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Dr. Weitz: If you’re looking for clinically useful insights, not wellness hype, then this is the place for you. Welcome to the Rational Wellness Podcast, the podcast for functional and integrated practitioners who want to practice with greater clarity and precision. I’m Dr. Ben Weitz, and each week I sit down with the leading clinicians, researchers, and lab innovators to explore the science lab testing and clinical reasoning behind modern root cause medicine.
This is a show focused on practical evidence-informed insights that you can actually use in patient care. Please subscribe to the National Wellness Podcast on Apple, Spotify, or YouTube. Please tell your friends and colleagues and if you could give us a ratings and review on Apple or Spotify, we would certainly appreciate it.Finally, to access the show notes and the full transcript, please go to my website, drweitz.com. [00:01:00]
Hello. I’m excited to be talking about one of my favorite topics, which is longevity, the science of extending your health span. And today we’ll be speaking with Dr. Will Haas on this important topic. Dr. Will Haas is a medical doctor and he is the founder and CEO of five Wellness in Charlotte, North Carolina, where he helps high achieving professionals reclaim energy, focus, and vitality through cellular optimization. He’s board certified in integrative and family medicine. Dr. Haas blends advanced therapies like IV nutrients, therapeutic peptides, hyperbaric oxygen, and red light therapy to deliver measurable results that help patients feel decades younger. Dr. Haas, thank you so much for joining us.
Dr. Haas: Pleasure to be here, Ben.Excited to talk about this.
Dr. Weitz: That’s great. So, why don’t we start with definitions. How do you define longevity or health span or optimal health?
Dr. Haas: Yeah, so kind of this construct between I just want to live to 100, right? Without kind of dropping names of influencers, right? You know, some people who want to live to 100, but it’s really about the difference of enjoying the number of years you kind of have here and living in optimal performance during that time period, right?
So instead of how long can I live, it’s how functional can I live during the time that I have left? And can we extend that period of functional and optimal health and performance. And so I think it’s kind of what we’re really getting at between longevity and health span. And what I think what most of us are after, most of your viewers are probably after is that health span piece, right?
Dr. Weitz: Right. Basically. What’s common among the average person is that you, after a certain age, 30, 40, 50, you [00:03:00] just slowly start going downhill with gradually accumulating chronic diseases. You start gaining weight, everything goes downhill. Your mobility decreases. You’re on, you know, 12, 14 different medications and so the last part of your life is not very happy, and the goal is to have this high level of health function, and then one day you just drop off.
Dr. Haas: Yeah. And I think that the interesting thing, and we’re gonna talk about a lot of kind of really exciting tools that you introduced here, but as you talked about kind of chronic disease, I think there’s a really interesting study or a statistic by the WHO that like 80% of premature deaths from chronic disease all have preventable, like modifiable.
Risk factors, lifestyle risk factors to them. So we’re gonna talk about some exciting things around how to improve the health of the cell. So you have that really nice long plateau of peak performance and then the cliff that you talked about,
Dr. Weitz: right? Yeah. [00:04:00]
Dr. Haas: But I, you know, it’s important to make sure before we dive into those conversations, we don’t overlook the fact that there’s just so many modifiable lifestyle factors, so you don’t have to end up on those 15 medications and have that, that, you know, kind of gradual cellular decline.
Dr. Weitz: Yeah. There’s no doubt that the major killers for today, these chronic diseases like heart disease, cancer, and neurodegenerative diseases are potentially venable, but not waiting until you are at an advanced stage.
Dr. Haas: And it’s really just kind of teasing back which of those modifiable factors are driving that cellular decline for every individual.
’cause it’s gonna look different and those patterns are gonna be different. I think when we, when you talk about modifiable lifestyle factors, everyone immediately assumes it’s like, oh, processed food. But there’s, I think there’s a lot more to it that’s not seen that you and I can talk about today, like toxins for instance.
Right. And we kind of miss the fact that we may just be living in a toxic environment, not the fact that we’re consuming toxic foods.
Dr. Weitz: [00:05:00] Right. Yeah. I think processed foods are the low hanging fruit or what we now call I forgot the newest term, but we’re constantly coming up with new terms for junk food.
Dr. Haas: Junk food is just junk food, right?
Dr. Weitz: Yeah, exactly. So what are some of the biggest blind spots in conventional medicine when it comes to age?
Dr. Haas: I think it starts by looking at the diagnostics, right? And this kind of concept of, you know, kind of normal or everything just looks normal on paper.
Dr. Weitz: Well, you’ve had all your labs, you had a c b c, a chem screen, and a basic lipid profile.
What else could you possibly look at? Right?
Dr. Haas: What will insurance cover here? Right, exactly. And so there’s kind of two levels, layers to that. So you identify which is the narrow scope in the conventional world because unfortunately for, you know, and a lot of times it’s not. It’s not that, the fact that doctors don’t want to look deeper, it’s, you know, most physicians are operating in an insurance system and they’re kind of handcuffed by what they’re allowed to look [00:06:00] at.
Dr. Weitz: Yeah. No insurance will. Yeah, absolutely. The insurance company, definitely the insurance companies run the healthcare system. Not only do they decide what labs are gonna be covered, you try to run a lab that’s not covered. They send you threatening letters and they’re only gonna pay you so much for an office visit.
So if you only have five or 10 minutes you don’t have time to go over detailed advanced labs.
Dr. Haas: Yeah. So we gotta kinda get past that hurdle. Right. Once you get past that hurdle, then you have the idea that most of what’s being reported and looked at is just kind of standard reference ranges.
Right. What the average person falls into, which basically is just looking at whether or not. Have you spilled over into disease detection or not? Not whether we’re functioning optimally. So that’s kinda the second piece to this, right? Which is, okay, you get the labs. Now we have to start interpreting them from the lens of optimal cellular health, not, oh, we’ve detected disease.
Dr. Weitz: Right? Yeah. That’s definitely not a concept. In fact [00:07:00] conventional medicine has kind of gone the other way. I’ve had patients come back with their vitamin D test and they’re being told that the, they need to be between 30 and 50, and if they’re at 60, then it’s way too high and toxic.
Dr. Haas: Yeah. So kind of moving too far to that other end, especially just not kind of knowing where the literature stands.
So that’s kind of, I think where a lot of this starts is just kind of understanding your true, you know, snapshot. Of health and going beyond those basic markers and whether that’s, you know, if you can’t find that and with your conventional doctor and you’re looking around and you know, the next best place to search is what sort of functional medicine, what sort of integrative medicine physician do I have nearby?
And can they do that? And then if you can’t, then luckily we’re at a day and age where kind of direct to consumer healthcare does have a role in a place, and whether that’s function, health, or some other direct to consumer [00:08:00] lab testing that’s focused more on functional diagnostics. You have the ability this day and age to get deeper evaluation on cholesterol panels and inflammation markers, and even go deeper into the stuff we talked about in terms of toxins, like heavy metals or mold.
Dr. Weitz: I think another issue has to do with the siloing of information that doctors are provided with and. There could be 30 studies on the benefits of Omega-3 fish oil or vitamin D. And the one study that seems to show that there’s some possible negative side effect, that’s the one that’s published in JAMA and that’s the one that the average medical doctor sees.
And then they come out with these guidelines like the American College of Cardiology and American Heart Association just came out with new guidelines and they’re ridiculous. All they focus on is LDL cholesterol as a marker and all they [00:09:00] recommend are drugs and more drugs and starting the drugs as early as possible.
And they not only claim that nutritional supplements like Omega-3, for which there are thousands of studies showing incredible benefits that they not only are not beneficial, but there are potentially harmful.
Dr. Haas: I think what also gets overlooked in that is, especially in that story, which is looking at some of those more advanced markers beyond LDL to better risk stratify.
So I’m always, yeah, they
Dr. Weitz: don’t, they don’t recognize any of that.
Dr. Haas: Yeah. The A OB and the L Lp(a) A and oxidized LDL, I’m always kind of
Dr. Weitz: talking and LDL particle size and homocysteine and inflammation markers, et cetera, et cetera.
Dr. Haas: And how do you make a bigger story out of that to look at risk, to determine and just have an open, honest conversation with your patient.
Right? Like it, it may be the fact that their risk profile. You know, I always tell my patients, I’m not an anticon conventional medical [00:10:00] doctor, right? We may talk about medications, but we’re gonna do it with enough information, right? So it may lead the fact that your homocysteine is 25 and your high senses CRP is five, and your oxidized LDL is one 20, right?
All these numbers basically just mean too high,
Dr. Weitz: right?
Dr. Haas: And it may be the fact that you may want to entertain that in the conversation as opposed to just saying like, Hey, you should absolutely have it because your LDL part, your cholesterol is one 50, right? So it’s just, to me it’s very much empowering my patients with data to allow them to make an educated decision whether it, it aligns with what they want to do.
Dr. Weitz: What are some of the top drivers of aging biologically that you like to focus on?
Dr. Haas: So we kind of hinted and talked around some, so there are like direct markers, but that there are indirect causes. Right. And so one of the ones we handed around and talked about a couple times are toxins, right? Right.
They can come in various different forms or fashion and, you know, it’s not the only thing I’m [00:11:00] always talking to my patients. I know we’ve mentioned it a couple times already in this short time period, but I think it’s something that gets overlooked so, so much. And because that can be the underlying thread to driving inflammation, that can be the underlying thread leading towards mitochondrial dysfunction.
And, you know, the fact that mitochondria drives so much of the response to oxidative stress and producing energy and communicating with the cells to turn over this concept of cellular senescence. So kinda a lot of layers there. But if you have a toxic environment from hidden toxins in the cells, there’s no way that they’re gonna thrive, right?
We’re not gonna balance oxidative stress and we’re not going to, we regenerate and repair and kick off cellular senescence appropriately. So I’m always kinda in. Having a conversation with a patient to determine whether or not do we need to look at things like heavy metals, right? Do we need to look at things like mycotoxins?
Right. I think one of the statistics that’s [00:12:00] kind of scary and alarming is almost 50%. It’s estimated almost 50% of dwellings in the US have mold in them. Yeah. Right? That, I mean, that’s shocking, right? And so how do we ever expect somebody to have optimal cellular health? If we have tons of mycotoxins floating around in their system, it,
Dr. Weitz: no doubt about it.
And part of that is the way we make homes, we make ’em very energy efficient so they’re sealed so there’s no openings between the walls. And so if some moisture gets in there, it’s much more likely to lead to mold. And of course, we lead live in a very toxic environment. You know, we’re still burning coal for energy, which spews hundreds of tons of mercury into the atmosphere that drops down into the oceans and gets into the fish.
And we have very little controls over the products that are used to build our homes and that we put on our on our bodies and clean our homes [00:13:00] with. And we have. Teflon pans and flame retarding chemicals. We know these P FOAs and PF ass are found everywhere, is in the drinking water across the country.
I mean, on and on. We are overloaded with lots of toxins. How do you like to test for toxins?
Dr. Haas: There’s a lot of different ways to do it. In my clinical practice, we do a lot of urine testing for heavy metals and the mycotoxins and the environmental toxins. There’s great labs.
Dr. Weitz: Yeah. Have favorite panel you like to use?
Dr. Haas: Oh, so I used to so Real Time labs as well as Vibrant America are the two different companies that I use. Right. So slightly different technologies behind them. But I, I know without going too far off topic right now, I know Dr. Paul Savage, who does a lot of work in the field now of therapeutic plasma exchange, has done some early preliminary studies using the Vibrant America.
Panel tox panel to look at pre and [00:14:00] post therapies Yeah. To help people detoxify. And so that’s a, that’s one, one off. Has it, has he
Dr. Weitz: published that?
Dr. Haas: I’ve seen him lecture on it. I don’t know if it’s actually hit an actual journal yet, but I’ve seen kind of his preclinical lectures on that,
Dr. Weitz: and there’s a big improvement.
Dr. Haas: Anthony the statistic was something like 90% of all the patients, a small case study, but 90% of the patients all saw some sort of meaningful reduction in their toxin load.
Dr. Weitz: That’s cool.
Dr. Haas: Yeah.
Dr. Weitz: Is that a therapy that you utilize?
Dr. Haas: Yeah, so it, you know, there’s a lot of different tools, right?
That’s definitely at the far end of the spectrum, kind of in the deep end, probably more aggressive, the kind of therapeutic plasma exchange. I think the technology is fantastic. It’s, you know, relatively safe relatively low risk and in the hands of a trained clinician, but there’s definitely a time factor to it.
Three to four hours, there’s a cost to [00:15:00] it, you know, so kinda several thousands of dollars. So there may be some more kind of basic interventions that we may want to entertain first and foremost, right? We talked about mycotoxins. So do we need to be doing binders and do we need to help elimination? So lymphatic systems and gut health, right?
We didn’t even, we got. I spend all this time talking about toxins and like environmental toxins. But you know, the gut itself can be a very toxic environment. If you have the wrong balance of good and bad bacteria in there and you’re struggling with inflammation in your gut and constipation, there’s no way you’re gonna clear out these toxins,
Dr. Weitz: right?
Dr. Haas: If you can’t eliminate them from your system because your gut health is wrecked. So,
Dr. Weitz: right.
Dr. Haas: As we kind of go further and further below the layers here.
Dr. Weitz: Yeah, no, the big
Dr. Haas: therapeutic plasma
Dr. Weitz: exchange by health as a core factor in everything.
Dr. Haas: Yeah. Yeah. But definitely for toxins. Right. So therapeutic plasma exchange has a role in a place.
But by the way,
Dr. Weitz: for those who don’t know what therapeutic plasma exchange is, can you briefly explain what it is?
Dr. Haas: Yeah, absolutely. So it is [00:16:00] a, it’s, you know, it’s an FDA approved technology is, you know, used commonly for neurological conditions or advanced autoimmune conditions where you’re basically trying to, in this case, clear, harmful antibodies or things that have attacked the nervous system.
And you do that by basically separating the blood layers, right? There are different types of technology. The one we use in our medical practice is basically a centrifuge. So you spin the blood and separate out the layers, right? And you’re trying to basically separate out this plasma layer and the plasma layer.
Is simply think about that as your transport layer. It’s what moves things kind of throughout the body, but unfortunately, that’s where all the toxins get stored, right? So your microplastics, right, your mold, right, your antibodies, be it from COVID or mono they all hang out in that plasma layer. And after you separate out that plasma layer, you can then just drain it off [00:17:00] and replace it back with a filler.
Most commonly albumin is the filler, and then you just dump out that plasma. And one session treats about 67% of your plasma layer. So commonly you’ll do more than one session, you know, 3, 4, 5, sometimes six sessions to get this serial dilution. After you kind of treat two thirds and then two thirds and two thirds.
But the cool thing about that albumin, once it’s back in the body, there’s this idea that they call kinda this peripheral sync hypothesis where as you add in this fresh albumin, you’re able to actually create a gradient to pull more toxins into the albumin. And then when you go to do your next plasma exchange session, you’ve kind of pulled in more toxins into that albumin.
And then now you’re dumping the plasma again and adding a new, fresh layer of albumin. So that’s kind of the, a high level crash course on therapeutic plasma exchange.
Dr. Weitz: Right. Okay. So what are some of the first things you’ll do when you why [00:18:00] don’t we start with, when you first get a patient in the office, you do a detailed history, and then what kind of testing do you do?
You’ve already talked about some of the testing, but give us some more information about what kind of testing you like to do.
Dr. Haas: I mean, before even grab blood or urine or stool test, looking at gut function and toxins and these functional diagnostics, I have every one of my patients do a body composition analysis.
Dr. Weitz: Right?
Dr. Haas: Right. So that’s where it starts. Right? And so normal doctor, you go and get your blood pressure and your heart rate. My office, everyone does that, but they also step on a body composition scale, right? Yeah. And it’s very telling and it can very quickly give you a snapshot of metabolic health, right?
Especially when we’re looking at visceral body fat. When we’re looking at the ratio of lean muscle. To body fat overall. I kind of joke with my patients in my office, muscle mass is really the currency of aging.
Dr. Weitz: Yes.
Dr. Haas: Right. And so, you know, I may get [00:19:00] really concerned with a patient who has normal body fat, but they have low average amounts of lean muscle mass.
Right. To me, that’s almost as dangerous as somebody who has just a little bit extra body fat and normal muscle mass. So I’m kind of looking at that picture on every one of my patients to get a good snapshot of metabolic health, potential for inflammation. And then we can also see hydration status.
Right. And that’s a big important driver for cellular health.
Dr. Weitz: Right.
Dr. Haas: On that hydration status. So that tells me a lot before I ever sit down and have a conversation with a patient and make decisions on labs.
Dr. Weitz: That’s great. Yeah. We like to use bio impedance analysis as well.
Dr. Haas: Yep. I think another tool on it’s kind of becoming very top of mind, especially with smart devices that I love using in the practice as well, is heart rate variability.
Dr. Weitz: Okay. It’s
Dr. Haas: a very easy marker to, to capture. And for those who aren’t familiar with that, that basically gives me a snapshot into [00:20:00] the balance of your nervous system, specifically kinda this concept of that fight or flight sympathetic nervous system and the rest and digest parasympathetic nervous system.
And it does that by the fact that your parasympathetic nervous system is what controls heart rate variability, meaning your heart should beat at slightly different intervals, and the more active your rest and digest system is, the more control it exerts over the heart rate. To have that variability and the higher variability means.
You have a better parasympathetic tone or rest and digest for your nervous system. And there’s a lot of studies linking that to longevity and health span. So that’s a really easy marker that we can grab in the office and that patients can continue to monitor.
Dr. Weitz: How do you measure that in the office?
Dr. Haas: Yeah, so we just kinda have little devices that kind of clip very similar to what you’d use, like an ora ring or a whoop device, but just a device where you just kind of clip on the finger and kind of looking at that b to beat [00:21:00] variability. So non-invasive, super easy to get. And then, like I said, patients can monitor that outside of the office as well.
Dr. Weitz: Kind of like a blood ox measurement device.
Dr. Haas: Correct? Correct.
Dr. Weitz: What brain do you like to use for that, for the heart rate variability?
Dr. Haas: So I think there’s a lot of different tools. I’m blanking on the name of, like the pulse ox style one.
Dr. Weitz: Okay.
Dr. Haas: But long time we used heart. Okay.
HeartMath has great tools, right? I just found a real easy one that’s just kind of clip on the finger, clip off. Less to add. Sure. Just kind of keeps my clinic workflow moving smoothly, but HeartMath is a fantastic one.
Dr. Weitz: Yeah. Good. And then tell us about the kinds of labs you like to run.
Dr. Haas: Kind of standardly I’m definitely gonna be looking kind of categorically, right? So, almost all of my patients, I’m going to be one to be looking at everything from detoxification pathways. I’m gonna be looking at inflammatory pathways, I’m gonna be looking at hormonal [00:22:00] balance, and I’m gonna be looking at key micronutrient status, right?
That’s just kinda my foundation. That’s what I want to see. I’m almost. All my patients and then along with metabolic health markers,
Dr. Weitz: right?
Dr. Haas: So that’s kinda how clad, like categorically I think about it, right? Metabolic, we’re gonna go deeper than, you know, fasting blood sugar. We’ll be looking at fasting insulin.
We’re gonna be looking at, of course you’re gonna get things like your A1C, but we’re gonna look at insulin resistance scores and then that might bleed into some of the inflammatory markers, right? We’re looking at things you and I had talked about earlier, iSense, the CRP homocysteine, maybe getting into some of the interleukins if we need to.
And then from there, the micronutrient. I like doing a balance of making sure I do some basic serum blood markers, like your vitamin D, but I also like to look at things like where do the nutrients actually live? Like magnesium should be primarily intracellular, so you need to make sure you get a specialized test for that called an RBC magnesium.
Yeah. But we have a panel of 80 different [00:23:00] micronutrients that we can look at a cellular level. Of how your cells are utilizing those micronutrients. And then from, there’s where you have a very pointed conversation with the patient in front of you to determine do I need to go deeper and look at gut health?
Right? Are we having symptoms of, you know, overt symptoms of bloating and constipation and are we having reactivities to foods? Are we having a lot of weird allergies and skin issues, right? So I might go more of a gut health and do some testing via stool and breath testing and ruling out things like SIBO and dysbiosis and leaky gut.
And if somebody’s developing a bunch of weird neurological symptoms, right? We have headaches that they never had before, dizziness or ringing in their ears, or weird tingling in their hands and feet, right? I’m gonna ask about where they work and where they live and water damage and maybe consider the myco talkin that we talked about earlier.
So. The layers deeper, really depend on the conversation that [00:24:00] I start having with my patients to see what pops up and what my pretest probability is for like, Hey, we need to go over here and look at this area of health that I don’t do on all of my patients when they walk into the practice.
Dr. Weitz: What do you think about the test for biological aging?
Dr. Haas: I think if you’re using the well constructed methylation testing,
Dr. Weitz: yeah.
Dr. Haas: Based upon like the Dunedin a aging
Dr. Weitz: Yeah.
Dr. Haas: Outta those I like them. I use them in my practice. You know, it is an extra layer of cost, but is it’s very eyeopening when you think you are, you know, a healthy 40-year-old and it says your biological age is 63.
Yeah. That motivates change.
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Dr. Haas: Yeah. We talked about on the metabolic side, you
Dr. Weitz: mentioned the fasting insulin. That’s one that is rarely run. You know, glucose will be part of their chem screen.
Dr. Haas: Yeah, I think I’m trying to remember the statistic that I had come across, but I think it’s like one third of individuals with a normal A1C are insulin resistance. And that’s gonna only show up if you go and do a fasting insulin. Right? Right. And that’s kinda this concept of the pancreas is having to work harder to keep your sugar normalized.
Right? Right. The body is built [00:27:00] to do that. Right? It has this hormone insulin to take sugar outta the bloodstream and shuttle into the cells. Right? And if it’s had the pancreas having to work harder and kick out more and more insulin, you’re gonna see that rise well before that’s gonna show up and your cells become resistant to that insulin.
And we can no longer shuttle that sugar outta your bloodstream and into the cells. So if you have an insulin, you know, conventional standards are gonna, you’ll see the lab, most labs are gonna be like 20, 25 is too high, whereas. Most in integrative or functional practitioners are gonna want to see that less than 10.
Dr. Weitz: Yeah.
Dr. Haas: So that’s an underutilized, relatively inexpensive one. Right? We’re not talking about, you know, a hundred dollars test here, we’re talking about just a few dollars to get that fasting insulin. Right. I think another underutilized one in the metabolic is gonna be oxidized LDL,
Dr. Weitz: right?
Dr. Haas: So people I think, are now cluing into this particle size, but it doesn’t really gimme a sense of the health of the LDL particles and are they going [00:28:00] around creating more damage to the endothelial layer?
So that’s another one I really like in my practice when it comes to metabolic health.
Dr. Weitz: Alright. So. When we talk about interventions, what are some of your favorite interventions? Obviously you gotta start with the basics, like diet, exercise, sleep.
Dr. Haas: Always. Right. And I think we kind of missed that and that’s what I kind of led in with the fact that most of those premature deaths are from modifiable risk factors, right?
And then a lot of the intervention,
Dr. Weitz: and course, of course diet is a is a tricky topic. It’s kind of like politics. There’s so many different versions of what the healthy diet is. I hear people all the time say, I’m doing the anti-inflammatory diet. Well, what’s your version of the anti-inflammatory diet,
Dr. Haas: right?
Well, I’m eating clean, right? Well, what does eating clean actually mean? Right? And the way where I fall on diet and how I talk to my patients about diet is, you know, there are receivingly [00:29:00] healthy. Diets, like an anti-inflammatory diet may not actually be the best fit for every patient. Right. We talk so much about Mediterranean diet or anti-inflammatory diet that it’s just good for everybody.
Well, let’s rewind and go back to that. The patient who comes in and they have digestive health issues, right? And they eat clean, but after all the meals, they constantly feel bloated. Right? Well, a Mediterranean diet and anti-inflammatory, I would tell you things like cruciferous vegetables, broccoli and Brussels sprouts are gonna be healthy, right?
But if you have dysbiosis and overgrowth of bad bacteria and it’s residing in the upper intestines, you throw in all those cruciferous vegetables and you’re just throwing fuel on that fire, right?
Dr. Weitz: Right.
Dr. Haas: And you’re creating more and more inflammation in the gut because you’re fueling the dysbiosis. So that’s where I, it’s kind of an example of.
Where I [00:30:00] say just like every therapeutic modality diet being, you know, a mo, a modality if you will, it needs to be precise and personalized to every patient and what their phenotype and what cellular dysfunction is going on in their body. Yeah.
Dr. Weitz: Where that person is right now. So cruciferous vegetables like broccoli are super healthy and cancer preventative and everything else, but if somebody has sibo, then they may need to take a break from those cruciferous vegetables till you clear up that SIBO and then they could potentially go back to that.
Dr. Haas: Exactly. Right. So I’m very much and aligned that you have to personalize the recommendation of the diet. And that could change for that individual over time.
Dr. Weitz: Right. So, outside of diet what are some of the other things you focus on?
Dr. Haas: Yeah, so we talked kinda cellular health and one of the big tools in the cellular health and is one of my passions lately is going to be peptide [00:31:00] therapies.
Dr. Weitz: Right.
Dr. Haas: And I know it’s a hot topic right now.
Dr. Weitz: It is a very hot topic,
Dr. Haas: especially with, you know, RFKs recent kind of comments on some podcasts. Yeah.
Dr. Weitz: It sounds like they’re thinking about having the FDA approve them.
Dr. Haas: Yeah. And it, it’s, I don’t want to get go too far into kind of political rabbit holes, but the question is, were these things ever unsafe to begin with?
And why did they disappear from the compounding pharmacies? Is everybody’s guess, but they were never proven unsafe. And some of those peptides that they took outta the compounding pharmacies three, four years ago. We’re FDA approved, right? So Teslin lin some of these growth hormone releasing secreted GOs, like they, they’re actually FDA approved peptides, right?
So it’s not like these things are all unsafe and they should have just disappeared overnight. And I’m glad to hear that they’re coming. They’re coming back with a level of, you know, scrutiny a level of additional evaluation on [00:32:00] safety going through, you know, the actual credible pathways of determining whether these compounds are safe and putting them in the hands of regulated facilities that, you know, have higher production standards.
And ultimately so they can go back under the prescription of kind of well-trained longevity and cellular medicine experts who understand a lot of what we’ve talked about, which is how do you look at the entire patient and determine what’s. What’s not operating optimally at a cellular level, and then pick the appropriate therapeutic peptide for that patient as opposed to reading a Reddit thread or watching a YouTube video on the topic.
Dr. Weitz: Let’s talk for a few minutes about the growth hormone peptides. And I want to touch on two things. One, I heard you talk about the different growth hormone peptides and you have some opinions on which ones to use at what time. And I also wanted to touch on the concept of whether it’s a good idea to [00:33:00] promote growth hormone or not for longevity purposes.
And so the reason why growth hormone is controversial is. If we go back and look at the history of longevity medicine they were one of the very early interventions for longevity with the concept that as people get older, their muscles break down. Their bones break down. So we need to regenerate, we need to repair tissues so that we can maintain our mobility and our strength as we get older.
But then in the last 10 years growth hormone has started to be seen as something that might increase cancer. And some longevity researchers have said that we should lower growth hormone levels that the leron dwarfs in Ecuador have a genetic defect where they have no growth hormone and they have no cancer.
So we really ought to try [00:34:00] to reduce growth hormone. And some of these researchers have recommended a low protein diet with the idea of reducing growth hormone. So what do you think about the whole growth hormone concept? And then go into some of the details about some of the growth hormone peptides.
Dr. Haas: Pretty deep here.
Dr. Weitz: Yeah, I know.
Dr. Haas: Sorry. I think what first kind of hits me is one of my mentor Dr. Bill Seeds, he always says something like, once we start thinking that we’re smarter than the cell is when we get in trouble Yeah. Is when we get in trouble. And so I think that’s where we got in trouble with growth hormone is there’s over like 20 different isomers of growth hormone.
Dr. Weitz: Okay.
Dr. Haas: Right. And we’re giving back one isomer. Right. And so, you know, we don’t know what’s happening and you know what’s happening when you’re not addressing all the other isomers and you’re not kind of getting the signaling of those different isomers to the different cells. Right? So we’re just kind of signaling kind of one set [00:35:00]
Dr. Weitz: of cells.
So explain that a little more. So growth hormone’s, not one hormone. You’re saying
Dr. Haas: there’s different kind of subtypes of growth hormone, if you will, is the way to think about that. Right. And the different subtypes may interact more with the brain or heart tissue or muscle. And, you know, we’re just kinda basically giving one predominant signal that is doing a lot of kind of muscular stimulation, right?
And so there’s just think of a different sub forms is the best way to think about it. And the thing about peptides in contrast to that, as in instead of giving the growth hormone, you’re signaling the brain to release its own forms of growth hormone,
Dr. Weitz: right?
Dr. Haas: So it’s, it is kind of releasing all of your body’s own natural different sub forms.
Of growth hormone that then intelligently knows how to go out there and modulate the different cells and communicate with the cells differently. And I think therein lies kind of the high level difference between why so many people feel like peptides can be a little bit more safe. ’cause they’re [00:36:00] just, they’re modulating, they’re communicating with the cells and the different pathways.
Whereas growth hormone is kind of akin to testosterone, right? You’re just kind of like overriding the system and forcing in more. And unfortunately, a lot of times, you know, the levels of growth hormone is were pushed really high. And I think that kinda then bleeds into your question and concern is too much growth hormone a bad thing and promoting more harm than good.
And I think that without getting too far in cellular pathways kind of stumbles upon this idea of mTOR versus A MPK, right? This hyper growth state versus this recycling and repair state. If you will.
Dr. Weitz: Yeah. And
Dr. Haas: kind of creating that balance. If you’re kind of pulling a lever and driving too much of this growth phase and never kind of balancing it out that’s where we’re gonna run into problems, right?
And so if you just kinda keep driving the mTOR state and never having an A MPK state, that becomes a, an issue at a cellular level and where you can potentially get in trouble and why I think you get in less trouble with [00:37:00] some of the growth hormone releasing peptides. ’cause it’s kinda modulating that balance if you will.
You’re not just overriding the system, right? And there are different types of growth hormones that may be a little bit stronger, more potent and more activating, if you will, to the pituitary gland and increase IGF one. So some of the concern is, you know, how much of that cell growth is happening from insulin growth factor one.
And there might be some of those growth hormone releasing peptides that, that stimulate IGF one more than others, like, abut Morlin versus Lin may not do that as much. Right. And so again, back to our conversation around personalized prescriptive therapy is how I really decide what growth hormone releasing peptide to use for what patient, right.
And what am I trying to accomplish with that patient?
Dr. Weitz: So, so tell us about these different growth hormone peptides and which ones do what.
Dr. Haas: Yeah, so I mean, they all kind of function the same way in terms of communicating with the, you [00:38:00] know, pituitary gland. But the way I kind of use them in clinical practice will differ.
And an example of that might be a, let’s say we have a 45-year-old female who’s worked really hard to lose weight. Maybe they used a GLP one. Maybe they just approached it with diet or a combination of both and they kind of. Landed at this place that they lost 30 pounds. But along the way, hopefully they did a body composition analysis and tracked lean muscle mass.
And they’re like, yes, some of that weight was muscle mass and I need to get it back.
Dr. Weitz: Right?
Dr. Haas: Right. I’m not gonna go with one of the stronger heavy hitters on a growth hormone releasing peptide because in addition to increasing IGF one, you may see more fluid retention. You may stimulate too much muscle growth, too fast, you may gain a lot of water weight.
And what happens, we freak out because the number on the scale goes up a little bit. Your clothes don’t fit like they did. And then, you [00:39:00] know, you have a patient who’s very frustrated with you because we’ve undone all of their kind of hard work to fit nicely in their clothes. Right. Even though it was for.
You know, longevity purposes of increasing lean muscle mass, right? So that’s where like a lin works better than something like an abut morelin, right? So I’m very much thinking about the patient application, whereas teslin, for instance, one of the FDA approved another one, the f FDA a approved peptides, right?
It was originally FDA approved for lipodystrophy in HIV patients, right? So a lot of these HIV medications caused an increased deposition of fat. And Telin was studied for that. And so it, it’s a fantastic tool to kind of bridge the gap on both, right? We’re trying to burn visceral body fat at the same time we’re trying to support lean muscle mass, right?
We see that problem all the time in GLP ones. And I don’t want to go down the arguments with people, whether GLP ones cause muscle mass or not. But you can use something like [00:40:00] teslin along a GLP one to help support lean muscle mass while further facilitating burning through that dangerous, visceral body fat.
Dr. Weitz: Yeah, that sounds
Dr. Haas: great. Examples of
Dr. Weitz: patient, there’s plenty of data showing that GLP ones are associated with loss of muscle mass
Dr. Haas: association and causation. Two totally different things, two totally different things. And I think what’s hard to, we’re not doing a good job. I think teasing out on that data is what are those individuals doing and how are they you know, being used.
Right. I’ve used GLP ones for 15 years, so when I was first a medical student, right. Like the days of biota and byon. And I probably treated well over 3000 patients with GLP ones since that time. Okay. And over the past five years, it’s always been with body composition analysis. It’s always been alongside functional nutrition.
And education on appropriate nutrition and lifestyle factors [00:41:00] like resin exercise training, appropriate macronutrient intake and the amount of muscle mass I see is definitely not what is reported in the studies. Right. And I think it has a lot to do with how you’re monitoring the patient while they’re on their GLP one and what you’re educating them, not only educating, but what you’re getting them to do while they’re on that GLP one and maybe what other tools you’re using alongside it, like Teslin,
Dr. Weitz: right.
So just for those who aren’t following what you just said the average person who doesn’t necessarily change your diet or their exercise and just takes Ozempic or another GLP one they tend to lose a certain amount of weight, but they also tend to lose a certain amount of muscle, which is not a good thing.
And what you’re saying is if they take a GLP one and maybe even use a lower dose and at the same time they’re eating sufficient amounts of protein, they’re doing resistance training and [00:42:00] monitoring the other factors of health, they’re gonna lose a lot less muscle if they need, or
Dr. Haas: they may not lose, they may not lose at all.
Dr. Weitz: Right.
Dr. Haas: Right. Okay. So, I mean, I think it’s completely unwise and dare I say foolish, to use a GLP one without doing any of that. You know, it’s a recipe for metabolic disaster.
Dr. Weitz: Right. And especially by adding in some peptides, you can also help to decrease that, especially to growth hormone when releasing peptides.
Dr. Haas: Correct.
Dr. Weitz: What are some of your other favorite peptides?
Dr. Haas: There’s so many. So many. So we didn’t, we haven’t spent a long of time talking about mitochondrial health. Right. Okay. Yet today. So
Dr. Weitz: yeah. Let’s talk about mitochondrial health and energy production.
Dr. Haas: Yeah. So kind of concept that you have these cells whose whole job is to produce a TP or the currency of aging or energy, I’m sorry, we talked about aging energy in our body.
Right? And we talked a little bit about oxidative stress with oxidized LDL, but you can kind of get kind of too much stress in the system and it can’t balance that out by way of [00:43:00] redox or reduction. And these mitochondrial cells start to wear out, right? And that’s, I think, ties into a lot of this concept of declining health span as your mitochondrial cells start becoming less healthy as you have fewer mitochondrial cells as we age, right?
And the foundations that we talked about earlier. Although you kinda asked me what my favorite peptides are and I’m going down the road of mitochondrial peptides. But there’s a lot of just fantastic things we can do, right? Like, you know, resistance exercise training. Zone two kind of cardio are things intermittent fasting protocols, all things that can improve and strengthen the health of the mitochondria, increased mitochondrial density and in the cells.
And that is gonna be very important for kind of extending out health span. Now we can help the mitochondria along with peptides like modest C SS 31, right? And kind of [00:44:00] describe mod modest C is the peptide that kind of communicates intracellular and works on kind of enhancing kind of mitochondrial pair at a DNA level.
Whereas SS 31 kind of protects the outer kinda layer of the mitochondria from getting damaged. So those are two peptides that I really like to support mitochondrial health. I think. One thing I have to caution my patients about, which is unlike your growth hormone peptide, you start one of those within four weeks, you should start noticing something.
You know, this is not like taking a drinking a red bull, right? You start working with some of the mitochondrial peptides. It takes time to start to feel the impact of improved mitochondrial efficiency and energy production. It’s not just kind of a quick dial, you turn on overnight and suddenly you wake up ready to jump outta bed and you have, you know, bounding energy for the entire day.
It’s not quite how those peptides work, and that’s something I always have to have a conversation with my patients about. ’cause they’ll come back to me four weeks later. I’m like, this is not working
Dr. Weitz: for energy cellular [00:45:00] energy for mitochondrial support. Do you like NAD or NAD precursors?
Dr. Haas: I like I gravitate a little more towards the precursors.
I think I like NADI think it has a role kind of in short term, but I’m thinking a little bit more through the whole pathway of NAD when I say the whole pathway. You know, instead of just blasting the cell with NAD I’m thinking about what you mentioned. Can I give it more of the precursors to support NAD production?
More importantly, can I facilitate more of the recycling of the NAD mode? You know, we actually don’t need a ton of precursors and a ton of raw NAD itself. There’s questions around how much of that NAD actually gets into the mitochondria, and not just the cytosol, but most of the NAD should just be from recycling our own NAD production.
And if we can kind of facilitate that via some of the things that we talked about. Time restricted eating or intermittent fasting and resistance exercise training. Those sorts of things kind of [00:46:00] help that. Then you can kind of support your body’s own NAD pool available NAD to support the mitochondria.
So, a little bit more to that story than you might have been looking for, but I will use NAD in short periods, but I’m thinking about how do we support the overall NAD production and recycling pathway.
Dr. Weitz: And NAD precursors include supplements like NR or NMN that people take to try to produce more NAD,
Dr. Haas: correct?
Correct.
Dr. Weitz: What about slys?
Dr. Haas: Not convinced that the slys that we have today, kind of moving the needle as much as we think. Okay. Especially on some of the sly people are I find using or come to me asking questions about a lot of times have more side effects than benefits, I think. So you kind of talk about the world of rapamycin you kinda a repurposed medication Yeah.
Of
Dr. Weitz: patients that’s big among longevity doctors.
Dr. Haas: Yeah. A lot of my patients actually will run [00:47:00] into more side effects on that and I’d much rather talk about you using foods rich in re rol and other kind of more natural, these kind of slys. So, and some of the peptides themselves will modulate those pathways.
So I think kind of more to come. I don’t use a ton of lytics in my practice at the moment.
Dr. Weitz: Do you like metformin as an anti-aging drug?
Dr. Haas: I do not.
Dr. Weitz: Okay.
Dr. Haas: Yeah, it’s kind of pushing that mTOR state too much like we talked about.
Dr. Weitz: Right. It may also negatively affect mitochondrial health.
Dr. Haas: Correct? Yeah.
Dr. Weitz: Yeah. So what should we be thinking about preventing neurodegenerative diseases?
Dr. Haas: Back to our original conversation we kicked off with, which is, what’s the cause and what’s the cause for that patient? What’s the driving factor for that patient? Right. If we look at Dale Bredesen’s work, you know, kind of a functional neurologist who does a lot of work with Alzheimer’s kinda champions that, that [00:48:00] space.
He’ll be
Dr. Weitz: on the podcast in a few weeks.
Dr. Haas: Yeah. He just, so I mean your listeners’ gonna hear his kind of five different subtypes
Dr. Weitz: Yeah.
Dr. Haas: Instead of exploring those subtypes. Right. And we talked about some of those factors that are gonna worsen cognitive decline, which is going to be. Poor metabolic health, right?
And too much blood sugar and high insulin levels and inflammation driving that picture. And the toxins, right? The mycotoxins create a lot of neuroinflammation, right? Think he kind of describes this kind of cold subtype of. Alzheimer’s, which are those who have very low levels of hormones that are supposed to kind of fuel the brain and neurogenesis, right?
We didn’t talk a whole lot about hormones today, but that’s something I’m sure Dr. Bredesen is gonna kind of mention and talk about. So to me, you know, again, the driver is gonna be different for every individual and you really have to take a personalized approach on what is kind of driving that, right?[00:49:00]
We could blanketly say inflammation, right? We could blanketly say toxins but it’s gonna be different for every individual you need to work with. A practitioner who is, who’s certified by Dr. Bredesen kind of gone through that training to really better understand what’s driving it for that individual.
Dr. Weitz: How critical is hormone optimization?
Dr. Haas: Very important. I think it’s, you kinda describe this as neurotrophic, so building, helping build and support the neurons, right? This is not all about men, you know, and muscle mass and libido, right? And for females, this is not all about hot flashes and brain fog and moodiness, right?
This is really important for kind of the connection of the neural synapses and maintaining that. And I’ll see that kind of commonly where even when women, you know, go through that historical use the lowest dose, shortest time period of HRT for five years and you come off and five years and you see, maybe that’s where some of the neurocognitive decline starts to [00:50:00] appear, is after they came off their HRT.
Dr. Weitz: We’ve had some discussions on the podcast about hormones. And the sad thing is, even though the Women’s Health Initiative is 25 years ago and has largely been refuted based on the types of hormones that were used and way they were used prior to that study, I think that it was 27% of American women were using hormones after menopause.
It dropped to below 5%, 25 years later was still only at 5% of women taking hormones in menopause. And that study continues to linger like a dark cloud. And it was good to see that the FDA finally is casting a more favorable eye on women who decide that they want to take hormones after menopause.
Dr. Haas: I see that catching up. Right. I think very quickly you’ll see 5% rising to [00:51:00] 10, 12, 15, back to 25% or more. As I see more and more primary care practitioners feel comfortable that they’re not gonna lose their medical license over this
Dr. Weitz: right
Dr. Haas: now. But I think the problem is there’s 25 years of clinical practice and knowledge to catch up on.
Right? Right. And so I am seeing a lot of my patients now just like, Hey, I’m gonna let my primary care or my OB GYN handle this. And the knowledge gap hasn’t cut up. ’cause they, they haven’t, you, they may have never been taught that in clinical practice because it was taboo where they forgot it so long ago.
And I find that even when it’s not as simple as, here, take this pill or here slap on this patch and maybe we’ll check your hormones in a year. Right, right. And unfortunately, that’s what I’m seeing. Even though this, you know, this cloud has been lifted and it’s no longer a taboo. It’s still not being managed optimally yet.
Dr. Weitz: Right. That’s definitely the case. What’s something that’s widely accepted in longevity medicine that you think is [00:52:00] wrong?
I know you’ve mentioned certain
Dr. Haas: You trip on some of ’em, like the, like certain particular
Dr. Weitz: Yeah. There’s some
Dr. Haas: other topics like metformin and things to that nature.
Dr. Weitz: Yeah. There’s some supplements that are pretty commonly used. Like what do you think about methylene blue?
Dr. Haas: I put that kind of in the same bucket as NAD actually, in terms of, I think you have to know why you’re using it.
For what time period are you using it? And
Dr. Weitz: because I saw this guy on the internet and he sounded really good.
Dr. Haas: Right, right. And then, you know, it’s, you know, does it have an actual, you know, scientific mechanism for supporting, you know, mitochondrial a TP production by moving electrons down the electron transport chain?
Yes. There’s kind of science to that, but it’s like, is that the tool we need to be using? And you know, what, how do we [00:53:00] actually ultimately supporting the mitochondrial health itself, not just kind of overriding the electron transport chain or trying to rev it up to pass more electrons through, but how do we actually facilitate more optimal mitochondrial health?
To me is the question as opposed to just, to me, methylene blue? Sometimes it acts as a little bit more of a crutch or a short term bandage.
Dr. Weitz: Yeah. Where do you see the field of longevity going in the next five, 10 years?
Dr. Haas: I think there’s more. We’re going to learn to better phenotype people in terms of what the cellular dysfunction is.
So we spent a lot of time talking to that as a theme today, right? So I’m really excited to see where the world of omics is going. So proteomics and metabolomics and looking at kind of these downstream metabolites that tell you, you know, signal you way before disease even shows up on some of the functional labs that we talked about, right?
So looking at [00:54:00] little small molecule markers that are gonna signal you have insulin resistance before even your fasting insulin is elevated, right? So I’m really excited about that particular space in the application of kinda the longevity space.
Dr. Weitz: Maybe you could explain a little more for those who don’t know what Metabolol Mix are.
Dr. Haas: Yeah. So, you know, in blood, urine, tissue, saliva, there’s these kinda metabolites that are downstream products of every biochemical process happening in the body, whether that be energy production, whether that be, give
Dr. Weitz: us a couple examples.
Dr. Haas: Yeah. So let’s say, let think about a good one here.
All right, so
we talked about kinda looking at some of the root cause analysis. So we might be thinking about let’s just use the A1C example, right? So,
Dr. Weitz: okay.
Dr. Haas: You know, normal insulin, normal hemoglobin A1C, but on metabolomics, we start looking at things like disrupted branch [00:55:00] chain amino acid metabolism. Altered TCA Krebs cycle intermediates, right, that are gonna be characteristic of early insulin resistance.
Right. Okay. So we’re looking at these cellular pathways with the Krebs cycle and branch chain amino acids as ways to characterize that we’re having early metabolic dysfunction with insulin resistance before you ever see insulin levels increasing.
Dr. Weitz: And is there a particular metabolol mixed panel that you like to run?
Dr. Haas: I use a company called Ethereum. I think there’s another, I mean, there’s other companies out there emerging metabolic you, but I’ve worked with the guys at Ethereum. They’re very bright super open to working with clinicians. And that’s who I use.
Dr. Weitz: Okay, cool. That’s great. Any closing thoughts for our listeners?
Dr. Haas: You know, we talked about some cool, exciting things today, like peptides and therapeutic plasma exchange. But I do really just want to echo the foundation, which is, you know, we really need to partner or take in your own hands the [00:56:00] need to kind of understand what’s actually happening at a cellular level before you start just reaching for tools.
Right? You know, we don’t need to reach for all these tools until we understand the application of those tools. We don’t need to use the methylene blue just because somebody on YouTube make it, made it sound really cool. And maybe the fact that your mitochondrial function is great, but your micronutrient deficiencies are terrible and that’s what’s driving your fatigue.
And methane blue is not gonna fix that. So we really need to get a sound picture of what’s going on at a cellular level to make. Sound decisions on using those tools and applications. And peptides may have a place and therapeutic pla plasma exchange may have a place, but don’t write off the foundational lifestyle tools.
Dr. Weitz: That’s great. How can listeners and viewers get ahold of you, get in touch with you, find out about working with you?
Dr. Haas: Yeah, just kinda head over to the website, vibe wellness.com. On the homepage, you’re gonna find a assessment, so
Dr. Weitz: that’s VYVE Wellness.
Dr. Haas: You got it. Thanks for stopping me there. VYVE Wellness [00:57:00] y instead of an I.
On the homepage, you’ll find right below the fold a cellular health assessment. I mean, that’s a great way to kinda understand a little bit about where you may be kinda struggling at a cellular level, whether it’s with detox pathways or redox pathways or repair pathways. And from there we open up a conversation with a free discovery call with a member of our team.
That’s a, it’s a great place to start.
Dr. Weitz: Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would very much appreciate it if you could go to Apple Podcast or Spotify and give us a five star readings and review.
As you may know, I continue to accept a limited number of new patients per month for functional medicine. If you would like help overcoming a gut or other chronic health [00:58:00] condition and want to prevent chronic problems and want to promote longevity, please call my Santa Monica White Sports Chiropractic and Nutrition office at 310-395-3111 and we can set you up for a consultation for functional medicine and I will talk to everybody next week.
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