Introduction

Kerry Reller 0:28

All right. Hi, everybody. Welcome back to the Get Healthy Tampa Bay podcast. I'm your host, Dr. Kerry Reller, and today we have Dr. Haley Todsen. Welcome to the podcast.

Haley Todsen 0:38

Thank you for having me

Kerry Reller 0:40

All right, this will be awesome. So we're all getting older, but there's a big difference between simply living longer and actually living healthy, strong, independent lives, right? So that's one thing that we strive for, and in September, we're recording in September it's Healthy Aging Month. So I thought it would be awesome to have our expert, Dr. Todsen, in longevity to come on the podcast today. So why don't you tell us a little bit about who you are and what you do?

Haley Todsen 1:09

Absolutely.

Dr. Haley Todsen’s Journey Into Longevity Medicine

Haley Todsen 1:10

So I am actually a board-certified emergency physician, and I've been practicing over 20 years, so you can imagine everything that I've seen in those 20 years. something that kept coming up in my mind was, how did these patients actually get to this point? Obviously, in the ER, I see them at the end of their story, but what if I would have seen them decades before in their prime and changed that little trajectory of what made them show up in the ER that day? So I started a company called Optimize Integrative Health, which is in Largo, Florida. We see patients actually in our office, and then we have a couple of telehealth states that I see patients, and then I see other patients, obviously, in Florida through telehealth also. And we focus on everything longevity, and what that means is we focus on hormone health and optimizing your hormones beyond just normal levels on your goals. And then we focus on weight loss. We focus on lifestyle medicine and basically everything to help you getting to feel like yourself again and age gracefully. The other part to Optimyze is I actually started healing myself. I had just graduated med school and residency, and you get your first job, you get married, and then I actually could not get pregnant. So I dealt with years of infertility, and obviously that didn't start just overnight. I wish I would have known what I could have done during that time. And then I dealt with perimenopause that, in my opinion, was very early, and then menopause even at a s- at a early age. So going through all of this when it wasn't talked about as much as it is now, that was very difficult. So I started learning everything that I could, going to conferences, reading, really helped myself through that hard time, and that's really what I share with my patients. We treat men also. Obviously hormones decline for them also. So really just treating myself helped me form what Optimyze is today, where I can walk along with other patients in the same story

Kerry Reller 3:34

Honestly, having that personal experience of your own, it really hones in on all the things that you know that these your patients need and would do so much better for. So I think it, it's amazing that you were able to, do that and work all these ti- all these years, as well. And what's interesting is you said you had to go read and learn outside your, clinical profession, right? And these things that you, some of you're do- you're doing are not things that we learned in med school, right? We didn't learn... Yeah, we didn't learn perimenopause, we didn't learn menopause, and you certainly didn't learn longevity in medical school. So you gotta go out of your way to learn it, right? And like you said, it's being talked a lot about now, which is great. I think at least, menopause, perimenopause are getting loud. I think that's a good thing, and it probably is gonna hop back into the curriculum, I think, in med schools, so the future doctors also get exposed to it. But all the longevity stuff is all kinda new and, I don't know, you're gonna tell us about it today. So what does longevity actually mean?

Haley Todsen 4:32

So what I like about longevity is it's actually your health span, right?

Lifespan vs. Healthspan

Haley Todsen 4:37

So we know our lifespan is how old are you today. So from your birth to now, how old are you, and then what does that look like? But health span is actually how many years you are well, you are healthy, you are strong, independent, doing exactly what you love versus just aging your lifespan. Maybe, the last 10 years of your life are spent in a wheelchair or unhealthy, not able to be independent. So really that's what longevity is aging well, and there's many ways to do that. You can change that trajectory. You just have to be willing to be compliant and kinda think for yourself and research and willing to make changes

Kerry Reller 5:24

Yeah, you make a great point. I think that the, like our parents' age right now are kinda didn't get this education at our age, and that's kinda where it's important to be getting it, right? These things are important to be setting up, though. So we see a lot of patients in the nursing homes, in the rehab centers, and there's And unfortunately, that's where s- they're spending a lot of final days, especially when we think about dementia and dementia care, and that's obviously something that we're trying to prevent. And, those patients are That's not where you wanna end up living out the rest of your, timeframe, hopefully. I think that's why, learning the things that we are now that can help prevent those things and have a better health span and lifespan, I think is obviously, I think, the goal and why it's important to be, learning these things now anyway.

Haley Todsen 6:13

Right, exactly. Independence is absolutely the goal

Kerry Reller 6:17

Yeah, independence. There was someone else, I think. I had another person on the podcast at one point, and she managed basically home healthcare and things like that, and she was like, "Aging in place," is like one of her t- her phrases. And I thought that was, it's great. You wanna be independent. You wanna be able to age at home, right? You w- you wanna be able to stay that way. So there are You mentioned we haven't mentioned yet, but there's some five pillars of longevity. So can you go through some of that for us?

Haley Todsen 6:43

Yeah, absolutely.

Nutrition, Protein & Fiber for Healthy Aging

Haley Todsen 6:44

So at Optimize, every visit, which usually we honestly see our patients every three months for any patient looking to optimize their longevity. So we always talk about these pillars. The first one I like to talk about is nutrition, because it matters what we're putting in our body. The food is going to drive your blood sugar to go up. It's gonna cause the release of the insulin. It can cause inflammation. That all can change how you build muscle, your metabolic function. It to do with your heart disease, dementia, and many cancer risk factors, right? Everything that we put in our body. And then what you can do about this, n- normally, I would recommend, depending on your goals, your health history, obviously really big into whole foods, Mediterranean diet for cholesterol. And then what you wanna do for this pillar is really hone in on how much protein you're eating. Eat your protein first, right? Try to get thirty grams of protein at every meal. Depending on your weight, depending on your goals is gonna depend individually how much protein you should be getting a day. And then remember, colon cancer is going up in dramatic fashion, so you wanna make sure that you're getting at least thirty grams of fiber also in your diet daily. So usually what I say is split up every meal, try to get thirty grams of protein and ten grams of fiber for that

Kerry Reller 8:16

Yeah, I... Those are great, easy recommendations, I think. There's so many things you could recommend in nutrition, but, getting down to the basics like that I think is really important, especially you mentioned the fiber too, and I think that's the long forgotten thing sometimes with I guess thinking about with aging and really any age. The fiber is a long forgotten one sometimes. So it's good that you include that as well.

Haley Todsen 8:38

It is. And

Kerry Reller 8:39

yeah

Haley Todsen 8:39

I tell my patients is, "Actually, I don't care if you count ca- calories per se, as long as you're counting your protein," 'cause then you're eating the right foods. You are gonna be full. And then I like to use ChatGPT. They can take a picture of their plate and ask how much fiber and how much protein is in this. It's pretty accurate. It's a good start. track it for a week, and then they kinda know then what they need to do to reach their goals

Kerry Reller 9:05

That's awesome. I've definitely used ChatGPT for like recipes and recommendations of like what do you got in the house, what you can do, how can you build it? Like yesterday with a visit, a patient and I who we found out had osteoporosis, we're like, "Okay, let's compare the breakfast that she wanted to eat." She wanted to eat one with Greek yogurt and granola and strawberries, and the other option was Cheerios, milk, and strawberries. And we're like, "Okay the, the calorie was actually lower with the Cheerios," but with the other one I'm like, "That's probably gonna make you fuller longer," right? It has more sustenance. Maybe you'll eat less of something else during the day if need, whatever. So I was like leaning toward the other one, depending upon highly what she put in that granola and then versus Cheerios. But ChatGPT, that's great. I haven't ever sent it a picture, so I think that's a great tip for people for, helping figure out their, I guess macros in this case, and that's a great tip. Yeah. I love it.

Haley Todsen 9:55

Thanks.

Kerry Reller 9:55

What else you got?

Haley Todsen 9:57

The

Strength Training, Muscle Mass & Body Composition

Haley Todsen 9:57

second pillar I like to talk about is movement or exercise, right? that's the closest thing I think we have honestly to a longevity drug, right? It's free. just have to be willing to do it. it on your calendar just like you do work or your job, anything that you have to be at. And that way, I usually say on Sunday, plan your week and make sure that it's in there. Of course, I'm gonna say strength training, right? Because we want to strengthen our bones to protect s- protect our bones against falls and fractures so that if we do fall, then we don't break a hip. normally what I say is I like for you to at least lift heavy for two to three times a week, then I meet patients where they are, right? If they're lifting one time a week, I'll say lift two to three. If they're lift- lifting already three times a week, we may push it up, or we'll make sure that the weight that they're using is actually enough. You really wanna make sure you're using enough weight to actually make a difference. So if you are doing reps, maybe the last two are almost impossible, then you know that you're kinda using the right weight is usually what I like to say on that

Kerry Reller 11:07

Yeah, absolutely. I agree that exercise is, the best medicine, really. And as you, I know you haven't, we haven't talked about medications and stuff, but obviously the lifting I think is something that has also been forgotten in years before, right? That wasn't the focus. It, women were afraid to bulk up, and all this si- kind of stuff has all been dispelled. And luckily, I think, we're all focusing, I think, on the strength training, keeping patients, s- so if they s- they're strong enough, if they fall down, they're gonna be able to get themselves up. Getting up off the toilet, like the basic things that you want to stay independent once again later years. So I totally agree with your exercise comments. But w- what you haven't mentioned lean mass, but why You were talking about building muscle mass, right? Why is that why do you think the lean mass is so important in longevity?

Haley Todsen 11:56

The lean mass is important because that's where your glucose uptake is, right? So you're eating all these calories, and whether it's turning to glucose, it's gonna be taken up in the muscle and then how your body is using it. And then the lean mass, m- building that muscle, which is lean mass versus fat, versus visceral or subcutaneous fat. So adding in the bulk will help with the metabolism. And then when you bulk the muscle around the bone, then it's gonna protect it, too. And then that's the load, right? That's the load on the bone that's helping with the osteoporosis

Kerry Reller 12:29

Exactly. Yeah. Yeah. I think also we're definitely talking more about, the le- different types of mass that we carry on our body and explain maybe, why the number on the scale doesn't, isn't that really important. You're already explaining it, but,

Haley Todsen 12:44

Yeah.

Kerry Reller 12:45

way.

Haley Todsen 12:46

at Optimize, we use a machine called the Styku 3D Body Composition Scan, It's close to a DEXA without the radiation, right? No, it does not replace a DEXA scan, but I'm not gonna radiate someone every three months to follow their lean body mass and their body composition. So you can weigh yourself on a normal scale, and it'll just tell you one number. It'll tell you how much you weigh. But you don't know the composition of that weight. Is it all fat? Is it eighty percent fat? Or is it mostly lean mass? And so that's why I always follow the true body composition, particularly when you're using GLPs, right? Because we know that you can lose muscle

Kerry Reller 13:30

Mhm

Haley Todsen 13:30

not doing the work and not doing it the right way. So I always say I'm not a weight loss clinic. I will never be a weight loss clinic. I will not just give you a medication and not see you in a year. That's just not good medicine, particularly for elderly people or older people because you will lose the muscle mass after the age of thirty, and particularly around menopause and perimenopause, unless you build it back up. So looking at two people that may weigh a hundred and fifty pounds can have completely different body compositions and a different health profile, and that's why it's so important to know how much lean mass you have versus fat mass

Kerry Reller 14:12

Yeah, I'm glad you brought in the whole I guess nutrition combo with the exercise and the muscle. That is the muscle is the glucose sink that's gonna, utilize all of those things, and also it's what fueling the muscle at the same time, right? So I think that's an important component. And then I love that you guys use body composition. I think that is hopefully... I'm, in an insurance-based practice. Hopefully that will one day be officially, reimbursed. Some things do, but not so much. But you- we're definitely hopefully moving toward that. But I think it's an important-

Haley Todsen 14:43

if that was part of the yearly exam, right? Not just stepping on a scale, but actually knowing, like another vital sign, the body composition. I think that is where medicine should go

Kerry Reller 14:57

I can imagine. That's actually what I try to do in our practice, and we have a little grip strength thing too. But and I think some of these concierge things are also mo- have moved toward that. And you're similar to a concierge practice, but anyway. I think that it should, right? And I totally agree with you. It just is not everywhere, right? I'm a little weird, so I do different things. But I think that the body composition is so important. And you mentioned the GLP-1s, and you mentioned older people. And now we have this Medicare Bridge program where all these older people are able to get GLP-1s at a more affordable rate, which is great, but I, in my practice, very much want to be doing it safely, right? And body composition is one of those things. I have threatened to take someone off of theirs already because I did not like where her body composition was going. It's important, as you said.

Haley Todsen 15:47

And you're right, they are so readily available, and I have patients come to me too, and they want the GLPs, people who have documented osteoporosis. And I'm like, "We can work on lifestyle, and we can see where we can go with that, and then we can discuss, but that's not an option right now." So exactly, you have to know the body composition, and you have to know each individual's history to know what's the right thing for them

Kerry Reller 16:13

And we, I don't think we've talked about this or if you're gonna get to it, but you mentioned, they had osteoporosis, right? S- most of the people in that age group didn't get any treatment, I'm talking about women, for preventing osteoporosis with hormonal treatment. So most of them have osteoporosis, unfortunately, right? That is

Haley Todsen 16:32

You're Exactly right. Exactly. Yeah

Kerry Reller 16:34

Yeah. We really we talked about the nutrition and the body composition and exercise obviously. Where do you wanna go next with your pillars of longevity?

Haley Todsen 16:43

So

Sleep & Longevity

Haley Todsen 16:44

the next pillar would be sleep. I think sleep is one of the most underrated pillars that is when the, the brain clears the waste, the hormones start regulating. It can help your muscle repair. That's why it's so important. you can have poor insulin resistance if you don't have good sleep. It's a cardiovascular risk. If you have sleep apnea untreated, it can decrease your life expectancy by 10 years. These are huge, changes that you can prevent. And so I love sleep trackers. I personally use a WHOOP. I do like the Apple Watch. Oura's hit or miss on certain things, depending. But knowing the REM sleep and the deep sleep that you're getting, how much are you waking up, making sure that you are going to bed around the same time and waking up at the same time, and then getting your first morning light, those are important takeaways for sleep that I think people don't realize, and that's the first thing that they'll give up

Kerry Reller 17:47

I'm not fam- yeah, they do give it up, right? I'm not familiar with the WHOOP. Is it similar to the Oura Ring? I've heard of it

Haley Todsen 17:54

So it's a little band

Kerry Reller 17:55

Okay

Haley Todsen 17:56

this, and it's an app. And it does your, pretty much everything that the Oura does except it doesn't do, I don't believe, menstrual cycles. It may. But I do like Oura for that part. I don't think Oura's the for workouts. Sometimes they don't pick it up. But yeah, the Whoop is very affordable and does a, a really good job, and it actually has workouts on it too that you can do

Kerry Reller 18:25

So you like the data that you get from it, and the patients, I think, that you're working with are probably liking... They like data. Some people are afraid of data, right? I'm sure that these are good for the kind of patients that you're working with, which is good. But I don't know.

Haley Todsen 18:41

all preventative, right?

Kerry Reller 18:42

Right

Haley Todsen 18:43

you can pick up some things on this that you never really realized may be a problem. Are they only getting five hours of sleep? They're not getting restful sleep, right? They're telling you that they're tired and groggy and craving carbs. So you kinda have to just keep picking away at and finding out what exactly is the cause

Kerry Reller 19:02

We do a lot of sleep studies, like home sleep studies, and, I tend to not just look at whether they have sleep apnea or not, but also looking at that quality, like that REM sleep cycle with the, I guess the machi- the PAP, not the PAP, sorry, the machine picks up during the test, right? So even if they are doing a test and they don't have sleep apnea, I'm also like kinda peeking at that a little bit too. Now, I don't have as much data as you do 'cause y- they're wearing it all the time. But I think it's somewhat insightful and, can lead to some other I guess clinical things down the line. So sleep is highly important, and I know I can't function without it.

Haley Todsen 19:39

Right? And then I'm glad you said that because I think even that's where a lot of education is missing for physicians, is that you'll get-- you'll have a sleep specialist read your sleep study, 'cause we do home sleep studies also. You'll have them read it, and they'll just say, "No sleep apnea," right? So I love that you look into it also, because you're right. You can learn so much from that test that is beyond the sleep apnea insurance approval score.

Kerry Reller 20:02

Yeah, and they're just looking, okay, do you qualify the PAP or not, or to treat sleep apnea. Yeah. Or get them Zepbound covered, which used to be the main reason. Not the main reason, but a reason. Yeah. Anything else to add on sleep? Do you... you're mostly tracking the data and obviously encouraging that-

Haley Todsen 20:21

It's something that we talk about all the time. Maybe they need to go to bed 30 minutes earlier. Maybe they need to wake up 30 minutes later. Just, being consistent with that and keeping the room really cool. Making sure that you have appropriate blackout lights. Really just following that and making it consistent

Kerry Reller 20:40

How about when sleep is overlapping with perimenopause, menopause,

Haley Todsen 20:44

so meaning that they're having like the 3:00 AM, 2:00 AM wake-ups? Yeah. of course it is hormonal. There are in perimenopause, maybe you do need progesterone to help. Maybe if you start having hot flashes and night sweats, maybe it's time to add estrogen. That is absolutely an individual conversation that needs to happen when those symptoms occur. And even just knowing about it, knowing what to look for is really important too

Kerry Reller 21:13

Yeah, I guess I meant sleep disruptors, right? You, we already talked about sleep apnea and the risk of not having good sleep, so I, the, the menopause and things is also a big sleep disruptor, right? And anxiety can come with menopause and things like that.

Haley Todsen 21:27

Exactly

Kerry Reller 21:28

was about supplement, supplements if people were having trouble sleeping. Is there anything that you go off, recommend anything?

Haley Todsen 21:36

So depending, but many times I'll recommend even magnesium glycinate. The supplement that you can take right before bedtime honestly can help too. Lot of times I'll have my patients stop eating hours before bedtime 'cause then your pancreas will stop- start releasing the insulin. and so a lot of people even just doing that, no alcohol, all of that will help too. So many times we'll stop eating around 6:00 PM even, so you're not digesting by the time you go to bed, and that actually will help with sleep too

Kerry Reller 22:12

Yeah, they really do recommend three hours. If not three, then at least two, but to stop eating before bedtime. And you're right, the big one, alcohol, right? So that, people think it helps them get to sleep, right? But then they don't have very good restful sleep when they do that.

Haley Todsen 22:26

And then just for

Kerry Reller 22:26

yeah

Haley Todsen 22:26

the wake-ups and the sweats, particularly in perimenopause and menopause

Kerry Reller 22:30

Yeah. Anything else to add on sleep before we go? What is the next

Haley Todsen 22:34

so

Kerry Reller 22:34

pillar? Did we do... We've done three, right? Pillars? Okay. What's the next one?

Haley Todsen 22:40

The next

Managing Stress for Better Health

Haley Todsen 22:40

one is more we talk about stress, right? So chronic stress obviously keeps our cortisol high. That cortisol you hear about all the time, the cortisol belly, right? It can cause belly fat. It can cause blood sugar problems. Here we go with sleep again. If your cortisol's too high, then you can have sleep issues and inflammation issues. And then even cognitive health also depends on keeping the brain challenged. So focusing on stress, usually I will do box breathing. I'll walk out first thing in the morning and get the first daylight sun. A lot of times on my way to work, particularly in the ER, actually only in the ER, I don't need it for the other pray or I listen to Christian music and really just calm myself down and set your mindset for the day, almost like gr- a gratitude practice. And I think that's one part that even ask a lot of my patients to have coaches or if they feel that they need a counselor someone for therapy. I think that's really where this comes into, just to talk through things

Kerry Reller 23:54

journal? I often suggest, journaling at night mostly 'cause then it's like a thought dump or in the morning if they have to

Haley Todsen 24:01

I really like the five-minute journal. It's very easy to use, and so exactly, that is a great idea

Kerry Reller 24:07

Nice. Nice. Yeah, stress, you got... You're an ER doc, so those are good practices to have before walking in. It's certainly a high-stress job. And then, everybody has stress, le- what levels of stress throughout the day, and it is a harder s- harder thing to manage, and it's gonna lead to poor sleep. It's gonna lead to weight gain, and, it's- stress is very stressful.

Haley Todsen 24:29

It is, and we all handle it so differently. So the purpose of this is to be able to handle the stress without feeling so on edge every time, right? So the more practice you get the less severe the stress seems

Kerry Reller 24:45

Yeah. Box breathing. There's another breathing method. I'm not sure if I can think of it, but th- those really, I think, help. And I think, honestly, I've used it with the kids, and they kinda help with them too, right? To calm down and not have a temper tantrum and things like that as well. Yeah. But okay. Are we ready to go to the fifth one?

Haley Todsen 25:07

Yeah. Let's go to the

Kerry Reller 25:07

All right.

Haley Todsen 25:07

one.

Community, Connection & Purpose

Kerry Reller 25:08

What is it?

Haley Todsen 25:09

So the fifth one is community and purpose, and I think as physicians, this is actually really important. This pillar I like because research shows that actually social isolation the same as smoking 15 cigarettes a day. That's what research shows. So you can imagine. So you need to have a sense of purpose. think physicians, their sense of purpose many times is their work, their job. And so when they retire, they feel like they lose that purpose, and many physicians go... kinda deteriorate pretty fast or stay in the job so long because that is their purpose. So don't ever, no matter what career you have, don't ever let your job be your purpose. Find a different purpose, whether it's spending time with your children, traveling church activities, something in your community. That is where will really find your purpose. And schedule meetings with friends, lunch with friends, working out with friends. That's double, right? Two pillars you can get right there. And I think that so important to realize that finding your purpose now and then kinda working at that really will build community and help with that pillar

Kerry Reller 26:29

Yeah, I think that's an important one. That always makes me think of the blue zones when we talk about the community one, 'cause they're always these tight-knit communities, and obviously they're very active and things like that as well as a community. And

Haley Todsen 26:40

and that's where a lot of the research comes from

Kerry Reller 26:42

Yeah, absolutely. And the purple potatoes, of course. I like the purple potatoes

Haley Todsen 26:47

I do too.

Kerry Reller 26:48

Yeah I have seen that unfortunately, like you said, after people retire and are no longer working, and, they struggle, is... And it's not it's not a, a fun thing to see. So I think you're right, having something outside of the actual job that you do is very important, and being involved in it and staying social. And, part of that social and aging thing, sometimes I talk about, hearing. If you're not hearing what's going on, you're kinda losing things, so making sure you get your hearing checked is an important thing as well.

Haley Todsen 27:18

It's absolutely true

Kerry Reller 27:20

yeah. So how do you assess longevity or in your practice and optimize tangible or integrated health?

Haley Todsen 27:27

Yeah. So

Longevity Testing & Cardiovascular Health

Haley Todsen 27:29

first, obviously everyone we have to look at individually. So start with their story, right? We look at their family history, their personal history. look at all the pillars. So how... What does your exercise look like now? Where-- I meet them always where they are, and then we add on, what does your sleep look like? How are you eating? What is your stress levels? And then obviously, we look at hormones. We measure over sixty biomarkers. So I look at your symptoms and all of the history along with markers. then we look at the body composition scan. I do look at an extended cholesterol panel with ApoB and LP little A. Kind of start there, and then based on their goals and what symptoms to them they immediately wanna work on because they're the, the most severe then we'll kinda start working on that. And then we will go from there and then add in based on what they do and then pivot based on their symptoms and how they react to whatever we decide, whether it's hormones supplements, peptides, whatever The most, honestly.

Kerry Reller 28:40

Nice. Yeah, I think it's nice with y- getting more data, right? With the comprehensive panel. What's, what is good now for other practices as well is that you mentioned ApoB and LP little A. Luckily, those are now in the evidence guidelines for, cholesterol management. I think that's, was earlier this year that they did that. So we're definitely seeing more of that deep dive on the cholesterol side of testing. I'm sure if you're looking at, what'd you say, 64 biomarkers, then you're... Is it with 64? You're doing a lot.

Haley Todsen 29:09

it's over 60,

Kerry Reller 29:11

Yeah, over 60. Okay. Yeah, it's nice to get... i'm, like I said, I'm a data nerd. I love, I like the data, too, so it's good to get some evidence on there for sure. Okay. So and then you start w- obviously wherever the, the person is and bringing it in. And, obviously not overwhelming them one thing at a time is much more appropriate, and then bringing them back, of course. So are there any tests, longevity tests, that you bring... Are you interested in bringing into your practice that maybe you're not doing that, that maybe some people might need?

Haley Todsen 29:41

Yeah. So one thing that we order out is have you heard of the Cleerly scan?

Kerry Reller 29:47

Yeah. Yeah

Haley Todsen 29:48

So I love that test. I think it gets so much information. It's AI generated. It's basically the hard plaque and soft plaque within the coronary system. So I think it gives us so much information, and I think that in prevention-wise really is more cutting edge. So I do that part for the cardiovascular risk assessment along, of course measuring the ApoB and LP little A. I hope that research shows that there are different medications that can even help with this. Of course lifestyle is very important but what else can we do to help decrease that soft plaque, right?

Kerry Reller 30:32

Yeah. Have, have you look- have- do you know about the new, the guidelines? They're bring- they're telling us to do more inclisiran, which I always forget the brand name. But and obviously they have the pathway with the statin bempedoic acid, or however you say it, ZEDIA, and then inclisiran, and then Repatha. They got all these things that supposedly reverse it. Or not reverse, but treat. Maybe reverse it. And they've changed the guidelines. The problem is with these things, they're very expensive, And so is the Cleerly. But it's an excellent test. So I, in, in an insurance world, we kinda do, "Okay, you can get $100 coronary calcium scan," which is a little bit more affordable for them. And I do similar thing, like educating, "Okay, this is not showing you the soft plaque, but it's showing the calcified plaque." And then, what can we do about it? How can we make that association? If you don't have a zero on your calcium score, what's going on, right? But limited means, but Cleerly is excellent test, yeah

Haley Todsen 31:27

Yeah, and then even in GLPs, right? For the inflammation to de- to decrease the plaque buildup. They're using them in cardiology offices even here in the area. So adding that to the regimen too, that you

Kerry Reller 31:42

Yeah. That's so awesome that you mention that because we were participating in a educational session on this ASCVD, so like risk of heart attacks and strokes, and they were talking about all these medicines that I just mentioned, and I'm like, "Why don't we just give them a GLP-1?" Because this is probably going to do just as good as all these other more expensive medicines, right? Or, inclisiran is an injection. I think you-- I don't know if it's monthly, I forget, or weekly, but you gotta go somewhere to get an injection. And I'm like we were like GLP could be just as useful in this situation, like you said, to decrease inflammation. And obviously we know that ha- has cardiovascular benefit. I think tirzepatide finally got its cardiovascular benefit recently, right? And then obviously w- semaglutide already had its-- I'm trying to figure out which brand name had the benefits. I'm blanking. But meaning, it's all the same thing. But the semaglutide got its benefits, and now as tirzepatide finally got their clinical trial to say that they also had cardiovascular benefit. So I agree, adding that on can be, yeah, game changer

Haley Todsen 32:47

Yeah. And I think we're still-- you know this. We are just at beginning of what I think GLPs can do. I see it in my practice, I'm sure you do, too, where they have decreased inflammation, so you're seeing a benefit in other symptoms that they may have that you don't even have them on the medicine for. So I think that's a huge benefit. Seeing patients in their 40s come in the emergency department with heart attacks, you wonder what could have helped them years before. And I think this is where going, right? This is the whole point of this, the longevity, getting them to where they don't have heart attacks

Kerry Reller 33:28

Yeah. No, I'm glad I... I don't know. That's scary on that side to think, gosh, we could have done so much already to help these people. But yeah I think the GLP-1s are in its infancy, and all the different diagnoses that they're going to be covered for. We've done a lot of different episodes on other stuff that they could be helpful for, and it is an exciting, a exciting thing. And on J- yeah,

Emerging Trends in Longevity Medicine

Kerry Reller 33:51

and then longevity industry in and of itself is an interesting thing. If you have anything to speak upon that. There's all these new things coming out, supplements, peptides, hormones, IVs, CGMs. Where do you g- see all these things fitting in?

Haley Todsen 34:05

Yeah. So I'm not big on IVs in general. If you think it, about it logically, there's... I just haven't seen the research that many of them can help with, right? If you're doing glutathione IVs, right? It's in your body, and then it's out of your body. So having more of a steady state is better than just once every three months, right? So just in general, IVs about that. The... one interesting I like is the stem cells, and we're not there yet in the US by any means. But I feel that stem cells in general, years from now will be very useful in many diseases for longevity and healing. I think that's where kind of the, the longevity piece will go. Other countries are definitely doing more than we are and have better stem cells than we do. But I think that's something that, that we can work on here. I think one of the things is just really be careful on what you're doing. If someone's trying to sell you something that's gonna fix everything, probably not true, right? Or proprietary blends, right? You can't see how much of an ingredient is actually in the supplement that you're taking or on the label. That's what I always preach on trying to be careful of. There's a lot of influencers out there that are selling products that have not been cleared by the FDA or have even been tested, nor do they even have to tell you what's in it. So if it's too good to be true, it's too good to be true.

Kerry Reller 35:49

Yeah. No, there is definitely some scary stuff out there. Even, with the new triple medicine coming out, the Ret- Retrotuti- Retta.

Haley Todsen 35:57

time.

Kerry Reller 35:57

Yeah. There, people are getting this on the black market and, it's coming from China, and it's definitely not a safe product yet. Certainly yet, right? 'Cause it's... We know it's gonna get FDA approved s- I don't know if it's end of this year or next year, but, it's not readily available. It's not safely compounded either, and I just really am scared for those that are already attempting that. That's just one example. But yeah, I don't really know much about people getting IVs for things, so I'm glad you kinda dispelled that for us, for sure. What else? Oh, you have some other interesting things at your office, I think, right? What are some other things that you guys offer that are in this longevity space?

Haley Todsen 36:40

Yeah. So we actually do have a hyperbaric chamber. It's a hard shell chamber that goes up to two ATA, so think of scuba diving. So our patients use it for different things, right? You can use it FDA-approved ways, and then there are non-FDA approved ways to use it. So wound healing. So we'll have patients who have plastic surgery. They want to come in and use it before surgery, and then they will use it a few times after surgery. So it helps with... really well with wound healing. It increases collagen. It increases the oxygen supply to those little vessels that normally don't get enough oxygen for healing. So obviously, we know that it's good for diabetic wounds, and it's treatment for traumatic brain injury. mostly ours are wound care. It helps with sleep, too. It helps with recovery. So a lot of NFL facilities have them around the US, and the players go in after the games because it can help with the strain from playing these long games, right? They're aging, too. So it helps with recovery for tendons and muscles, too. So there's a lot of different ways to use it. And then we also have a red light sauna, and that helps with collagen repair. It can help with sleep, too, and detox. Really just kinda sweating everything out, getting those red lights on you can help with all that

Kerry Reller 38:12

Does it help with wrinkles?

Haley Todsen 38:14

And

Kerry Reller 38:14

All these things. I was wondering. Ah, you could get some people lining up for that instead of Botox or something like that. That's great. Okay. Yeah, and I was thinking, you mentioned TBI, and I was, first thing I was thinking was football players, and then you mentioned that they have them there, so that kind of makes a lot of sense, for sure. And obviously very much used in wound care as well. But I was wondering, does that also help with wrinkles? 'Cause something you said with that, I was, like, picturing wrinkles. Yeah.

Haley Todsen 38:40

yeah, 'cause of collagen.

Kerry Reller 38:42

Yeah. Yeah.

Haley Todsen 38:43

And a lot

Kerry Reller 38:43

They both do

Haley Todsen 38:43

will do the hyperbaric first. There's a protocol where you can do the hyperbaric first, and then you actually go into the sauna after

Kerry Reller 38:50

Man, I wonder what you come out looking like. You sh- do you have befores and afters? I don't know. It'd be cool.

Haley Todsen 38:56

I, I should.

Kerry Reller 38:57

you should.

Haley Todsen 38:58

it's a medical practice,

Kerry Reller 38:59

oh, you have to get them to sign their life away, and then you can get your befores and afters. Yeah. Yeah.

Haley Todsen 39:06

I'll

Kerry Reller 39:06

do you do any biological age testing or anything like that?

Haley Todsen 39:10

I do. I use a blood test for that, to kinda test down to the DNA level. It's one that was tested I believe it was at Johns Hopkins that it's a test from there. So that's the one I use. If you look at Function Health, they will give you a biological age, but actually not... it's based on the labs that you get done and then they put it together in a spreadsheet and give you just a number. So it's not really down to the DNA level. So the best way is to do certain blood tests. That's how I do the biological age

Kerry Reller 39:49

Okay. Is there anything else that you're excited about in longevity medicine that we haven't discussed?

Haley Todsen 39:55

I think just having patients aware what they can do on their own that's free. Just, the pillars, working out, making the right decisions. Because our epigenetics, we can actually change those, and I think a lot of people don't realize that. We may have the BRCA gene, right? But it doesn't mean that we're going to get cancer. It means that we may have a higher percentage than the average population, but things that we can do every day can try to help with that. So I, I think just educating patients and that this is talked about every day. There are many resources, podcasts that are available for patients to actually learn. I think that's really what I'm most excited about, is just getting into patients' hands what they can actually do

Kerry Reller 40:51

I know you're not really functioning at a primary care, but a lot of longevity medicine has to be focusing on preventative medicine too. So I was, like, gonna make sure that, you're doing all the regular... Not that you are, but somebody is, their regular screening tests for the cancers and things like that

Haley Todsen 41:08

Yeah. So all my patients have to have a primary care physician also, and that's mostly the reason why,

Kerry Reller 41:16

Mhm

Haley Todsen 41:16

that they are getting their... they, most of them can order their colonoscopies theirself. But yes, all of my patients have to have a primary care physician. I am not their primary care physician. This is completely separate preventative longevity medicine

Kerry Reller 41:31

Cool. Okay. I know we've covered a lot, and I probably have a million more questions, but is there anything that you wanted to discuss today that we haven't covered yet?

Haley Todsen 41:40

I think really just knowing that no matter what age you are, you can start today. It's never too late. So take that out of your brain that, if you're thinking that way. Start with strength training two to three times a week or increasing your weight if you're already strength training. will help with your independence. Eat the protein at every meal, 30 grams and 10 grams of fiber. And then know your numbers and go beyond what's normal. Know what's optimal. Ask for that ApoB and LP little A if you haven't got that. Get your body composition or your DEXA scan even earlier than this, than 65, what the insurance tells you can. They're not that expensive. And know your baseline so you know what you're working from. And then build community. Remember, that's one of the pillars also. Call a friend. Pick up a new hobby

Kerry Reller 42:34

Find an old neighbor who's practicing medicine like you.

Haley Todsen 42:38

Yes,

Kerry Reller 42:39

Fun fact, you're my old neighbor. No, those are great recommendations. I think that's perfect, really. And I was gonna say the opposite, right? As you're... I won't, I don't wanna say you're just never too young to start, but maybe as a young adult, not like a teenager, but to start doing some of these things too, right? To be more empowered about your health and wanting to have a strong and long lifespan and health span, right? So you said it's never too late to start, but also maybe it's never too early. I don't know.

Haley Todsen 43:08

No, that's a great point. I actually have a lot of patients who are in their 20s, many that are in college. So you are absolutely right. It is never too early to start and learn. The earlier you start, the better you will be set up

Kerry Reller 43:25

Nice. So where, you mentioned it a little bit already, but before we wrap up, where can they find you if they wanna work with you or follow you on social media or wherever else?

Haley Todsen 43:35

I am at optimizetampabay.com on the-- That is our website, and through there you can contact us. We do discovery calls only because we are, like I said, not a typical primary care office. We wanna make sure that your goals are what you-- what we can strive to accomplish for you. So you can schedule a discovery call there. And then on Instagram, I'm also at optimizetampabay.com or Dr. Haley Todsen is the other handle on there and TikTok also

Kerry Reller 44:11

I think that's where I got-- I started calling your practice Optimized Tampa Bay, and I think that's where it came from. My bad. Yeah

Haley Todsen 44:18

that's, yeah, that's our website, and then it

Kerry Reller 44:20

Perfect. Okay

Haley Todsen 44:21

Health, but that is our website. That's pretty much all of our handles

Kerry Reller 44:24

Nice. Thank you so much for coming on the podcast today. We have learned so much, and, I think everybody has a lot to be able to take home and implement right away. These are things that are not that hard, and like you said, some of it is free. So they can find you and work with you if they want to or do some of these things on their own until they're ready. So thank you so much for joining me on the Get Healthy Tampa Bay podcast, and everybody stay tuned next week for next week's episode Bye