You know, whether like the worst day. Yeah, whether it's something simple like a broken arm all the way up to I just lost my husband of 60 years, and you know, like, or the worst part of it is is the death of children. That that is that is the worst part of medicine, in my opinion.

SPEAKER_02: 12:22

That's a that is a good perspective to think through of just how doctors for the emotional yeah, or like the people that are coming into the ER are having essentially the worst day ever. Like, wow.

SPEAKER_04: 12:33

And every everyone you meet is having a terrible, terrible day. And so that does kind of wear on you emotionally. Yeah.

SPEAKER_02: 12:39

So how did you balance that? Like, how did you find like joy in the midst of being in a place that was just so heavy and and hard?

SPEAKER_04: 12:50

It's a little difficult. It's uh one is you do desensitize to some extent. No, I I do think if you desensitize too much, you're not a great physician anymore. But you you do kind of separate and categorize how you're responding to things and and can sort of learn to emotionally distance yourself to a certain extent. Right. And then I think the big one is the camaraderie of the staff. So um, you know, I can remember once we were working on a on a 10-month-old baby that was dying, and so there was another doctor that was helping, and we had you know, like two or three techs in there and like three or four nurses, and we're all just bawling. Like every single, every single provider in the room has tears in their eyes, and the parents are crying, and it I mean it was it was awful. But going through and and I I've never been in the military, so I can't say this, but that's the only thing I can think of is like going through something so terrible as a team, the stress of combat or the stress of losing a baby, like it really draws your staff closer and and lets you rely on each other. And I I can remember after that baby died, the parents hugged me and they knew that we tried everything we could, and like the nurses afterward were hugging me and like asking me if I was okay, and like and so that is something that's really like that support system is helpful, but it's it's really difficult.

SPEAKER_02: 14:18

Yeah. So, how did that impact you in moving forward? And then as you've kind of gone in a different direction, away from away from emergency care to kind of like preventative and wellness, and how so what what are some of the things you learned in that space that have kind of helped you in this new space that you're working in? I guess it's not new because you've been doing it for a while now, but like how did that impact you or did it? Oh, absolutely.

SPEAKER_04: 14:46

So I I think one of the cool things about emergency medicine is you're sort of really broad in your knowledge base. Yeah. You know, like a uh orthopedic surgeons, for instance, are super, super smart. But I remember I was so I was going to be an orthopedic surgeon, is was what I initially wanted to be. And then I was on my ortho rotation, and somebody handed the orthopedic surgeon an EKG, and he goes for because it was pre-operative. Right. He goes, I don't know what to do with this, give it to somebody else. And so at that point, I was like, you know what? Like I want to be able to take care, I I love sports medicine and I love musculoskeletal stuff, but I was like, I want to be more broad than that. And I remember one day in the hospital, I had a six-day-old infant in one room, and right next door I had a hundred-year-old man. Wow. Wow. And I was like, you know, that's really cool. And so I I think how it helped me is number one is just dealing with a broad variety of medical issues. And then I think number two is I I do a lot of procedures. And so being in the emergency department and and intubating people and setting fractures and doing central lines and all of you know, suturing, I think being able to do all those procedures made me adept at doing the procedures that I do now.

SPEAKER_02: 16:05

That's really awesome.

SPEAKER_01: 16:06

Yeah, you're expensive. You have a really broad experience too. So now your focus, you talked about aesthetics or that side of it being like 35%, and the other part is hormones and wellness, which is super important because we go through these fluctuations all through life. Like I have a daughter who's 11 and she's got what are you talking about? And I'm 40, so I have some other stuff going on.

SPEAKER_02: 16:34

We have none of those things. We're not experiencing any of that. What are you talking about?

SPEAKER_01: 16:39

I know, right? So hormones play such a big part of life as we age. And so I think it's good to have a doctor that's open to talking about those. And supplements as well, because supplements are unregulated. And so I feel like it's hard to know which ones are good and which ones are tested because there's so many.

SPEAKER_02: 17:01

Wasn't there something in HRT that just got approved?

SPEAKER_04: 17:04

Or no, so the uh just last week or the week before, the FDA removed the black box warning of hormone replacement therapy about breast cancer, and unfortunately it took them about 15 or 20 years too long to do that.

SPEAKER_02: 17:18

That is insane. 15 or 20 years too long. Sorry, I interrupted you.

SPEAKER_01: 17:23

No, I'm actually glad you asked that because I had it in my mind I was gonna ask about that shit. No, I really did because I have a family member who would not do it because of the warning. Yeah. It made me think about that.

SPEAKER_04: 17:33

My own mother-in-law wouldn't do it. Yeah, um, she's had hot flashes for held 20 years. Yeah. And I was like, I was like, she got but breast cancer risk. There is zero evidence that bioidentical hormones are linked to breast cancer risk. Zero. So the it was the women's health initiative. Um I believe it ended, they ended in like uh 2001 or 2000, showed that synthetic progestins increase the risk of breast cancer.

SPEAKER_03: 17:58

Okay.

SPEAKER_04: 17:59

Interestingly, too, the the estrogen therapy that was primarily used in that study was primeren, which premerin is pregnant mares.

SPEAKER_02: 18:08

Yeah.

SPEAKER_04: 18:09

It literally they were taking the urine of pregnant horses so crazy. And isolating the estrogens and giving it to humans. And they they still I know, isn't it crazy? Yeah, so the but I love your favorite comes from pregnant mares.

SPEAKER_02: 18:22

And so females pregnant horse hormones throw flowing through my body right now.

SPEAKER_04: 18:26

No, yeah, pregnant rain. Pregnant horses have like, I think it's like 10 different types of estrogens versus female humans only have three. Yeah, and so you're they it just it was it was a really big study, but they it just and we did get a lot of information from it, but it it wasn't designed well initially. Yeah, no, they kind of freaked out because they're like, oh my god, breast cancer, breast cancer. And then once they went back and looked, it was just this particular class of synthetic hormones that was the link to breast cancer.

SPEAKER_02: 18:56

Wow, interesting. That's really interesting. I've done a lot of work with breast cancer patients through film, like film documentary work. And so I've learned a lot about hormones, and I'm actually doing HRT now, but I'm really thankful for it. It's finally starting to kind of take effect, I guess you could say. So I think that that that when we are listening to our bodies and paying attention and we have the right care, I think that it can be really helpful. So I'm glad that those things are changing.

SPEAKER_01: 19:28

Yeah. What age do you think women should start checking on that? Do you think it's something that should be checked before you're feeling any type of age-related kind of symptoms?

SPEAKER_04: 19:41

Or tough question to answer with a straight just number, but um, so the average age of menopause is 49 to 51, but that's when like you stop your menstrual cycle. Okay, so the definition of menopause is no menstrual cycle for a year. So that average age is 49 to 51, but that can depend on lifestyle, it can depend on medical conditions, it can depend on when your mother stopped menstruating. So a lot of women are having symptoms much earlier than that. And so, you know, if you're having mental fog, difficulty losing weight, uh, hot flashes, vaginal dryness, night sweats, thinning skin, all of these things can be related to that. But the the other problem too is because of environmental risks like endocrine disruptors in plastics that contain the like are storing our food or or packaging of our food, um, water bottles. So these endocrine disruptors, so we're actually seeing a disruption in hormone production much, much younger. So I have some patients in their 30s, but I would say a good ballpark would be if you're asymptomatic, when you turn 40, you should probably get your hormones checked. And then certainly if you have symptoms before then. Okay. I mean for sure. Yeah, whenever you have symptoms, you know, obviously. But um, you know, and again, lack of libido, lack of arousal, all of these things can can really be hormone related. Not that they always are, but frequently.

SPEAKER_02: 21:38

Yeah. Welcome to your 40s, Danielle.

SPEAKER_01: 21:41

Well, look, I just turned 40. I'm just I got my mam and grandma, right? One step at a time.

SPEAKER_02: 21:47

One step at a time. I love how we I love how we told our our listeners that we're gonna talk about the flu and the seasonal illnesses are going on. And we are talking about vaginal dryness.

SPEAKER_01: 21:58

No, we are no, but that's important.

SPEAKER_02: 22:00

Um, we should things are.

SPEAKER_01: 22:04

We should shift to, but I think that what we talked about, you know, in terms of wellness could also be helpful, just all around health. So when October hits or it it starts to get cold, what do you recommend people start taking in terms of supplements or vitamins, or maybe even this lifestyle, just getting outside in terms of uh keeping them and their kids safe?

SPEAKER_04: 22:29

So all sorts of stuff, actually. What I personally do is about October, I so I take all your I take a multivitamin that has some vitamin C in it, and I take vitamin D. But about October, I double my dose of vitamin D. So I do a vitamin D3 with vitamin K2 because vitamin K2 helps protect against vascular disease, cardiovascular disease. Okay. So vitamin D can redu a whole bunch of things, but it does have a negative. Vitamin D can reduce risk of certain cancers like cold and cancer, it can improve mood, it improves your immune function, but and bone density, but the downside is vitamin D mobilizes calcium. And excess mobilized calcium floating around in your bloodstream can deposit in atherosclerotic plaques, which we all have, and even younger ages we all have. And so um I always recommend vitamin D3 with vitamin K2 because vitamin K2 helps prevent that calcium deposition. Oh and so vitamin D is super important. So even our white blood cells have vitamin D receptors on them, and they are able to activate vitamin D. So a lot of what we get in our diet and a lot of what's in our body is a precursor of vitamin D. Sunlight is one trigger to activate that vitamin D, but if you don't have enough of the precursors or if you're darker skinned, you have a difficulty, a difficult time doing that. But our white blood cells can actually activate vitamin D to its active form, which then activates the white blood cell. And so it's a big portion of our immune system for viral immunity, bacterial immunity, and anti cancer. So that's how that part works. Vitamin C is also really important. So when October rolls around, I start taking a thousand milligrams of vitamin C twice a day. And then I do on the vitamin D, I do 5,000 international units twice a day, like October through February. Okay. And then the rest of the year I just do 5,000 once a day. I also really like if you have an acute illness, there's a supplement called SPM or Selective Pro-Resolving Mediators. And so it's a molecule that's in your body that's made from essential fatty acids like fish oil, like omega-3s. And so when you get sick, your body turns on an inflammatory cascade. And so you remember when people are talking about the cytokine storm with COVID? So some people turn that off and some people don't turn that off well. So we want an inflammation an inflammatory response when we get sick, but when you get the flu, for instance, it's not the flu virus that makes you feel bad. It's your immune response to the flu virus that makes you feel bad. So your white blood cells start recognizing the flu, you start producing antibodies against it, you start trying to um kill the cells that the virus is using to replicate itself, and it causes fever. So the your body releases these inflammatory cytokines that cause fever and muscle aches and headache and make you feel like crap. And then what is supposed to happen is around 48 to 72 hours, your body says, Okay, we've started making the antibodies, we're neutralizing the virus, we got to start cleaning up the collateral damage, and it switches over to an anti-inflammatory cascade. And a different type of white blood cell called macrophages come in and start cleaning up all the dead cells and whatnot. So some people don't do that anti-inflammatory shift very well. And so you can actually there's two companies that make a selective pro-resolving mediator that's synthetically made from fish oil. And so if I get sick, I immediately start taking those. So that can can be beneficial. So I vitamin D and C great for preventative and treatment. If I get sick, I take even more vitamin C. Like I'll take six to eight thousand milligrams a day. I also really like zinc. So like for an adult, 25 to 50 milligrams a day, probably 25 for preventative, 50 if you're acutely ill. And then I do a whole bunch of stuff. Like when I get sick, I can't afford to miss. And so I go like kitchen sink at it. I do IV vitamin treatments, I do IV ozone therapy, I do sauna therapy, I do like a million different things, but I can usually reduce my illness by about 40 or 50 percent duration. And I don't treat the fever, for instance. I don't take Tylenol and ibuprofen for fever, I just let it run.

SPEAKER_01: 26:51

Right.

SPEAKER_04: 26:51

Because the fever upregulates your immune system.

SPEAKER_01: 26:54

So fever is okay as long as it doesn't get too hot or you're pregnant, because when I was pregnant and I had the flu, they didn't want me to have a fever too high.

SPEAKER_04: 27:04

Yes, and there's some evidence of different issues, like autism, for instance. They, you know, they're trying to link like pregnant women who took Tylenol who had higher risk of autism. Well, that's a correlation, that's not causation. And so did they take the Tylenol, did the Tylenol cause the autism, or was it because they had an acute viral illness, such as the flu, while they were pregnant, and that's why they were taking the Tylenol?

SPEAKER_01: 27:29

Or took tamaflu. I didn't take Tamil flu, but I had actually mixed opinions on if I should take it or not. And I didn't because I think I had waited too long anyway, so I didn't. But my fever was so high that my doctor wanted me to take. I don't know if I took Tylenol or not. Um probably. But here's the reason why. So you want to hear something weird. This is very personal, but I had epilepsy as a child. And for some reason, and I don't know why, because I don't know, I didn't think to ask because I was a kid. My doctor told me never to take Tylenol. I don't know why. And I that's just my own personal experience. Have no clue why he would not hate that.

SPEAKER_02: 28:07

Were you on medicine for epilepsy?

SPEAKER_01: 28:09

I was dilantin'.

SPEAKER_02: 28:10

It could have been maybe it mixed weird. It was though. I don't know. Yeah, because my sisters, I think, weren't allowed to take it because it could hurt, it could affect their I think because the medicine they were on for their epilepsy was hard on their liver. Uh-huh. And if they take too much Tylenol, then it adds more problems to your liver.

SPEAKER_01: 28:26

But I take Tylenol now, my kids take Tylenol. Anyway, no, we're not, you know, everyone has to make their own choices with their own doctor, but um, but no, I thought it was interesting when you talked about the fever because I will let my kids run a little bit of a fever because it's supposed to, but not too high, right? You don't want it to get like 105. One time I had to take my daughter to the ER when she was like 18 months, she had like 105 fever. That's scary. For one day, went away. The most bizarre thing.

SPEAKER_02: 28:52

Is her body working, her immune system. I love this conversation. I think it's really informative. And I it's funny because I'm like, I don't understand medicine super well, but like I am tracking with all of this. I am tracking. The way you explain how you're explaining things is really well, and it's kind of like we're getting like good advice. Like, I had uh fungal pneumonia a little over a year ago, and I was on antifungals for like eight months or something, and it's just interesting, like all the things that we've talked about today, just about like the gut stuff and the different things. I was on antibiotics, antifungals, I spent time in the hospital. It's like a lot of a journey, and all the things you're talking about, the inflammatory stuff and things. I was like, ooh, ooh, I need to wait. I'm like, I need to take some notes now. I know. Like, well, when I re-listen to this, I'm we're gonna relisten some. Like, okay, I'm gonna take this, and this is gonna help me with my inflammation, and this is gonna help me like all get the transcripts.

SPEAKER_04: 29:46

Yes, we are definitely doing that. Is because I I had these very frequently asked questions. And so what I started doing is, you know, someone will ask me about a supplement or a treatment or or a particular topic. And so what I've started doing now is I say, okay, here's the 30-second answer, here's my podcast, there's the 30-minute answer. That's great. And so that's it's a way for me to stop repeating myself and then just also it it forces me to pick a topic and like deep dive into the research. So it's kind of a way for me to make myself stay current as well.

SPEAKER_02: 30:21

Yeah. What are some of the topics that you've enjoyed deep diving into?

SPEAKER_04: 30:25

Uh, so hormone replacement is a big one. So my practice as a whole, like I said, is maybe 35% aesthetic. My my personal practice is about 50% aesthetic, 50% functional, and hormone. So we've talked about like the weight loss drugs, the GLP ones, we've talked about hormone replacement therapy, platelet-rich plasma, supplements in acute viral illness, osteoporosis, sleep. Uh, a couple of my favorite ones were actually hot and cold therapy because that's getting a lot of like media attention now.

SPEAKER_02: 30:53

Yeah, it is.

SPEAKER_04: 30:54

And so um just kind of linking it to this particular topic of acute viral illness. In a lot of countries like Denmark, Norway, Finland, they will let their babies outside in the cold. They will never let them nap. So something that would be considered child abuse in the United States.

SPEAKER_02: 31:14

They wrap them up. They're not like Yeah, but they'll I mean they're they dip them in water and then they put them out in the freezing cool. Oh, I have zero doubt about that.

SPEAKER_04: 31:26

And culturally, you know, like here, like, oh, don't get cold, you'll catch yourself in a cold. That's that's not true at all. Oh, my grandma used to say.

SPEAKER_02: 31:32

That through yeah. And we're also like in the south. My uh in-laws who live up north, they like pretty much make fun of us. Like when we're like it's snowing, they're like, ah, so cute. Yeah.

SPEAKER_04: 31:43

And so they'll um, and then the first time it significantly drops in temperature, even adults will culturally off often they'll go outside in the cold, and it's it's a bit of a shock, and it actually improves it reduces your risk of viral illness.

SPEAKER_03: 31:57

That's awesome.

SPEAKER_04: 31:58

Saunas. So a lot of those same countries, and then Russia as well, uh, it's like a cultural thing to do dry sauna therapy. And so um, dry sauna has all sorts of benefits, you know, reduce risk of heart disease, but it also boosts your immune system.

SPEAKER_01: 32:12

How long do you stay in the sauna? Because I always wonder, I I like to go to the sauna. How long do you stay in and at what temperature is like a good temperature?

SPEAKER_04: 32:21

So the the time is fairly clear 10 to 20 minutes. Okay. Minimum of four times a week is ideal.

SPEAKER_01: 32:27

Oh.

SPEAKER_04: 32:28

For heart disease specifically.

SPEAKER_01: 32:29

Okay.

SPEAKER_04: 32:30

Like in um there was a big observational study, and they did thousands and thousands of people that they monitored through surveys, and the ones that did sauna four or more times per week had a almost 50% lower risk of heart disease than those who did it one or fewer times per week.

SPEAKER_01: 32:48

And that's like the number one of the number one killer. Oh my gosh, isn't it?

SPEAKER_02: 32:52

Jeff, I know you're listening. We're getting a sauna, okay?

SPEAKER_01: 32:55

And I have another question about cold plunging. So I am all about this type of health care. I love to cold plunge, even in my pool in the winter. I don't know, it's not really regulated. I just jump in freezing cold even in my hot tub. Okay, good. It totally works. My kids do it too.

unknown: 33:11

Yeah.

SPEAKER_01: 33:13

But so for a while I was always under the impression, you know, of cold plunging was really good for you. But then I read some article recently that said there was actually no legitimate studies, and I should check the source, but um about the all the benefits that they're saying. But I just know from so many people that I know in the medical community and out like athletes, how good it is. Like, I don't understand what the controversy is.

SPEAKER_04: 33:42

There there is a fair amount of data, actually, but um, so for the sauna, 10 to 20 minutes, probably nobody knows exactly, but probably 170-ish or higher on the temperature for dry sauna. It probably also works for like if you got in a hot tub at 105 and went all the way up to your chin, or if you did a steam room or something, it it probably would work as well, but it's not well studied.

SPEAKER_01: 34:06

Okay.

SPEAKER_04: 34:07

Um, so the the the thing is you're trying to activate a group of proteins called heat shock proteins. And these are proteins that chaperone the folding of other proteins. And so if you have normal, it's to ensure that your normal enzyme proteins and and other proteins are folded in the proper form. And so that can occur from a DNA mutation or from inflammation and different things, and it will actually help correct the form of misfolded proteins. But the hot therapy also acts like a hormetic stressor similar to exercise. So um I wear a heart rate monitoring device, and when I go into the sauna, my heart rate gets up like really high. 140s, sometimes into the 150s if I stay a long time.

SPEAKER_01: 34:52

I thought I heard this. Remember when I had you over the hot tub and I told you it's like having a workout?

SPEAKER_04: 34:56

Yes, I did.

SPEAKER_01: 34:57

Can it replace the workout? No, can it?

SPEAKER_04: 35:00

You're not getting the muscle stimulation. Supplement to the workout. From a cardiovascular standpoint, it is helpful. Cold plunge, probably one to three minutes, two, three times a week.

SPEAKER_01: 35:10

Okay.

SPEAKER_04: 35:11

Always, if you're gonna do both, do hot first, then cold.

SPEAKER_01: 35:13

Oh, hot then. Well, because I have noticed when you're doing an intense workout, cryo, and I've had friends tell me you've got to do it. It helps. Cryo afterwards reduces your DOMS, right? Your delayed onset muscle soreness. And I have so many friends that are in Iron Man and have done Iron Man, they do cold therapy. I've heard nothing but great things, and I always feel great after I cold plunge.

SPEAKER_04: 35:37

So yeah, yeah, it does reduce inflammation. And funny enough, cold plunge also activates heat shock proteins, so it's the temperature extremes that do it. The other benefit you get from cold plunge, which probably helps a lot with your DOMS, is you get a spike and growth hormone. Oh, and so the shock to your system causes spike and growth hormone. And it it wouldn't harm you to cold plunge every day if you wanted to. But these people that are doing it for like 10 and 15 minutes, they're may or may not be doing any benefit. Probably one to three minutes is adequate. But they I read a study and I talked about it on my podcast, but basically, I don't remember the exact numbers, but they did cold plunge weekly for people, and then they took that same group and they did it daily. And the spike of growth hormone that you got from the cold plunge exposure diminished the the more frequently you did it. Oh. So it's still on on day seven of the week, it still showed a bump, but it was like a tiny little blip versus if you just do it once or twice a week, you get a big jump in your human growth hormone. That's probably where you're getting the reduction in DOMS.

SPEAKER_03: 36:38

Okay.

SPEAKER_04: 36:38

And it could be from just inflammation as well. But I personally take a peptide called Surmorlin that increases human growth hormone production and it tremendously helps my DOMS Oh. So I'm I'll do a heavy leg workout and I'm minimally sore with it versus if I do that same workout without it, I'm sore for like three days.

SPEAKER_01: 36:56

I know, and then sometimes I can't go back to the class for the rest of the week because you're so sore. Yeah.

SPEAKER_04: 37:01

Yeah.

SPEAKER_01: 37:02

So at your uh med spa, what type of cold plunging do you do?

SPEAKER_04: 37:07

Do you we don't do cold plunging med spa? No, it's it's really a financial decision. Yeah. And well, practical and financial. A cold plunge takes up a lot of space. Right. You can't charge very much for it. You have to keep them clean, and when you have multiple people doing it, so then you need a shower. And it's so just from a practical standpoint and from an overhead cost standpoint, we don't do sauna, we don't do cold plunge, and we don't do hyperbaric oxygen.

SPEAKER_01: 37:32

Okay.

SPEAKER_04: 37:32

If I had more space, I would love to incorporate all three of those things. And I know I would love to do hyperbaric oxygen. It just doesn't make sense from a business standpoint because you can't make much money on it unless you have a whole area dedicated to them. Okay. Like I go to the Fayetteville Athletic Club and they have, you know, a cold plunge outside, but then they also have this additional space that has like infrared, red light saunas, and cold plunge. And so you it's just tough.

SPEAKER_01: 38:00

Yeah. You do lasers though. I love lasers.

SPEAKER_04: 38:02

Yes, we do a lot of lasers.

SPEAKER_01: 38:04

So here's a question for you. How many different lasers are there in the med spa world? Because I know I've at least had two different lasers.

SPEAKER_04: 38:14

There's tons? Hundreds. Really? Yeah. So um, but they're largely there's ablative and then there's non-ablative laser.

SPEAKER_03: 38:22

Okay.

SPEAKER_04: 38:22

And so what we do mostly it's like laser that cuts the skin. So you're breaking the surface of the skin.

SPEAKER_03: 38:28

Okay.

SPEAKER_04: 38:28

And so most of the time, those are through either erbium or CO2 lasers. And so those are using the focus of the laser to actually shave layers of skin off. So you have more recovery, but you get better results from those. Okay. And you can go as deep as the patient can tolerate as far as pain, and us also as deep as they can tolerate as far as recovery, because the deeper you go, the more recovery.

SPEAKER_01: 38:51

Okay.

SPEAKER_04: 38:52

Then we also have lasers that don't break the skin. And so the most common example of that would be laser hair reduction.

SPEAKER_01: 38:58

Oh, okay.

SPEAKER_04: 38:59

So that is a type of laser, but doesn't break the skin. And there's multiple different wavelengths based on, you know, durability of the laser, cost of the laser, skin tone of the patient versus their hair color. And you would use different wavelengths for that, for instance. And then one of the most common laser treatments we do is called BBL, which is a proprietary version of IPL, which is Intense Pulse Light. And ours is a brand called Cyton, because I think it's the best, and it reduces sun damage. So like your reds and browns that are pigment, but it also doesn't break the skin.

SPEAKER_01: 39:32

Okay.

SPEAKER_04: 39:33

And so I sort of just categorize lasers as ablative and non-ablative.

SPEAKER_01: 39:37

Okay. Your practice is a combination of your medical experience as well as lifestyle and diet and just all around wellness. And I feel like that is something that people have been wanting for a really long time that hasn't necessarily been available. Is there anything else that you want to share about what you provide?

SPEAKER_04: 39:59

So I I like to view our practice as holistic as an W-H-O-L-I-S-T-I-C, not just an H. Like we look at the whole person. So not that we're perfect, but we started doing this in 2017. And so there was me and one other physician in Fayetteville doing this. And now there's a lot of people that are trying to copy it, but I don't feel like they do it well. We really try to focus on the patient experience as a whole. So you come in and you do labs, and so we do a very thorough lab panel, which is much more expanded than like your primary care doctor would do. Then you come back and see a provider to go over those. And that first appointment, we actually spend 45 minutes with you.

SPEAKER_03: 40:37

Wow.

SPEAKER_04: 40:37

And so we talk about, I kind of break my stuff up into five categories, which is physical fitness and nutrition, stress and toxins, hormone replacement, and just optimize wellness type stuff. It's like just my foundation. And then we kind of deep dive into everything. So I ask you everything from how you're sleeping to what you've eaten over the last several days to what you do for a living, you know, family history, all sorts of stuff. And so we we really try to be quite thorough in that first visit. It can be almost overwhelming because people aren't used to that thorough of an examination and history. And then we have you come back. So we'll kind of do a few things because you don't want to do too many things at once. So we'll have you come back with six to eight weeks and do repeat labs if we started you on something that would affect labs like hormones, and then then we kind of like fine-tune things every couple of months after that. And um, so I feel like we do a really good job of getting to the base of these things, trying to find out what is the underlying condition. And some stuff is really easy and and some stuff is not, you know, like fungal toxins and and chronic Epstein bar and you know, Lyme disease, and all these things can can take months to years to flesh out. Gut health is one that often takes several months to like really, really turn around significantly, but it's a process, and so I feel like if you keep the this very thorough approach to looking at the person as a whole, then you're much more likely to get to those underlying issues and and be able to remedy those problems.

SPEAKER_02: 42:11

Well, now I want to come in. I know. I was like I always come in with the about to leave my PC. Here's all my problems, Dr. Jim. Here's all my problems. Fix me. Yeah, yeah. He's like you have to fix yourself too. Yes, yeah. Follow directions, take your supplements, do the things. Yes, absolutely. I think it's really great. Now, do you? I mean, I this is like a personal question, but also probably good for our listeners. How does insurance work at a at an office like yours? We don't take insurance at all.

SPEAKER_04: 42:44

So um, but we actually we tried for a while years ago, and it was a nightmare.

SPEAKER_02: 42:49

Yeah.

SPEAKER_04: 42:49

So I would literally have to hire two full-time employees to take insurance with the volume of patients that we do, at least one and a half. So we tried for a while and didn't work. For our first evaluation for patients, we do super thorough labs and a 45-minute office visit, and it's$2.99.

SPEAKER_02: 43:07

Yeah, that's great.

SPEAKER_04: 43:09

Pretty reasonable for most things. The only things that we do that get, you know, fairly expensive sometimes when we do platelet-rich plasma or stem cells, those types of things can get more expensive. But most of what we do is very, very affordable. Yeah. And if you start thinking about like, okay, like my family pays$2,000 a month in healthcare insurance premiums, that and our insurance is terrible. And so, and then whenever I want to go get something, they're like, Yeah, sorry, we're not gonna cover that. Yeah. And I have to end up paying out of pocket for it anyway. So most of what we do, you know, like hormones, they'll cost you for a woman ballpark,$1,200 a year, maybe a little bit more once you tack on labs or something. It's pretty affordable considering what healthcare costs in general. Right. And so we found that it's actually less expensive. And like for our male patients, there's some competitors that do take insurance. And I would say probably 80 to 90 percent of them that switch over to us for just a better expertise and better experience. They're like, I came to you for a higher level of care, but it turns out after all my co-pays and deductibles and everything else, I'm paying less.

SPEAKER_02: 44:18

That's wild.

SPEAKER_04: 44:19

And so it it really is kind of interesting that we're able to keep those costs down. And we actually haven't raised costs in several years, which is somewhat difficult with you know the cost of literally everything going up in the last few years. But we try to keep things very, very reasonable and affordable because we want to take care of people.

SPEAKER_01: 44:38

Yeah, that's awesome. That's really great. Well, thanks for taking the time away from you know your work and everything you're doing to come chat with us. And our listeners definitely have to. We'll link his podcast because, like I said, we could ask him questions all day, but he does deep dives into all kinds of topics that are super interesting. So make sure you check it out. Do you want to plug everything? Your your website, how they can find your podcast, everything like that.

SPEAKER_04: 45:04

Sure. Uh, so the men's clinic is called Maverick Mail Medical, and it's just maverickmailmedical.com. The so we do men's health focus there. The medical spa where we do female functional health and hormones is called rejuvenated medical spa, and it's just rejuvenatedmed spa.com. And then my podcast is called Not So Taboo. And so we address everything from longevity, functional health, sexual health, all those sorts of things.

SPEAKER_01: 45:28

One more question before we end, because Daniel and I just went to a TED talk. Oh, yeah. And one of the guys was talking about fitness tracking, like with an O ring or a whip band, whatever. Do people ever provide you with the information that is tracked on that?

SPEAKER_04: 45:40

I use it all the time.

SPEAKER_01: 45:41

Okay. They were saying like 25% of people share that with their doctor, and that it can, you know, track or predict certain illnesses before you're symptomatic, and you can share those things with your doctor.

SPEAKER_04: 45:52

So I was just curious if you like really quick. Sorry, I can't shut up sometimes, and I apologize for that.

SPEAKER_02: 45:58

Neither can we. So you're good. You're in good company.

SPEAKER_04: 46:01

I actually did a podcast episode with a uh a a Danish physician called Torquil Fierro, and Dr. Fierro um wrote an entire book on heart rate variability, which is the space in between each heart rate and how much that varies. And the higher that is, the more relaxed state you're in, and the healthier you are, the lower it is, it increases an increased uh sympathetic tone and stress. And so it can often help me know, like, okay, this person is seemingly healthy, but that's too low. We use that. I have diagnosed abnormal heart rhythms because I'm like, okay, this shows that your heart rate was 167 at you know 6 p.m. Were you at the gym? And and they're like, no, I was just watching TV. I'm like, all right, well, that's not normal. Um, and then it can also help you track sleep. And so all of those things, you can look at sleep patterns, you can look at heart rate, heart rate variability. So they're actually really, really helpful. Some of them are better than others, but but they are another piece of the of the data that can, and more data is always better.

SPEAKER_01: 47:04

Okay. I know I'm getting my husband for Christmas. All right, or a ring. If he doesn't listen for Christmas, though. Hopefully. Thank you so much for coming in. Absolutely.

SPEAKER_04: 47:13

Had a great time.

SPEAKER_01: 47:13

Hey, thanks so much for listening today. If you liked what you heard, please consider subscribing to the podcast so you never miss an episode. You can also follow us on Instagram at People of NWA. Thanks so much.

SPEAKER_00: 47:23

People of Northwest Arkansas with the two Danielles, produced by me, Brock Short of Brock Entertainment. Please rate, review, and like us on any podcast platform where you listen. For more information about today's guests and the show, please check the show notes. Thanks for listening.