Automatic episode summary
Keith Vance opens episode 30 by naming the ground it covers: hormones, peptides, toxins, nutrition, and longevity. His guest is Dr. Tareq Khader, a physician who owns Naples Longevity Clinic in Bonita Springs and runs a second company, Longevity Blueprints, that helps doctors around the country move out of insurance-driven practice into preventive care.
Khader traces how he got there. Training gave him textbooks, diagnoses, and treatments, but nobody asked how a patient arrived at the hospital in the first place. COVID changed the question. Working the wards in hazmat suits and watching people die alone in the ICU, he kept running into the same puzzle: two patients who looked identical on paper caught the same illness, and one survived and one did not. That sent him into mitochondria, DNA, and epigenetics, and to the line that anchors the episode: health is not the absence of disease. The people who supposedly drop dead out of nowhere, he argues, were not healthy the day before. They had been unhealthy for twenty years and it only surfaced then.
Keith then hands over his own chart as the worked example. Turning fifty, watching parents who had him at seventeen keep putting their own care off, and wanting to still be standing for seven children and arriving grandchildren, he searched for a clinic, got lost in the weeds, narrowed it with a shortlist, and reached Khader on the third call. He went in convinced his fatigue was low testosterone and determined not to start TRT. The labs said otherwise: testosterone in the thousands, higher than a thirty-five-year-old. The real deficiency was vitamin D, in a man who lives outdoors. From there Khader explains who actually decides what a normal lab value is, why insurance thresholds override symptoms, and the idea he calls N equals one: every patient is their own statistic, and a randomized trial describes a population rather than the person in the room. He also makes his most quotable clinical point, that fitness level predicts cardiovascular mortality better than cholesterol, blood pressure, smoking, or family history, yet appears in no guideline, which is why he puts patients on the VO2 max machine.
The protocol itself is walked in order: 1-MNA to stop NAD from draining rather than pouring more in, methylene blue for mitochondrial support, and sermorelin last, because peptides are modulators that need an environment to work in. Keith describes what the sermorelin felt like using a fresh power-tool battery as the analogy. Heart and lung scans, self-paid and not run through insurance, gave Khader the visual basis to decline a statin for a man labeled high cholesterol for twenty years.
The middle of the conversation turns practical and cheap. Four pillars: sleep, resistance training, food, and stress. Sleep starts in the morning with sunlight on the retina, not at bedtime. Food is a short list kept eighty percent of the time. Water means chlorine, filtration, and remineralizing. Stress means telomeres, the ninety-second rule before emotional decisions, and breathing as the single strongest lever. Keith offers the change that lifted the most weight off him, swapping one word: he is responsible to people, not for them. Khader connects isolation to dementia and contrasts a sixty-year-old in Jordan who considers himself finished with a ninety-year-old in Naples still going out, while crediting the culture he came from for never sending anyone to a nursing home.
The last third is harder. Microplastics have no good test, no good removal, and the one promoted intervention appears to age you. Heavy metals and parasites, by contrast, are testable. Khader then explains why a licensed physician and an influencer with seventy million followers are not held to the same standard, and teaches the difference between association and causation. He grades American healthcare a six out of ten, faults cost, prior authorization, and defensive medicine, credits accessibility and emergency care, and closes on incentives finally beginning to reward prevention.
Speakers
- Dr. Tareq Khader guest
- Intro voiceover other
- Keith Vance host
- Crosstalk other
Chapters
- 1:10 From COVID wards to longevity medicine
Dr. Khader describes a medical training that taught him to treat disease but never to ask how a patient got sick, and the COVID ICU that changed the question for him. He lands on the claim that anchors the whole episode: health is not the absence of disease.
- 7:03 Turning 50 and finding a doctor
Keith explains why turning fifty, watching his parents defer their own care, and wanting to be strong for seven kids and arriving grandchildren sent him looking for a longevity clinic. He walks through the search that lost him in the weeds and the third phone call that finally reached Dr. Khader's office.
- 10:19 Bloodwork, normal, and VO2 max
The labs came back the opposite of what Keith expected: testosterone in the thousands, and a vitamin D level that was low despite a life spent outdoors. Dr. Khader questions who decides what a normal lab value is, explains the N-equals-one idea, and argues fitness level predicts cardiovascular mortality better than anything in the guidelines.
- 20:22 Peptides, methylene blue, and scans
The protocol in order: 1-MNA to plug the NAD leak rather than pour more in, methylene blue for mitochondrial support, and sermorelin last. Keith describes what the sermorelin actually felt like, and the segment closes with the heart and lung scans that let Dr. Khader decline to prescribe a statin.
- 35:47 Insurance, concierge, and telehealth
Keith asks whether this kind of care can reach ordinary people, and gets an honest not yet. Dr. Khader lays out the economics behind thirty-patient days, the shift toward concierge and direct primary care, and where telehealth genuinely helps and where it does not.
- 44:46 Sleep hygiene starts in the morning
The first of four pillars. Dr. Khader argues sleep begins with morning sunlight on the retina rather than at bedtime, then covers a fixed schedule, screens, late meals, magnesium glycinate, and shutting the sympathetic nervous system off at the end of the day.
- 52:59 Simple food, cleaner water
The food rule is a short list kept eighty percent of the time, and Keith presses on whether eating well is really affordable. The water conversation moves to chlorine, filtration, remineralizing after reverse osmosis, and why glass bottles are not a full answer either.
- 1:03:16 Stress, boundaries, and social life
Telomeres, the ninety-second rule before making a decision under emotion, and breathing as the one lever with the most control over the stress response. Keith shares the single word change that took the most weight off him, and Dr. Khader connects isolation to dementia risk.
- 1:14:45 Lift heavy, live longer
Dr. Khader describes research on biological age in which resistance training outranked every supplement tested. Grip strength, muscle on a seventy-year-old, and why keeping the advice simple removes the excuses.
- 1:18:20 Microplastics, metals, and parasites
Keith asks for the truth about microplastics without the panic and gets an unsatisfying but honest answer. Heavy metals and parasites, by contrast, are testable and treatable, and the parasite question becomes the doorway into the next chapter.
- 1:33:29 Influencers and the melatonin study
Dr. Khader contrasts what a licensed physician may say publicly with what an unlicensed influencer can claim without consequence. He uses ice cream and summer drownings, then a real melatonin headline, to show how association gets sold as causation.
- 1:39:52 Grading American healthcare
He gives the system a six out of ten. Against it: cost, insurance control of clinical judgment, prior authorization, and defensive medicine. For it: accessibility, real regulation, and an emergency room that turns nobody away.
Key takeaways
- 16:00 N equals one. Every patient is their own statistic. A randomized trial tells you what happens to a population, not what to do with the person in front of you. Dr. Khader says making that call takes two things: understanding that being a doctor is an art rather than something memorized, and having enough time with the patient to know their history, stress and story.
- 18:40 Fitness level is one of the highest indicators of mortality risk from cardiovascular disease, ahead of cholesterol, blood pressure, smoking and family history, and it appears in no guideline whatsoever. VO2 max measures it in about thirty minutes of sweating in a doctor's office, and Dr. Khader says it delivers better risk stratification than any other test.
- 21:30 The NAD bucket. Fill a bucket with water, and as you age a hole in the bottom keeps widening. Infusions and precursors just pour in more water; 1-MNA plugs the hole by tricking the enzyme that breaks NAD down, and lets the body find its own equilibrium. Dr. Khader calls the four hundred dollar NAD IV a money scheme, since the molecule is too large to cross into the cell at all.
- 33:10 Dr. Khader is not anti-statin, but he calls them mitochondrial toxins with a real correlation to diabetes and metabolic syndrome, and says cyclists routinely tell him their endurance collapsed after starting one. That is why he wanted imaging before accepting a high cholesterol label Keith had carried for twenty years, and the clean scan meant no statin.
- 44:39 The four pillars: sleep, resistance training, food, and stress control. Get those four in place and Dr. Khader says you have achieved eighty-five to ninety percent of your health goals and prevented more than ninety percent of your diseases. Keith's response is that simple things eliminate excuses.
- 45:40 Sleep starts in the morning, not at bedtime. Fifteen to twenty minutes of morning light hitting the retina, no sunglasses, shuts melatonin off on schedule. Blue light at eleven at night tells the body it is still daytime, which is why people fall asleep exhausted and wake two hours later unable to get back down.
- 1:09:40 Dr. Khader extends Keith's point: other people's happiness is not your responsibility, and people pleasers are the most stressed people he sees. He is careful to say this is not a green light to be rude, that sympathy and respect still apply, but the burden of another person's reaction belongs to them.
- 1:16:00 In the biological age research Dr. Khader cites, resistance training topped the list of interventions, with omega-3 and vitamin D the strongest supplements behind it. Grip strength tracks with lifespan in a straight line, and five pounds of muscle on a seventy-year-old improves bone, heart, lipids, sleep and balance at once.
- 1:38:26 How to spot a bad health headline. In summer, ice cream sales rise and drownings rise, and neither causes the other. Dr. Khader traces a viral melatonin causes heart disease claim back to a chart review that never asked why those people took melatonin in the first place, since twenty years of bad sleep is the likelier culprit. He also notes an influencer who is wrong pays nothing for it.
Pull quotes
The thesis for the whole conversation, in Dr. Khader's own words: health is not the absence of disease. He says doctors are taught that healthy means you are on no medications and your numbers are fine until next year, and then asks how many supposedly healthy people drop dead. They did not become unhealthy that day; they had been unhealthy for twenty years and it only just showed up.
Keith's reason for starting: he was turning fifty, his parents had him at seventeen and keep putting their own care off with I'm too busy, and with seven children and grandchildren already arriving he wants to still be fit and present when they need him. He describes it as not wanting to get caught in the I'll do it later cycle.
Keith on his VO2 max result: you can't have a podcast called Still Strong and come in with some weak numbers, man.
Keith's description of what sermorelin felt like: his pull-up sets had been sliding from five to four to three as recovery took longer, and on the peptide it was like swapping a three-year-old power tool battery for a brand new one that charges fully and holds it. The methylene blue he barely felt; the sermorelin he felt in the first week.
The word change Keith says took the most weight off him: I'm responsible to people, but I'm not responsible for people. He lists his wife, his children, his employees, and the son-in-law and daughter he cannot buy a house for, and describes the shift as finally being able to take the cape off.
Scripture & context
- 1:30 Dr. Khader owns Naples Longevity Clinic in Bonita Springs, bought from a physician who was retiring in his late seventies and rebuilt around preventive care. He also runs Longevity Blueprints, a consultancy that moves doctors across the country into the same model, on the reasoning that teaching one doctor who then teaches another spreads knowledge further than lecturing.
Questions answered
- Why did a hospital physician move into longevity medicine?
- Dr. Khader says his training taught him to diagnose and treat, but never to ask how the patient ended up in the hospital in the first place. Working COVID wards, he watched two patients who looked identical on paper catch the same illness and have opposite outcomes, and that pushed him into cellular biology, mitochondria and epigenetics. He later took over a retiring physician's hormone clinic and rebuilt it around prevention. jump · 1:10
- What does it mean to say health is not the absence of disease?
- Dr. Khader argues doctors are trained to call someone healthy when they are on no medications and their blood pressure and cholesterol are in range. That is a statistical description, not a description of the person. He points to how often supposedly healthy people drop dead and says they did not suddenly become unhealthy that morning, they had been unhealthy for twenty years and it simply surfaced. jump · 4:00
- Keith expected low testosterone. What did his bloodwork actually show?
- His testosterone came back higher than a thirty-five-year-old's, in the thousands, so his fatigue was coming from somewhere else. The real deficiency was vitamin D, which surprised Keith because he lives outdoors; Dr. Khader explains that skin, time of day, genetics and depleted soil all affect it. They started with vitamin D and built up slowly instead of reaching for testosterone. jump · 10:19
- Is a VO2 max test actually worth doing?
- Dr. Khader calls fitness level one of the highest indicators of mortality risk from cardiovascular disease, stronger than cholesterol, blood pressure, smoking or family history, and notes it appears in no guideline. VO2 max is how you measure it, and it takes about thirty minutes on the machine. In his view it gives better risk stratification than any other single test he can order. jump · 18:40
- Are NAD IV infusions worth the money?
- He calls them money schemes. The NAD molecule is too large to cross from the blood into the cell, so the lift people feel afterward is a transient reaction to the infusion rather than the NAD itself. His alternative is 1-MNA: if NAD is a bucket with a hole that widens as you age, infusions pour in more water while 1-MNA plugs the hole and lets the body hold its own equilibrium. jump · 21:30
- Why order a heart scan when the cholesterol number is already high?
- Because the number alone does not show what happened to the arteries. Dr. Khader has seen pristine cholesterol with near-total blockage and the reverse, and he was not willing to start a statin on a man who had carried the high cholesterol label for twenty years without seeing the damage. Keith's scan came back clean, so the plan is simply to rescan every two to three years. jump · 31:10
- What are the four things a person can control on their own?
- Sleep, resistance training, food, and stress control. Dr. Khader says covering those four gets a person eighty-five to ninety percent of their health goals and prevents more than ninety percent of disease. He repeats through the whole segment that none of it is complicated or expensive. jump · 44:46
- How do you sleep better without buying anything?
- Sleep starts in the morning: get outside fifteen to twenty minutes without sunglasses so light reaches the retina and melatonin shuts off on schedule. Then keep the same bed and wake time daily, budget about eight hours in bed for seven hours of sleep, drop screens thirty to forty-five minutes before bed, and stop eating roughly three hours before. If more help is needed, he suggests plain melatonin, magnesium glycinate, and five minutes of meditation, journaling or gratitude to come out of sympathetic mode. jump · 45:40
- Can you get microplastics back out of your body?
- Not really, and Dr. Khader says so plainly rather than selling a fix. There is no good test to quantify microplastics, and the one promoted intervention, plasmapheresis, showed up in the biological age research as something that ages you, so it trades one harm for another. What a person can control is the last step: their water, their silverware, what they store food in, and eating out of whole food categories instead of boxes. jump · 1:19:40
- How should a listener judge health advice from an influencer?
- Dr. Khader points to the asymmetry: a licensed physician who oversells a peptide online can lose a license, while an influencer with a supplement line and seventy million followers has nothing to lose. He teaches the difference between association and causation with summer ice cream sales and summer drownings, then walks through a viral melatonin and heart disease claim built on chart review that never asked why those people were taking melatonin in the first place. He names Dr. Huberman and Peter Attia as examples of more legitimate work, while explicitly saying he is not endorsing Attia. jump · 1:33:29
Helpful links
other
- Naples Longevity Clinic Dr. Khader's health, wellness and longevity clinic in Bonita Springs, where Keith's bloodwork, VO2 max and body composition were done.
- Longevity Blueprints Dr. Khader's consulting company that helps physicians and providers around the country transition into a longevity and preventive care model.
- Vance Ranch The mid-episode sponsor: the Vance family's 100-acre ranch in Henry County with a 6,000 square foot barn for weddings and events.
book
- Breathe The book on breathing technique Dr. Khader recommends for stress control; no author is named on air.
product
- Whoop The wrist wearable Dr. Khader is wearing during the recording and uses to explain heart rate variability.
Full transcript
Dr. Tareq Khader: I
Intro voiceover: learned the hard way, nothing's overnight, some days you lose, some days you survive. Still Strong, even moving slow, every step counts more than you know I found gold in the everyday, showing up and staying brave. Still Strong.
Keith Vance: Today's conversation is going to be about hormones, peptides, toxins, nutrition, and longevity. Dr. Tarek Kader, welcome to the Still Strong Podcast. Thank
Dr. Tareq Khader: you. Happy to be here. Thanks for having me. Such a pleasure.
Keith Vance: I'm looking forward to this one, brother. Yeah, same here. We've been trying to get together like two or three times and we finally made it happen. Yeah. It's been two months, I think. Three months. Yeah, I think so.
Dr. Tareq Khader: Yeah. Life happens, man. Life happens.
Keith Vance: Yeah, no, it's good. I'm glad to have you here. It's an honor. Yeah. Before we get rocking and rolling, for people who don't know you, who are you today and what's this current chapter of life like for you?
Dr. Tareq Khader: So I am a physician by training. I currently own Naples Longevity Clinic in Bonita Springs, which is a health and wellness and longevity clinic. I take care of a lot of issues, but mainly I try. I try to keep people healthy, well, live longer and live better. How did I get here was quite a bit of a story, actually. So training and med school and residency and all that, you're given a textbook, you're given some cases, you're getting some sick patients, go to the hospital, see them, go to the clinic, see them. Here's the diagnosis, here's the treatment. Nobody really touched base on, hey, well, how do we do this? We prevent this from happening. How did this person end up here? What could have we done 20, 30 years ago before this has happened where this person would have been well and happy with his family or her family? Really didn't ring a bell at all up until we got to COVID. COVID happens. A lot of issues happened. I was at the hospital in the middle of it. All the hazmat suits and all the stuff that you saw on TV, we did that. Lived it. Nightmare. So I see a lot of sad stories, a lot of people dying alone in the ICU, all these isolation metrics, which I understand, obviously, but how do we get here? From there, I started noticing, why do I have two, quote unquote, healthy people or very symmetrical patients? One of them died and one of them barely made it to the hospital. They were fine and they got the same disease. Okay. And that started a very big thought in my head and a light bulb came up. There is something more than healthy means being on a drug or healthy means you take a medicine or healthy mean you don't have a disease. And eventually came down to the conclusion, health is not the absence of disease. That is not what health is, right? But doctors. Are taught that. Healthy means that you're not on any medications. Your blood pressure is good. Your cholesterol is good. You're good to go to your next year. That's what health means or healthy means. How many times have you heard of, quote unquote, healthy people drop dead? They did not just suddenly become unhealthy. They've been unhealthy for 20 years. It just showed up right now. So that took me down the rabbit hole of cellular matters and mitochondria, DNA, epigenetics. What is beneath the surface? Why is blood work? Not showing what we're looking for? Why are people really sicker than what they look like? Why do people react differently to certain diseases? Why people in the COVID era drop dead? Why other people just survive with no problems? Why did people have long term effects? And, you know, don't get me wrong with COVID. There's still a lot we don't know. There's a lot we're discovering as we go. But the whole idea and the whole concept of health and what does health mean started over there. So that led me to where I am today. There's the clinic I run right now is a it started off as a hormonal clinic, which came across for sale because the doctor was retiring. He was getting closer to his 80s. So, you know, it was a great opportunity. So I took it on, but applied everything I learned and, you know, learned more and got into the field of longevity, which really a longevity is nothing more than one on one listening to the story. And focusing on preventive care. Because longevity is very, very, very simple. Longevity is not stem cells. Longevity is not PRP. Longevity is not all these, you know, fancy drugs out there. Longevity is very simple. 95% of longevity can be achieved through very simple measures. So, you know, that led me to the idea of doctors are underrated, they are overworked, they're underpaid by insurance, insurance dictates the game. So, I started helping other doctors do this. So, on top of the clinic, I have a consultation company where I consult on doctors and providers to transition from what they do to what I do all across the country. The company is called Longevity Blueprints. And, you know, been successful transitioning a lot of doctors, and that is very rewarding in other ways, you know. But because you spread the knowledge, right? At the end of the day, you want to spread the knowledge. You want to spread the knowledge. And you kind of just, you know, sit in lectures and lecture people because that's actually the least effective way of spreading knowledge. I think the best way of spreading knowledge is that way is you teach somebody, that somebody is going to go teach somebody else, etc. So, it's been a successful, it's been a great chapter. I'm going to be 40 exactly in a month. Good for you. And I think I did not see myself being here when I was 30. So, when I was 30, I did not think at 40, I'm going to be where I am today. Very happy, very content with it. You know, obviously, always looking for growth and, you know, spreading the word and helping more people. And there's nothing more rewarding than really helping people achieve their health goal. And you really see the transformation, you know. You see somebody come in struggling and having a lot of questions. They don't know. They don't know where to start. Yeah. And then, you know, a year later, you look at them, they're, you know, they're there. We have actually a lot of people, they quit our program just because they got where they want to be. Nice. There's nothing, nothing can tell you, you
Keith Vance: know. Nice. Yeah. Yeah. I want to set the stage with how you and I met. And you can, what we'll do is, we'll go from when you and I met with that phone call and where I am now, just use me as an example of a blueprint of what you do. But before we get going, everyone that comes on the podcast, I think it's a gift. Yeah. I was on your podcast and I gave you a gift on yours. Yeah. This is a different design. Yes. So I got to keep you up to date. Thank you. These are Richardson 112s. Thank you. My kids tell me they're the best. Thank you. Thank you. Thank you. You have the originals of the design. That's version two.
Dr. Tareq Khader: I do. Amazing.
Keith Vance: Thank you so much. You're welcome. All right. Great. Great. So I'm going to set the stage, brother. Let's do it. I was getting ready to turn 50. Mm-hmm. My parents had me when they were 17 years old. So in all reality, they're not much older than me. So I just kind of been measuring my health off of them just because they're a little further down the road. Mm-hmm. And there seemed to be this reoccurring theme that you get a new ache or pain and it's just your new normal. Mm-hmm. Hey, mom, why don't you go get that checked out? Oh, I'm too busy. I got to take care of the chickens or I got to take care of the grandkids. You know, they put off their health. I'm too busy. I'm too busy. And with me having seven kids and now I'm having grandkids already, like the potential for me to have a bunch of grandkids, I want to make sure that I'm fit, that I'm healthy, that I'm there when they need me. Like, it's very important to me. Plus, just in regard to my fitness level, I just feel better. Like when I'm working out, it detoxes my stress. It cleans my brain. So. I wanted to, in preparation to be 50 and knowing that the closer you get to the core of that toilet paper, the faster it goes. I didn't want to get caught in that cycle where I felt like, I'll do it later. I wanted to do it now. I did a Google search and I'm thankful for Google. I'm thankful for technology. But when you don't really know what you're looking for, you can get lost in the weeds. And I got lost in the weeds quick. Mm-hmm. So I used my Chad GPT. I set parameters. Here's where I'm at. Here's where I want to be. Set me up with the three best ones. And you were one of the three. Actually, you were the third one that I called. The first one never called me back. The second one, an appointment was three months out. I called your office and your nurse in-house and said, well, the doctor's here now. And do you remember that conversation? Yeah. I thought that because I was fatigued, I was tired. I thought my testosterone was low. And I told you, I said, listen, I don't want to take TRT because I'm afraid that if you . . TRT, your body will stop making it. I want to do things the natural way first. And you and I were vibing. You were that holistic. Let's do this holistic stuff first. Give your body what it needs to jumpstart it. And if it doesn't work, there's other options. So I'll set the stage there. You take the ball and run with it. Yeah.
Dr. Tareq Khader: That's where it started. A lot in the background. We prepared for your visit. You came in. We did the blood work. Based on your symptoms, I was expecting something. But my eyes were open for other things. Your testosterone came back higher than a 35-year-old. And definitely your symptoms were not from testosterone.
Keith Vance: Tell them what my numbers were. Hike me up here.
Dr. Tareq Khader: They were in the thousands. In the thousands, bro. In the freaking thousands. Yeah, they were in the thousands. So what you have just described about working out and living a healthy lifestyle, being outdoors and all that stuff, contributed. You probably have some genetic also superiority there. But at the end of the day, you take care of yourself. Everybody who has that mindset where I want to take care of myself before it's too late, I want to do this before it's too late, really has the right question in mind. Because you're not 80 years old. You're not 70 years old. Because we have a lot of people that come at that age. And it is a little too late. We still work with them, but it's a little too late. So the age you came in is great. I have people come in earlier, which I prefer. But the good news is, even though that you were not at that lower age in the late 30s, early 40s, your body is acting at that age, right? So you listed your symptoms. You were talking about the fatigue, the tiredness. And you were ready to go on some sort of testosterone treatment, whether it's holistic, whether it's supplements, whether it's nutrition, et cetera. I think we talked back then about ashwagandha and magnesium and how can we push it. And I think that's what we're doing. So our surprise is like, oh, this is great. That's not what we're doing. Then we started looking at other things, other venues, your growth hormone. We started looking at thyroid, at the DHEA, at the pregnenolone, other things. And we came up with this formula, right? And we slowly built up to it, if you remember. We started with just a couple of supplements. I think your vitamin D was very low. Dr. Justin Marchegiani That's what it was. Which
Keith Vance: surprised me because I'm out in the sun, no shoes, no shirt. And it just surprised me. Dr. Justin Marchegiani Yeah. Dr. Justin Marchegiani Yeah. Dr. Justin Marchegiani But the type of vitamin D I was deficient in, I think you said was from nutrition. Dr. Justin Marchegiani Nutrition.
Dr. Tareq Khader: Yeah. Because we are, again, going back to education and teaching, you think that you just, oh, I'm going to spend some time in the sun. Well, no. Your color makes a difference. Your skin makes a difference. The time of the day you go out makes a difference, right? And your genetics make a big difference. Some of your vitamin D comes from food. Some of it comes from sun. Some of it comes from the sun. Our food is void. Our soils are empty. There's no more nutrition right now. So our foods do not have as much vitamin D as they did before. I am yet to have a person who has, I'm not going to say normal vitamin D, right? That's another challenge we'll talk about in a little bit. Yet to have somebody who has a vitamin D level that is optimal, that is not on supplements. Dr. Justin Marchegiani
Crosstalk: Mm-hmm. Dr. Andy Roark That
Dr. Tareq Khader: was not the case 100 years ago, right? So we put you on vitamin D, as simple as that, right? And we didn't jump you into peptides from day one. We didn't do all these fancy measures from day one. We hit you with a VO2 max, I think, from that first week or two weeks into it. And that was also pretty impressive. Dr. Andy Roark Just say it. I
Keith Vance: crushed it. Just say it. Dr. Andy Roark You crushed
Dr. Tareq Khader: it. Dr. Andy Roark You crushed it. Dr. Andy Roark You can't have
Keith Vance: a podcast called Still Strong and come in with some weak numbers, man.
Dr. Tareq Khader: Dr. Andy Roark Yeah. No, no, no, no, no. Great numbers. Great metabolism. Great VO2 max. And the vitamin D made a difference. Now going back to that lab situation, why is it a challenge for me to say normal? Who says normal? Right? A bunch of people who looked at about 100,000 samples, and they took an average. And again, healthy people, right? Quote unquote. People between 40 and 50, they're quote unquote healthy. They're not on drugs. They're testosterone averaged between 300 and 1,200. Hence, that is our average. That's what we're going to put in. Dr. Andy Roark Well, great. That's for statistics. If you want to go into statistics and say, statistically, you're going to fall between this number and that number. But everybody's a little different. Everybody reacts differently. Somebody might have very low testosterone symptoms at a 500. Right. but yet if you look at the lab, if you look at the insurance payments, if you look at when insurance is going to pay for it, it's not going to pay for it until you test it twice. then you are less than 250. So what if you have the symptoms of low testosterone? What if you have all the classic symptoms? You're weak, you're fatigued, you're depressed, you cannot work out, you're losing your muscle, and your testosterone is 400. Sorry, you don't qualify, right? So this is when we let a lot of non-clinicians, bureaucrats dictate healthcare. And this is not how it should be. It should be a clinical judgment, a clinical workflow. You look at the labs, you talk to the person. Now, I'm not saying that the alternative is picking up the phone or the Zoom and talking to some sort of service and looking at your numbers and talking to you for three minutes and prescribing you testosterone. That's not the alternative, right? I think everybody should be looked at differently. There's a concept in longevity called N equals one. N equals one means every patient is their own statistic. Okay, so example. You know, this study showed that when we looked at 300,000 people who had the following criteria, and we excluded these criteria, and we put them through this filter, if we gave them intervention A, this happened. Okay, so this is a randomized controlled trial. And this is the standard of care of evidence in medicine. What? That's not the reality, right? I love this concept when you are dealing with a population level. When you're able to apply the concept of N equals one, me and you sit down one-on-one, one hour, two hours, three hours, over and over, talk about nutrition, talk about exercise, meet you, know about your social life, know about your stress, know about your story, know your history. This is where, wait a second, despite Keith being on that list of patients, who had checked the boxes, one, two, three, four, if I do intervention A, then according to statistics, he must have that outcome. But no, from my knowledge of Keith, from me understanding what he's going through, I think that we have to do intervention B, not intervention A. I made that decision based on two things. Because I'm a physician, and being a doctor is an art. It's not just something you memorize. And number two, I spend enough time with you. So I think, these two things, we have a lot of doctors, but we don't have a lot of time. So from there, we took you on, we brought you, we did the blood work, we put you through the torture machine on the bicycle, we placed that big mask on your face, that is the VO2 max. That is, I'm going to tell you one little fact there, and I actually educate doctors about it, and everybody's just opening their mouth. When you hear about cardiovascular disease, what are the risk factors? Just out of your mind. What is, when I tell you risk factors, factors for cardiovascular disease, what comes to mind? I don't know. Cholesterol is the first thing that people talk about, right?
Keith Vance: Oh yeah, everybody's cholesterol is high. Cholesterol. They told me my freaking cholesterol is high.
Dr. Tareq Khader: Hypertension, smoking, genetic history, you know, diabetes, right? There's a few of them. You look at them. So when you want to look at somebody's score, according to current guidelines, 2026, you look at all these things, and you determine a score. And based on that score, you determine your next step. Should I do an imaging? Should I put them on a stat? Then should I do this and that? You know, but there's one thing that is determined to be one of the highest indicators of mortality, which is fitness level. Your fitness level determines your mortality risk from cardiovascular disease more than anything else I just mentioned. But it's not in any guideline. It's not in any guideline whatsoever. How do you measure fitness level? Freaking VO2 max. I know it's a torture machine, but it's 30 minutes off exercise. That's what it is. 30 minutes of sweating and being in a doctor's office, you'll get so much information. You get so much risk stratification better than any other test. Better than cholesterol. I mean, yes, of course, if you're cholesterol through the roof, if your blood pressure is high, if you're diabetic, I'm not ignoring that, but there's so much stuff in your lifestyle. That are not looked at. And we measured that for you. We looked at it. And you sat down with Justin, the nutritionist back then. I didn't have Libby back then. Right now we have her. And he talked to you about exercise. And I believe he gave you some exercise tips and tricks. You did the body composition. We knew how much visceral fat you have, how much muscle you have. Also score through the roof. So people know. And we gave you. Okay. Comprehensive plan, and I think this whole process took us a month and a half. Between back and forth, phone calls, this worked out, this didn't work out, let's do this, let's do the supplement. And after that, we jumped into peptides. After we got you to a point where, okay, I'm feeling better, I know where I am right now, now I just want to improve, and I want to excel.
Keith Vance: And even the peptides, you didn't hit me with a bunch of them. Yeah. It was systematic. Do you remember the first one you put on?
Dr. Tareq Khader: Either Cermarolin or CJC, I think one of these two.
Keith Vance: It was an oral one. It was MNRA or something like that. 1-MNA.
Dr. Tareq Khader: 1-MNA is not a peptide. 1-MNA is a precursor. It is a way to trick your body that there is not enough NAD, so it stops breaking down NAD, so your NAD levels could climb up.
Keith Vance: That was the first thing you put me on. And then you put me on, and you can talk about that, what it does in depth if you want. And then you put me on something I heard on Joe Rogan, but I never knew what it was, Methylene Blue. What does that do? What are those two things you put me on? So
Dr. Tareq Khader: Methylene Blue, let's talk about 1-MNA first. 1-MNA is an actual supplement, so everybody has it. So we have it all in our body. What it does, it tricks one of your enzymes that breaks down NAD, and NAD is that compound that is crucial for majority of enzymatic functions in the body. If we have no NAD, we all die. But now there's a huge thing out there, NAD infusions, NAD infusions, NAD infusions. They're nothing but money schemes. So you go there to an ID clinic, they give you an ID, it costs you $400, it costs maybe $30, and you're out of there feeling great. The reason you're feeling great is because there's a transient elevation and certain markers on your body as a reaction to the infusion, not the infusion itself. That's going to go away in a few hours. And that, physiologically, that doesn't work. The NAD molecule is so big, it is almost impossible for it to cross from the blood into the cell. It's just so huge, it's not going to cross the cell barrier. So we still need to work on your NAD. How do we do that? So again, you think about the art. So let's think backwards. So we trick your body to think that you don't have a lot of NAD. So let's stop breaking it down, because that is a cycle. And if you look at NAD as a bucket, so you fill that bucket with water, and as you get older, there is a small hole in the bucket that keeps getting bigger and bigger and bigger. As you get older, you're going to lose more and more NAD. NAD infusions, NAD precursors, all of that stuff, you're just pouring water into the bucket. What we do with this trick is we plug the hole. You plug the hole, and you let the body handle it. So you keep the body equilibrium. You don't give it too much, and you let the body do its thing. You just allow the body to do its thing with no pressure. Also, people don't understand that inflammation, prediabetes, insulin resistance, stress, will tank your NAD levels as well. So there's so many factors why NAD could be low. Nobody looks at it. They just want to give you the infusion, just charge you $400 for it. But that's the reality of today, because I think what I started with the traditional medicine, which I think still has a huge role today. I think I still take call at the hospital, and I know how important it is, and I know we need to understand a lot of these things. But the frustration from traditional healthcare system created that paradox, created that other end where, you know, a Quack Jones at the end of the street. Here, you know, he goes on a podcast, and he just talks about whatever he wants, just because he looks nice, and he has some followers. You know, you go look at his background. You know, the person never attended school, medical school, pharmacy school, nursing, none of that. They just read online some stuff, and they're just teaching people some medicine, and then people follow that. So, but it comes from frustration. It comes from people being frustrated about healthcare system, about how things are going.
Keith Vance: Let's save this for a segment on its own, because I know you want to talk about that. Yeah. So, I want to do, I want to kind of like turn pages in a book. Okay. Right now, I want to talk about what you did for me through the whole process. Yeah. And then I want to jump to another chapter, and we can jump to that chapter next, because I know that's a hot topic for you.
Dr. Tareq Khader: Yeah. So, the other thing, the other supplements, or the other addition we added for you was the methylene blue.
Keith Vance: Yeah. What does that do? So, methylene blue. Other than turn your pee blue. Well, methylene blue. Listen, the nice thing about that is, I rarely forget the flush, but sometimes when I do, my wife don't get mad anymore. She thinks it's the toilet bowl blue stuff. Oh, yeah, yeah. Yeah. Yeah. It'll turn your pee blue. And it lasts for a couple of days. If
Dr. Tareq Khader: you miss it a day or two, it's still there. It's still there. Pee blue is a medicine. It's been around for a very long time. It used to be the gold standard for treatment for malaria. Some anesthesiologists still use it to battle certain toxicities. So it's still around. You can get it as prescriptions. It is for certain overdoses, et cetera. We use very small dose compared to the traditional dose. It is a mitochondrial support medicine. So the mitochondria, just in a nutshell, is a very small powerhouse that sits inside your cell and it generates the energy, ATP. That's the main function of it. But there's billions of functions that happen, but generating energy is the biggest thing and the most thing that we know about right now. So what methylene blue does is it optimizes that process. If there is some mitochondrial damage, mitochondrial injury, methylene blue helps that. And, it helps the mitochondria utilize oxygen better. So what we call the cellular respiration. So they're literally breathing. So the cell breathing gets better. Symptomatically, a lot of people with brain fog, a lot of people who have issues concentrating, a lot of people who had some depression, anxiety, generalized anxiety disorder, et cetera, they do benefit a lot from methylene blue for the same reason, but we're talking about brain cells. So it's not oxygenating? It's helping the cell utilize oxygen better.
Keith Vance: Okay. Which would make sense that you would have less brain fog. Correct. Okay. That makes sense. Correct.
Dr. Tareq Khader: Correct. So that is what it does in a nutshell. I usually use it on cycles. We sometimes use it for a short period of time. We stop it. Sometimes we do cycling. Sometimes people benefit from it so much that we keep them on it. So there's no current protocol for it, but that was what it is. And I think the third thing we put you on is a growth hormone secretagogue. Okay. Which was the injection. Somorolin. Somorolin. And what that does is it tells your body to produce more growth hormone. It is not a growth hormone. It is a growth hormone secretagogue, a stimulator for growth hormone production. It does very similar things to the muscle as what the testosterone does. Improves muscle endurance, improves muscle strength, well-being. Some people benefit for sleep, but again, it's the last thing we added. Right. So we built up to that because you cannot start it if you, for example, have terrible sleep. If you have very poor sleep and you give yourself a peptide, that's just not going to work. Right? So peptides are great and they're great additions, but they're modulators. They are not going to work if you don't provide the environment for them to work. So that's why I usually choose to start peptides towards the end. Okay. Okay. Okay. Okay. It's, you know, obviously if you have something wrong going on or we need to reassess, blood work twice a year, things happen. Stoatron could drop. Other vitamins can show up as their deficients. We could see some inflammation popping up. We could see some changes in your heart numbers. Forgot to say something about what we did for you too. We did the heart scan.
Keith Vance: Before we talk about the heart scan and the lung scan, I want to go back to Somorolin because I felt that brother. I felt that. So I remember my pull-ups were becoming weak. So if you do, say, five sets of five pull-ups, I noticed that I would have to rest longer to get that five by five. Okay? Okay. So where before, the first set I could do five, maybe I rest 30 seconds or a minute, I'm back on. I can do my five, rest 30 seconds, a minute, I'm back on, I'm back on my five. I noticed that it was taking me longer rest to hit that five. So my first set would be five. My second set would be five. My third set's four. My fourth set's like three. The last one's like two. That first week I was on that freaking Samorlan, the best way I can describe it was, you guys that are in construction, my boys like Milwaukee, when you have a brand-new battery, that sucker holds a charge and charges faster than the one that you've been using for two or three years. The one that you've been using for two or three years, it doesn't get up to a full charge and it doesn't last longer. I felt like my battery charged 100% and I felt as I was doing my pull-ups, it was ramping back up. I felt strong, man. The methylene blue, I didn't feel too much. The other thing that you didn't talk about, but that's Samorlan. I felt like I was like the Hulk, man. I told my wife, I was like, girl, I thought I was strong then. i was excited about it yeah so i felt that one yeah the only thing i didn't like about it was the injection that's a shot i know i don't like it i'm used to it now but i didn't like it
Dr. Tareq Khader: yeah yeah well you're a little scared of needles yeah you can tell people that yeah
Keith Vance: so the samorlan i felt yeah yeah and then you did this the scans i went to uh heart scan i think two hearts and a lung scan yeah go
Dr. Tareq Khader: back a little bit when you said that people said you have high cholesterol and you need medicine right yeah they did so um we do a heart scan because we some people and we have all these classic examples with absolutely pristine looking cholesterol numbers you do the heart scan and they almost have a 90 blockage well why because the problem is not the cholesterol and then you have somebody like yourself was really good cholesterol and you do the heart scan and the heart scan looks uh sorry your cholesterol was quote unquote not good right for other doctors um and i remember when i told you it's like listen i cannot make a judgment just by looking at these numbers i need to see visual i need to see what did this do to your arteries because statins are not side effect free and i'm not a conspiracy theorist who would say statins are the worst thing in the world or you know it's over it is over prescribed no question but there is a place and a time for them and you're not in that place or town And the only way we knew this is by looking at your heart and your blood vessels. And it's not something we're going to sit on forever. We're going to do the scan every two to three years and see if you develop anything. The likelihood that you're 50 years old, so when the statistics say at 60 years old, if we do that scan and you come back with a clean, pristine scan like yours, the likelihood of you developing cardiovascular disease, if you do not change anything in the next 10 years, is virtually zero. Zero. I'm talking about cardiovascular disease from plaque, like heart attacks or any of that. We're not talking about arrhythmias or AFib or structural disease or any of that. So that was the purpose of the test, is just to have a visual. I was like, you've been labeled high cholesterol for maybe 20 years.
Keith Vance: Yeah. If for that... You know what they told me? Yeah. You need to work out more. I said, come on over and let's do it. Yeah. Come on over and let's do it and tell me where I'm slacking. Yeah. Work out more. What was this? And then they want to prescribe me with that, whatever it was, that cholesterol medication that you see on TV all the time. What's it called? Lipitor. Lipitor or something like that.
Dr. Tareq Khader: Yeah. Yeah. So that scan is very enlightening because if you... Let's say the other way. Let's say that your scan came back with 20% or 10% or 15% blockage, right? I'm going to tell you, listen, Keith, right now it's not a problem. What's 15%? 15 years from today, I promise you it's going to be a problem. You know? But let's look at likelihoods again. N equals one. You've been labeled like that for 20 years. For 20 years, nothing happens. What is the likelihood that this is the problem? If there is a problem, start with. You know? So if we're going to go that route, your likelihood is very low. The reason is, back to the mitochondria and methylene blue, statins are mitochondrial toxins. They directly affect mitochondria. There is a good correlation between statin use and diabetes and metabolic syndrome. People get muscle aches and pains. A lot of people just don't feel well with them. They're all athletic. I see them all the time. They come in and they have lesions on their heart scans. And I put them on statins. A lot of them are cyclists. And a lot of the response is, Doc, I cannot cycle anymore. My knee... My endurance is down. So obviously we stop it and we look for a replacement. So, you know, put a bookmark on that one because I'm going to mention that in the traditional healthcare system section. So, and then we did your lung scan. We're looking for cancers, for lung cancers. And we gave you as close as it gets to a clean bill of health. I didn't say 100%. Right. But we did over a course of two months or three months, maybe more than what you did over 20 years.
Keith Vance: Yeah. And I just want to say that I didn't run any of that through my insurance. I self-paid it. Yeah. And those scans really weren't that expensive. They're reasonable. Yeah. So just that to have a little bit of peace of mind. Yeah. For something that's not that expensive. It just felt like the right
Dr. Tareq Khader: thing to do. Absolutely. I agree with you 100%. Because... A heart attack is very expensive. Regardless of the health outcome. You know, that trip, the ambulance trip alone. I've been on strip alone. It's more expensive than the heart scan. You know, so, preventive care is like an investment. You put the money up front. Yeah. You know, health insurance is like a very bad investment. You have to do it, though, you know, because you never know. That day when you have a car accident or appendix ruptures or something, you're going to need surgery. But the way the structure it's made, it's just when I get the hesitation about paying the money, I understand it, obviously. But I think if you look at it as an investment into your health, I think it'll make a lot of sense.
Keith Vance: I want to move to another chapter. Are you ready? Yeah.
Crosstalk: I think you hit that one pretty well. So, is
Keith Vance: there a move from traditional mainstream medicine that's driven by insurance companies? Yeah. to this type of style that you're doing? And is it affordable for most people?
Dr. Tareq Khader: Yes and no. So, this is where my longevity blueprint company really comes in handy to a lot of doctors. Is it affordable to most people? The answer is unfortunately not. Regardless how you phrase it. The heart scan was how much? $360 maybe? $370? You know, I don't know. I think if I'm not wrong, 80% of Americans, they don't have that extra cash that month. Right? But can you do N equals one for everybody? Yes, you can. Okay. But here's where the trick is. As a traditional doctor, a regular primary care doctor, the way it works, you come in, you present your insurance card. A lot of the staff up front takes your insurance. You fill out a paper. You come see me for 10, 15 minutes. I build the insurance. The insurance pays me. Okay. Insurance pays me pennies. I'm going to say pennies. Very little. Okay. It's actually a little insulting. You know, the numbers. I'm not going to say them because it's really bad. Okay. So, the doctor has to make a living that is decent. The doctor has to see about 30 patients a day. Call it a 10 hour working day. No lunch, no breaks, back to back. What kind of day is that on the doctor? On their mind? What kind of care did they provide? What kind of outcomes are they looking at? So, they're driven all by protocols. What it is is EMRs or electronic medical records or systems right now, EHRs. You log in to these brand new ones and the ones that are driven by insurance and you say, you know, this patient has Medicare or whatever. It has a checkbox. It's like a machine. Ask them about the colonoscopy. Ask them about the heart. Ask them about this. Ask them about family history. Duck, duck, duck, duck, duck, documents. If you document. Don't document all that. You're not going to get paid. Right? So, you have to go. You spend more time documenting than you're actually talking to the patients. So, this is the health insurance world. So, for the doctors to make a decent living, they have to see this many patients on daily basis, take no more than three, four weeks of vacation a year. And at some point, the life expectancy of doctors was 59 years. You know, this is the reason. So, the cash pay out of that is we reduce that number from 10,000 patients to 200 patients. But you got to get paid. Right? So, this is where the cash pay comes in. And, you know, you pay a fee. You pay a membership fee that covers that cost. But it also gives you as a patient a peace of mind that this doctor is my quarterback. I can call him regardless what's going on, what time of the day. Yeah. And he can give me an advice. And I can call him and pick up the phone and say, hey, listen. This is what I ran to. This is what I want to do. What do you think? Yeah. That luxury is not just because the other doctors don't want to give it. It's just because they don't have time for it. Time. So, that is why if you want to, you know, call the number 300,000, right? If a doctor wants to make $300,000 a year, roughly. And if you want to translate that into, you know, the current model of the cash pay, you know, they don't have to see more than 100, 200 patients. Right? They just have to see what kind of price they set up, what kind of overhead they have and all that stuff. So, this is why it's very challenging for doctors on insurance plans. And that's why you're seeing a lot of shifts. A lot of the stuff I hear from patients, they come in, my doctor switched to concierge. My doctor switched to concierge. My doctor switched to concierge. And, you know, or you hear something like, do you know any primary care doctor? My doctor switched to concierge. And right now, you have big companies actually purchasing these concierge practices. Now, you have Naples Community Hospital has a concierge practice. Now you have specialty concierge, you have cardiology concierge, you have GI concierge. So is
Keith Vance: that solving a problem or is that causing another problem?
Dr. Tareq Khader: Nope. That is solving a problem for doctors, right? But it's not solving a problem for population as a general.
Keith Vance: Yeah. People who... So I remember my wife's original doctor. I'm going back when we were in our 20s. We got a letter saying that he was going to this concierge service. And like, if I want to be involved in it, it's going to cost me like five grand up front. And as a 20-year-old kid with kids getting started out, that might as well have been $50,000. Correct. So enough... There was enough kickback. They're like, oh, never mind. We're going to scrap that. So... Yeah.
Dr. Tareq Khader: Yeah. Yeah. So, you know, right now you're in a great position. You're in a great position and all, but majority of Americans are your 20-year-old version.
Keith Vance: Yeah, I know.
Dr. Tareq Khader: Right? Where I feel great right now. I don't think I need anything. I think I'm just going to stick to urgent care or I'll just go see the doctor when I have to. Yeah. But you have other models too that came to solve that problem, which is called direct primary care. Direct primary care is pay for a fee for service. So you come in, you're a member, but you come in, you only pay if you come in and see the doctor that day. Okay. That's geared towards real primary care. Okay. Yeah. Towards preventive care, right? You come and see me once or twice a year. You pay $200, $300, $400 a visit, whatever it is. You pay less money, but you get less of me as well. But a lot of these people don't have insurance and this is the way out of that. And then you have the new services that are coming out, the tele-services, the telehealth services. Hims and Hers and all these big companies where you log in, you talk to a doctor. I think it's solving a big problem, but it's creating another problem. The
Keith Vance: telehealth is solving a problem?
Dr. Tareq Khader: It's solving part of the problem. But it's creating a different kind of problem.
Keith Vance: I like the telehealth. It's nice just being on calls. I need my prescription filled. It's convenient. So what is the problem that it's creating?
Dr. Tareq Khader: So it is not addressing the big problem for traditional medicine. It's making it easier for you as a patient because you can call and get your prescription filled and you don't have to drive anywhere. Right. It's good for urgent issues. I have a sore throat. I have a red eye, whatever it is. But it is not... It's not something that you're going to experience like what you experience with models like ours, where you can sit down and you have all these testing. Because even the telehealth, you're going to call. Next time you call, you're going to speak with somebody else. Yeah. Right. It's not going to be the same. Got it. You know, during COVID, there was not a lot of work as well. So I did some of that work back then. It's yeah. I mean, it's not we... It was funny. It's actually a texting app. So I would be texting with a patient. Wow. Yeah, it was ridiculous. I mean, it solves a problem. Don't get me wrong. It solves a problem for, you know, young kids in college who, you know, have an earache or they have a sore throat or they want a letter for their work, for their college, something like that. Right. You know, usual, you know, there's something that honestly today AI can solve with no problem. Really? Yeah. No, I think if we sit down again in a year here, you know, we probably have to prepare ourselves that a lot of that work will be solved by AI. And I have a lot of faith in that. I think if you... If you combine the telehealth services and you combine something like direct primary care and you can come up with some sort of model where you can help people create their preventive care, create a platform where you can plug in your information, something like in the AI version where you can plug in your information, guides you through it, tells you here's what you have to do. In a legitimate medical way. Not that this is what we think. One, two, three, four. But please call your doctor. Right. You would actually get legitimate advice. I think that would solve a lot of the problems. But I think the biggest solution here would be is education. What I say when we first started, longevity is very simple. I think the biggest hurdle in it is really at that age when you get yourself into that journey is to know if there's something going on. You know, if you understand there's nothing going on, the rest of it is education. Just you have to understand what... What food does to you. What exercise is good. What is too much exercise? What is good sleep? What is bad sleep? If you put in these four metrics, sleep, resistance training.
Keith Vance: Let's get it. There you go. Food.
Dr. Tareq Khader: And stress level control. You're golden. You're golden. You achieved 85 to 90% of your health goals.
Keith Vance: Okay. So I want everybody to hear this. Yeah. Okay. When it comes to taking your own health into your own hands. Managing your own health. What were the four things you just said?
Dr. Tareq Khader: Sleep. sleep All right. So, we're talking about seven to eight hours of quality sleep every night.
Keith Vance: Okay. So, you and I can vibe with this because you don't get good sleep by staying up till 10 o'clock at night watching TV and then saying, okay, I'm going to go to sleep. You need to set your body to prepare for sleep. You don't just go to sleep, right? You got to prepare. You got to wind down, right? So, we can talk about any of the stuff that vibes you. We can talk about it, or you can keep going. So, let's just hit them first, and then maybe we can back up. i think
Dr. Tareq Khader: that is a very good educational point of view here you know people listen to this they're going to appreciate that so
Keith Vance: sleep is number one
Dr. Tareq Khader: number one is sleep if you everything we just talked about right if you don't have good sleep nothing's going to work you're going to actually regress so um sleep starts in the morning well starts when you wake up you go out to the sun you connect with nature because we as humans progressed so much faster our sorry our technology progressed so much faster than our bodies did our bodies are the same for the last 10 000 years but but the machinery the lifestyle the the technology is completely different right got it so back in the day right your grand grandfather or maybe maybe your father woke up at four or five in the morning got out to the field worked got home sunset there's no power there's no electricity they ate dinner and they went to bed right right now we don't have that it's all halogen lights schools are sitting kids are sitting in school for eight hours sitting is this position is not a natural position right eight hours they go out for 20 minutes outside they eat god knows knows what kind of launch it is. And that's the life cycle. So first thing I say when we talk about sleep is that morning sunlight. If you live in an area where you can get that morning sunlight, even if it's cloudy, even if it's a little cold, that 10 minutes, you don't know how much of a good effect it has on you. The sun hitting your skin activates a cascade of events that is very anti-inflammatory so certain chemicals in your body actually start climbing in the morning once the sun hits the skin it's very like our bodies are so complex and complicated a lot more than what we think even the sun hitting your skin is going to create that change sun hitting your eye the back of your eye that's why no sunglasses in the morning hitting the retina once that happens the melatonin turns off right when the melatonin turns off the melatonin is the stuff you buy over the counter from the drugstore to sleep the reason you buy it is because your melatonin is all over the place because you know as you said you're up 10 11 o'clock watching tv or on your phone that blue light is telling your body hey listen it's still daytime it's daytime it's nighttime but oh no it's still daytime don't worry about it you're sleepy but your mind is not it's not ready so you go to sleep
Keith Vance: bro you're hitting like 90 of the of the the population right now right that's like all of us and
Dr. Tareq Khader: here and i think it's gonna it's gonna resonate well with a lot of people you think that you're sleepy and you're tired you sleep and you wake up two three hours later that's true yeah the reason you do this is because your body thinks that it's daytime and you have a tough time going back to sleep takes you two hours you fall back to sleep and And then you wake up at 6, 7 in the morning to go to work and you're a zombie all day. And you don't have, when you wake up, like when this happens, you don't have time to go in the morning. You're not in the mood to go for a walk in the morning. You're just rushing. You get the kids ready, get their lunch ready and whatever it is, right? So first thing in the morning, going out to break that cycle. Go out for 15 to 20 minutes. The longer, the better. That morning sunlight, get the sun in. Sometimes it doesn't work out. That's fine. It is what it is. Sometimes we have to leave home before the sun is up. but that's okay second thing is set to sleep hygiene which means sleep schedule if sleeping and waking up should be at the same time every day so you want to eat you want to sleep uh seven hours a night you set yourself to be in bed for about eight hours because there's about an hour of tossing and turning getting up to go to the bathroom etc so 11 to 6 11 a.m to to 7 p.m or 10 10 to 6, that's 8 hours. Every day should be the same time. So that's the sleep hygiene. Number three, avoiding any screen. 30 to 45 minutes heading up to bed. If you have to, absolutely have to, there are certain glasses that block the blue light. Phones today, they have some sort of blue light filter. Eating, heading to bed towards bedtime. Nighttime should not be any digestion going on. Nighttime is for brain cleanup. No. Nighttime is for your body. This is practical
Keith Vance: stuff, man. Yeah. This stuff is simple and it's cheap. 100%. A hundred percent. This is going to help a lot of people. Yeah.
Dr. Tareq Khader: Yeah. So eating a meal shorter than three hours before bedtime is not a good idea because you're going to be digesting going to bed. And your body is not ready for that. Your body is not meant to digest food at nighttime. Your body is meant to rest the gut at nighttime. A lot of people would have reflux issues, et cetera. The blood sugar goes all over the place. So all these sleep hygiene techniques are going to help people sleep better, get better quality. And even if you think that you sleep very well, if you apply these metrics, your quality of sleep will be better. Better. Right. Now, we're not even talking about sleep apnea yet here. Sleep apnea is where people stop breathing at nighttime multiple times an hour. And that restricts blood flow, restricts oxygen, which makes a lot of issues. Ice cream. A lot of people. A lot of people for sleep apnea. But that's a medical issue that needs a little more hands-on work.
Keith Vance: We're just talking about basics right now. Basic stuff. Stuff that you can do at home.
Dr. Tareq Khader: Yeah. Right? Now, if you're still having trouble, melatonin is a good option. Melatonin that's just melatonin. Magnesium glycinate at nighttime. That's going to help you relax your body a little bit. Meditation. You have two forms of nervous system. I'm wearing the whoop here. A lot of people wear that. A lot of people wear that. I'm wearing a ring or whatever. That measures a lot of variables related to your heart rate. There's something called heart rate variability, which is a result of constant push and pull between a nervous system called sympathetic nervous system and another one called parasympathetic nervous system. Sympathetic nervous system is when you're working out or going, you're yelling at your employee, you're having a big meeting. This is sympathetic nervous system. Parasympathetic is your, you know, with your grandchild, you're relaxed. You have them on your lap and you have like that relaxed feeling. These are two different forms of nervous systems. Towards the end of the day, you want to turn off the sympathetic and turn on the parasympathetic.
Keith Vance: So practically speaking, shut the emails off. Put your phone on. Put your phone on like sleep mode and start winding that stuff down.
Dr. Tareq Khader: Winding down. Meditate for five minutes. Sit down. But practicing gratitude. Right? Practicing gratitude. Actually has a lot of benefits. Some benefits. Medical benefits. Amazing, isn't it? And just writing and journaling and just reflecting on your day. And there's a lot of things that would turn off that sympathetic system. Because if you do not turn that off, you're in trouble. At nighttime, your body's not resting well. Right? So I think all these tips, put them together, is going to create a better quality of sleep and is going to get people to sleep better. I think that's when it comes to sleep. Food. Very simple. Very simple. And it's going to be the shortest one.
Crosstalk: You eat out of these categories. Meat. Red meat. Chicken. Fish. Eggs. Fruits. Vegetables. Coffee and tea. And nuts. That's it. Nothing else.
Dr. Tareq Khader: If you do this 80% of the time, you're good. Right? If you want to eat an ice cream every now and then. If you, you know. Okay. So hold on a minute.
Keith Vance: Hold on a minute. What you just said. Again, I'm putting myself back in my 20 year old shoes. Like some of that stuff that you talked about is more expensive than the pack of hot dogs for 99 cents or the buy one get one free hot dogs. You follow me? But I think you and I had a conversation before that in the long run, there's a lot of people that are like, well, I'm going to go to the supermarket. The quality of food is not cheaper. It's the garbage food over a long period of time that is that is more expensive because it has an effect on your health. Absolutely.
Crosstalk: Absolutely.
Dr. Tareq Khader: It's like paying your credit card minimum payment. Right? Got it. So if you pay up front, you're not going to be interest. But if you do minimum payments, you're going to continue to pay interest until you know you end up being triple the credit card amount.
Keith Vance: Quality of food. Is one of the. Keys to being healthy. So if you can find somewhere else in the budget to scrape, you would you would put that extra money in food? Absolutely. Okay.
Dr. Tareq Khader: Absolutely. At the end of the day, I think it is not. Let's just be real. I think it's not just the price. I think it's a convenience. Understood. Right. Right. Yeah. So is it cheaper to go buy a family meal from McDonald's? Or KFC? Of course. But here's what I argue. Here's what I argue. You, Keith, in the morning, you wake up, and I give you two options to eat. Waffles and pancakes and fried chicken, right? Or three eggs and avocado. Which one is going to give you a more productive day?
Keith Vance: The second. can right
Dr. Tareq Khader: so if you look at it from that perspective i eat a healthier meal i'm actually going to do better in my job i'm going to i have better chances of producing better if you're self-employed you have more chances to recruit more clients or more business that day you are not hitting that midday fatigue and you don't know what to do with yourself and you really want to take a nap so on the long run no we're not talking about a very long run we're not talking about 50 years we're talking about five to ten years it is much cheaper to eat healthy food and you're gonna need less food because understood when you eat a hamburger from mcdonald's or you know a fast food chain or whatever it is there's a lot of carbohydrates in that right and a lot of sugary condiments and whatever it is right what that's going to do is that's going to spike your blood of sugar, that's going to spike your insulin. What does that do? That's going to tell you that you're hungry quicker. So you're going to need another meal in about four to five hours. But if you eat the meal I just told you about, three eggs, half an avocado, you're going to be full for a good six, seven hours. So you're going to actually eat less. If you eat more protein and more fats, then you eat carbohydrates, especially refined carbohydrates. So that's another argument against against the price it would it still be a problem absolutely yes there you're gonna still have people who unfortunately just can't afford it what do you do you make the best out of it make the best out of it yeah that's out of it whatever you can whatever you can do if there's one day a week where you can go grocery shopping and buy yes do that better than you know buying yourself the most you know the the newest iphone right
Keith Vance: understood nobody's ever gonna get it 100 hundred percent no but just try to get as close as you can with what you got absolutely understood absolutely this is practical stuff yeah thank you water
Dr. Tareq Khader: let's get it 100 ounces a day easy right easy to remember 100 ounces a day of water wake up you know half of this bottle how much is this a liter 800 so a little less than a liter so 27 ounces so about 20 ounces when you wake up in the morning, get everything going. You're going to feel better. You're going to feel more refreshed. You're going to get your bowels going. So it's going to get you, get that habit in. And that's 20 ounces out. Because a lot of, I can tell you that's 50% of my patients, they come to me with less than 40 ounces of water a day. These people are chronically dehydrated. It's unreal. Once they start drinking water. Say
Keith Vance: that statistic one more time. 50
Dr. Tareq Khader: % of my patients, they drink, when they walk in through the door, they drink less than 40 ounces a day of water.
Keith Vance: Okay, so this hits close to home because I have a son and a wife that they say water hurts their stomach. Like they say water actually hurts. Like me, I can drink lukewarm water and it like feels good. Like cold water hurts, but like lukewarm water. So for someone who says that they just can't get the water in or it hurts, like hurts your stomach, is there a solution to that? is that a common thing or is that uncommon it's
Dr. Tareq Khader: not that common it's not that common it's not common um you probably you know a person like that would probably not drink the 20 ounces over 15 seconds um i wonder if they have symptoms if they drink the 20 ounces over you know 30 minute period time understood you know got it they get a little slower play with the temperature
Keith Vance: everybody Everybody has those, like, what do you call them? Those Stanley Flask or Yeti. Yeah. Maybe just fill it up and just have it and just. Yeah. Sip on it. Sip on it. Yeah. And
Dr. Tareq Khader: if it helps, you want to add some electrolytes or some taste to it, go for it. Understood. Yeah.
Keith Vance: So we got sunlight. We got sleep. We got food. Stress. We have water. Water. Does it matter? I've heard the term dead water. Is all water the same? Should we add electrolytes to our water? Should we add salt to our water? We're going to get into toxins at some point, but bottled water? When we're talking about water, are there tiers to water?
Dr. Tareq Khader: Yes. So not all water is equal.
Dr. Tareq Khader: so you live you're on well water right yes sir okay so i mean that's a problem that's that has its own problems but it's a lot better than ours I'm talking about our county. Our city water is filled with chlorine, and the chlorine, think about it that way. Think about it this way. What does chlorine do to the water? Why do they add chlorine? Just to kill bugs, bacteria, right? What do you think the chlorine is going to do to your bacteria, your own bacteria? They do the same thing. So, what I recommend, again, this is unfortunately not very affordable to everybody, but a filtration system. A filtration system that cleans up the chlorine. In addition to that, you do an RO system, but after you do the RO system, you add minerals back. Understood. So, yes, there is the dead water, which is basically distilled water that has no electrolytes in it. If that is not an option, I think bottled water, preferably in a glass bottle, but these are expensive. But then you get into microplastics, which we'll check on in a little bit. My preference would be if you have that filtration system and you have that going at home. If not, you have also the small filtration systems you can buy and you can just forget the name of these. It's like a carbon.
Keith Vance: Like a carbon filter?
Dr. Tareq Khader: A carbon filter that does not remove all the electrolytes, but removes the toxins. I'm more worried about the toxins in the water, the chlorine in the water. You're more worried about the chlorine, and the toxins in the water. Than the actual electrolytes. Because a lot of people do the RO water because they want to preserve their equipment. You know, the fridge and all that stuff, which is great. But from the health perspective, the chlorine is going to destroy everything. So if you don't have a legitimate RO system and a system that, even an RO without a chloramine filter is still not going to remove all the chlorine. So you can tell the difference. When I installed it, I immediately know when it broke because the taste immediately changed. You can smell and drink the chlorine and taste it. So when it comes to bottled water, I think glass is your best option. But there is a fact, not a fact, piece of information that I cannot verify. Even if you have a plastic cap, I'm not sure if that's plastic or not, you still have a good amount of plastic contamination in the water. Even if it's a glass bottle. So it sounds like water is a little more complex. It is more complex. Now, if you live on well water, it is a hefty process to get your water up there. But that's well water. It's clean. It has not been processed. It does not have chemicals as much as you know. As far as you know, it has the natural chemicals in it, but you're taking care of that. But chlorine really, really worries me. And aesthetically too. It gets dry skin. People start getting their hair falling hair. And bloating. It's incredible. What it can do to you. So that is when it comes to water. And the last pillar is stress. And I'm going to combine it with social life.
Keith Vance: Let's hear it.
Dr. Tareq Khader: So, stress. Let's go back up a little bit. You know what a telomere is?
Keith Vance: I've heard the term, and I heard that as you get older, they get, they get shorter. They get shorter. Right. But I don't, I hear these terms and I like, I'm familiar with them for a little while and then I lose it. So telomeres over here is as you get older, they get shorter.
Dr. Tareq Khader: Correct. Shorter and more ugly. Right. Think about the DNA as your shoelace. That's your DNA. The end of the, the end of the shoelace, it has a little plastic cap on it. Right. So that is your telomere. Okay. And as it gets older, what happens to that plastic cap, it gets like getting loose and loose and loose. And you get that thread coming out. Yeah. This is exactly what happens on your, on your DNA. Okay. So that gets shorter and shorter. One thing that affects telomeres negatively across the board in all the studies that were done. Stress. Specifically health related stress. Right. If you're taking care of a sick person or you have a sick loved one. Yeah. But that applies to a lot of stresses. How do we cope with stress? That's, that's a whole episode, right? You know, to go through. There are professionals that can help you with that. Online professionals, I really think that they're great when it comes to that, because they do spend the time. They sit down with you 30, 45 minutes. They go through your family history. They go through your childhood. They talk about why are you stressed out? 95% of the things you're stressed out about never happen.
Keith Vance: That's true. You know,
Dr. Tareq Khader: but you and I know that it's easier said than done. Yeah. We are all getting stressed. The thing is you cannot control what hits you.
Keith Vance: So what I want to do, is you talked about. Oh, you can hire these psychologists to help you with your stress. I want to talk about the... Practical. The family that's trying to make it happen. Yeah. Right? That growing family, that 20-year-old Keith. Right. So what does 20-year-old Keith do that he can afford when it comes to managing stress?
Dr. Tareq Khader: If you understand this concept and you put this in your mind, first of all, one, 95% of your things you're stressed about, it's not going to happen. Two, you cannot control stress. You cannot control what's going to hit you. You cannot control the events. You can't control how you react to it. Okay. Say that one more time. You cannot control what hits you, but you cannot control... But you can control... Your reactions. How you react towards it. Okay. Right? So, example. Simple. Driving. Right? Somebody cuts you off. You cannot control that person. They cut you off. They're not good drivers. They're rude. You can control your rage. Yes, sir. You can stop yourself from chasing him. You can stop yourself from yelling. You can stop yourself from cursing and sounding the horn. All that it takes is take a deep breath, do three times, and move on. I recommend if somebody wants... So,
Keith Vance: when your mother used to tell you to count to three... Mm-hmm. That's it. That was a real thing. Mm-hmm. Yeah. Before you do anything... Take a deep breath and count to three. Yeah. That was a real thing. Yeah.
Dr. Tareq Khader: Yeah. Another thing... Trick. Do not make any decisions under stress. Mm-hmm. Wait if there is... Or under emotional pressure. Understood. If there is something emotional going on and you are about to make a decision, all what you have to wait is 90 seconds. Really? 90 seconds and that wave's going to go. If you still have the urge to make that decision, do it. Most likely, that urge is going to go away and you're going to go back to your sane mind and make that decision. So, you're going to make a decision. Three. Breathing techniques. That's days of practice. But there's a book called Breathe. It's simple as that. Read it. Understand about breathing techniques. You can do so much through breathing. There's the breathing is like four on, four off, four on, four off.
Keith Vance: There's box breathing. I was doing box breathing for a while.
Dr. Tareq Khader: The way that you breathe... I think if I want to choose one thing that controls your stress and stress response is your breathing. Yeah. If you control your breathing and if you understand how your breathing affects your nervous system. And it really connects with meditation too. Five minutes at the end of the day, it's going to help you. Stress is going to keep your sympathetic system. Remember, I talked about it a bit ago. Always on alert. And that is not a good thing. This is how these watches measure your stress level. They measure your sympathetic system. So, if you apply these three concepts, understand what stress is, understand that your response is what you're doing. Understand what matters. And understand how you breathe. You solved a good amount of that stress.
Keith Vance: One thing I learned
Crosstalk: recently is me, personally, I try to take care of everybody. And I changed one
Keith Vance: word. This is awesome, dude. This like took stress off me. I'm responsible to people. I have responsibilities to my wife. I have responsibilities to my children. I have responsibilities to my employees. I have responsibility to you. But I'm not responsible for people. And that just took a lot of stress off of me because I was always trying to be responsible for people. And that lowered my stress level. I have responsibilities to you. Just two little small words. Just changing those two words out. A four to a two. Absolutely. It helped me. It helped me. It was like I was able to take my cape off. Yeah. Keith, you don't have to save everybody. You have responsibilities to people. But you're not responsible for everybody. And that was a major thing that drove my stress levels. Especially as my family's been getting bigger and there's more and more of them that I feel like I'm responsible for. My son-in-law and my daughter, they're renting a house. They need a house. You know what I mean? Everything's getting more and more expensive. Will they ever be able to afford? A house trying to like figure out all these things. I'm not responsible for that. I'm responsible to them, but I'm not for them. That helped me.
Dr. Tareq Khader: People's happiness is not your responsibility. Right. You are absolutely correct about that. And I think if you apply that term and, you know, people pleasing. People pleasers are the most stressed out people. Right. Because they're trying to make everybody happy. And that is impossible. So I think if you understand what you just said. very well and you know that you're responsible for you and how you react. That's it. Your wife or your spouse, your neighbor can be upset. They can say whatever they want to say. You cannot be rude. You have to be respectful. You have to keep your boundaries. That does not give you a green light to do whatever you want. But that is on them. It's not on you. Of course, you have to have sympathy. You have to have sympathy towards your spouse who is upset or who is angry. You have to try to understand. But you do your best. But at the end of the day, it is their responsibility to take care of that. It's not yours. And that removes a lot of burden. Absolutely. As you said, your stress levels are going to start coming down.
Keith Vance: Is there anything else about stress you want to talk about? I
Dr. Tareq Khader: wanted to connect this with social life.
Keith Vance: Oh, yeah. Thank
Dr. Tareq Khader: you. So. There is a clear connection. And I think you and I talked about this during the other podcast is there's a clear connection between social life and dementia. The less social you are, the more likelihood you're going to have memory problems, especially towards end of life. The study that was a hallmark study actually was done in postmenopausal women, women after their menopause. They have less social connections. They fared a lot worse when it comes to their mental health and mental performance. So continue to mingle, continue to see people. Do not get isolated because as people get older, they have a tendency to just to stick to their routine and stay away. So I really honestly, if you allow me here, I'm going to go back a little bit in my personal history and where I grew up. I grew up in Jordan, the Middle East. It's probably the most important place in the world. I'm probably hitting a little bit of the headlines right now because they're in the World Cup, but small country in the Middle East. So there's a lot of, you know, cultural things that would never change. So you would go there. A 60 year old man there just waiting for himself to die. Basically 60. I'm done. I'm done with life, right? Really? Yeah. I mean, I said like 60. I've done it all. I'm retired. My kids are grown. That's it. I'm done. Right. Not necessarily. They're sick, but they're like, quote unquote, old. You come here. Go to. Let's. Naples is not a great example, but I think you can generalize that. A 90 year old person would still be trying to live, right? Still trying to have a good life. Not everybody can afford the lavish lifestyle in Naples, obviously, but you still have. You still see a lot of older people going out, enjoying themselves, going out for dinner, embracing their retirement, traveling, a lot of that stuff. It's. It's a. It's generalization. I know. But you see that. And to me, that's. That's very striking because where I came from. When you're old and you're, you know, mingling a lot or you're going around and you're being social, people look at you weird. Oh, what you're doing. You did your time, man. That's it. You're done. Move over. Next person. Wow. Right. And that's. That's how it is. You know, that's. That's how. You know, you have a few people who, you know, get out of the cycle, but that's, I think, I guess, a cultural thing. But at the same time, I get to give it to that culture, too. Nobody ends up in a nursing home. There's always a family member who's taking care of that. Nursing homes do not exist really virtually. Yeah. Yeah. I mean, they're going to be out of business because nobody wants to send their family to the nursing home or rehab center or any of that stuff. So that's what if you if you cover all these pillars that we talked about, you solved 85 percent of your problems. And you prevented more than 90 percent of your diseases. I
Keith Vance: want to ask you two more questions and then I will move to another chapter. When you mentioned social life. Would. Social media interface. Be included in social life or does it have to be face to face? They have to be doing something physically. Yeah,
Dr. Tareq Khader: because in social media, you're only engaging very little out of your emotions.
Keith Vance: So find a hobby, find a group of people of common interest. Go do some knitting. Go play cards. Visit your family. You know, go out with your
Dr. Tareq Khader: wife. Meet other people.
Keith Vance: OK. We talked sunlight. We talked nutrition. We talked sleep. We talked anxiety and stress. We talked social life. You haven't talked about lifting heavy weight yet. I don't think. Oh, yeah. We
Dr. Tareq Khader: missed that one. So how
Keith Vance: important is weight training or stress in the body?
Dr. Tareq Khader: Oh, yeah, absolutely. Absolutely. I. I just posted. Something on my page actually on Instagram this morning. About an article that came. two months ago, the article looked at something called the biological age. So the biological age, in a nutshell, what it is, is they check your DNA and they check certain changes on the DNA. And they get millions of samples. And they built algorithms. And based on these algorithms and mathematical calculations, they can determine how truly old you are, right? So you're 50, your DNA age or your epigenetic age is 45 or you're 55. Understood. So the nice thing about it is it is trackable. So you can do it on a yearly basis. I think we should do it for you, actually.
Keith Vance: Let's do it.
Dr. Tareq Khader: And you can see what your interventions are doing. Are your interventions making things worse, better, et cetera? Especially in a controlled environment like mine, right? Virtually controlled or actually know all of your health-related issues. So this article looked at all the interventions that were done and looked at the effect on that biological age. The supplements that were super strong there were omegas and vitamin D, omega-3 and vitamin D. But on top of the list was resistance training. So resistance training improves your muscle mass. Improves your insulin resistance. Improves your mental well-being. If you get a 70-year-old man and you slap five pounds of muscle on them, they immediately become healthier. Their bone health, their heart health, their lipids, the way they feel, the way they sleep. If they fall, they don't break as far, as much. Their balance is better. So longevity, and we did that for you, is that grip strength, remember? Yeah. The stronger your grip, the longer you're going to live. Straight line. Yeah. So as I tell people, lift that heavy weight, put it down, eat healthy, rest your body and sleep, and you're good to go. It's simple. Simple. It's not expensive. It's not expensive. Okay. It's not expensive. I
Keith Vance: like simple things because I can do simple things. If you make it too complicated, I won't do it. It's got to be simple, brother. And you just made it extremely simple. And also simple eliminates... Excuses. Yes. If I can understand it, I have no excuse not to do it. I appreciate you being here. Yeah, of course. I don't want to rush this. Let's take a little break. What do you want to talk about next? Do you want to talk about influencers and peptides, or do you want to talk about toxins? What are you feeling? We're going to talk about all of it anyway, but what are you feeling?
Dr. Tareq Khader: Let's do the influencers. Let's get it. Let's do influencers and peptides. I'm going to take a few steroids and get it on my chest.
Keith Vance: Yeah. All right, let's do it. This part of the podcast is brought to you by Vance Ranch. Vance Ranch is our family 100-acre ranch in Henry County. We have a 6,000 square foot barn where we host wedding venues, corporate events, anniversary parties, and whatever else you want to use it for. Find the link in the bio. Now let's get back to the show. All right, brother. We're back. All right. All right. So toxins. We hear about microplastics. We hear about heavy metals. I heard that a baby's first poop has microplastics in it. I hear microplastics are in every living thing in the world, like fish. So obviously this is the world which we live in. What's the pathway forward? A coffee cup. Yeah. You get a coffee cup from Starbucks. That lining has microplastics and that hot coffee goes in there and that breaks down. We're ingesting that. Some of that stuff I heard actually crosses the blood-brain barrier that we still don't know the effects of that is. So this is your wheelhouse. Try not to freak me out, but give it to me the way it is, how it is, and what's the best path forward.
Dr. Tareq Khader: You're not going to like my answer, but... I knew it. I knew it. The answer is there's not a whole lot you can do about it. Right now. Two challenges. Number one, it's very hard to check for microplastics. Right? So we don't have a good test for it right now. So it is very hard to actually quantify it. So that's the first thing. Second thing is the way the world is operating right now, 7 billion people, you're going to get microplastics. You know? You can control small things. But in the grand scheme of things, you're not controlling much. You can control... Control your water. You have personal control of your water, right? You can control your silverware. You can control what you put your food in. You can control that you don't drink coffee at Starbucks. You can bring your own mug, but there is not a whole lot to do about the plastic you have currently and where you sit at it right now, where you sit right now with how much plastic you have. That is unfortunate reality, and this is one challenging thing, and I think there is a lot of weight on it right now. There's a lot of working going on there, but that's
Keith Vance: a good thing.
Dr. Tareq Khader: Everybody knows that so far, we don't know what to do about it. There is one intervention that has been promoted, which is plasmapheresis. So, they hook you up to something like a dialysis machine, right? And they run your blood through it, through filters, and they pump back the blood. They dump the plasma, and they give you some albumin instead of that. So, remember the article I talked about a little bit ago? That intervention shortens your lifespan. It makes your biological age more, longer. So, it actually ages you. So, yeah, great. We got rid of your microplastics, but we made everything else worse, right?
Keith Vance: So, you know what's funny is I just saw a video on social media. This is a video of a guy who was a influencer guy, and he was hooked up to that, like a dialysis, and they were taking the microplastics out of him, and it was like in this little vial, and it looked a certain color. So, you're saying that actually, that process actually shortens your lifespan?
Dr. Tareq Khader: Dr. Andy Roark So, that process is a very, very old process, and we've used it for many diseases. So, people with certain cancers, et cetera, blood cancers, we were able to filter out the blood. The whole process is basically you take the blood, you filter it out, you dump the plasma. The plasma is the… part of the blood that is not cellular, doesn't have cells. It has liquid, it has proteins, it has toxins, it has all that. And that's the whole idea of it. We clean it out of the toxins, we filter the toxins out, we dump a bunch of albumin, and we replace that, and you're supposed to just be, quote unquote, cleaned up. In theory, great concept. So far, studies have not shown that much benefit.
Keith Vance: Dr. Dean Mitchell Okay. Dr. Andy Roark Yeah.
Dr. Tareq Khader: So, yeah. Yeah, he could have removed the microplastics. But again, I get back and say microplastic per concept, they're harmful. But you don't want to try to fix harm by causing more harm. You know? So that is my take on microplastic. Unfortunately, there is only so much you can do when it comes to controlling it. And because it's a forever chemical, it's just not going to go anywhere. The microplastics you have, you may have ingested when you were 20 years old. I
Keith Vance: had a farmer on this podcast. He's been farming for 55 years. Good dude. Salt of the earth guy. I'm thankful for farmers. But they put the plastic down for the rows to keep the weeds down. You know when they get done harvesting the crop, you know what they do with that plastic? They burn it. They burn the plastic. You know where that plastic goes? Into the soil. And then the next crop comes. So there's no getting away from microplastics. It is everywhere. It's everywhere.
Dr. Tareq Khader: It's everywhere. You control, you know, what we're trying to control is the end step. There's so many steps. As you said, farming, the fish in the water, how they caught the fish, how they processed the fish, how they got the cow, what did the cow eat? You know, what did the plant, what kind of fertilizer are you using? What did the cow eat? All the stuff I told you that you control is that the last step. You're really not controlling that much. Got it. You know? So
Keith Vance: do we know what harm microplastics cause? I heard that they cause infertility in men.
Dr. Tareq Khader: That's correct. So men have 50% less sperm count today as 50 years ago. So if we don't fix this problem, we're going to have to do something. We're going to go extinct. How's that for optimistic? Well, yeah, you know, there's no sperm. There's no babies. So,
Crosstalk: yeah. You know what sad is?
Crosstalk: What's sad is my 18 year old daughter told me that. And
Keith Vance: that's what she's worried about right now. She's worried that by the time she gets married, she might die. You may not be. I'll have. Kids. Because. A. Micro. A. A. Plastics. She left it. What a freaking thing for an 18-year-old to be worrying about. Right, right.
Dr. Tareq Khader: Well, she's going to be okay. Her daughter's going to be okay. Her granddaughter might be okay. But then after that, I don't know. Now, I'm really hopeful for humanity to find a solution. But if we're going to tap into plastics, and who makes plastics, and why plastic is made, and why are we using it, and the oil industry, and the petroleum industry, it's a losing game.
Keith Vance: It's a losing game because as long as there's money being made, it's going to keep on rolling. Yeah, it's cheap. Yeah. So,
Dr. Tareq Khader: that's my opinion on it. But the more natural you live, the more you isolate yourself from, from boxing and processed food, because even controlling that last step could be important. Because if you think about it, remember the food categories we talked about. If you're limiting yourself to that food category, you're not going to go eat something out of box. You're not going to go eat a bag of chips. You're not going to go eat, you know, that hot dog you talked about. How much plastic? That's the whole thing is plastic. You know, it's, you can't control that part of it. I think the more you do it, the more you teach your kids to do it. Because here's the thing. You started doing this stuff recently, right? Call it 10 years. But if your daughter, she's worried about it. It's heartbreaking that kids are worried about it today. But at the same time, she's aware. Yeah. And she knows, and she understands. And that is a driver for her to stay healthy, eat healthy, get out of the farm.
Keith Vance: That girl bought... Our family toothbrushes that are bamboo to get rid of the plastics. She's like slowly just going room by room and saying, okay, what can I control? Amazing. At 18 years old. So hopefully she's not an extreme case. Hopefully this younger generation is all aware of it and change can happen. Right. Hopefully. So that's, I'm always trying to land on optimism. Right. Absolutely. Because you can, this, this will drive me crazy.
Dr. Tareq Khader: Yeah. Yeah. You know, that generation is, you know, we're going to diverge back a little bit here. That generation, I don't know what they call them. They're not Gen Z. They're younger than Gen Z. They were born into this. When you look today, some of them were born into Facebook and Instagram and YouTube and all that stuff. And I think a lot of them are going back. To. To what you and I were when you were younger. That's good. I have a little bit more hope in them. And I think humanity eventually is going to survive. Right. You know, we're not going to witness it. Our kids are not going to witness it. But there's a lot of good that will happen. Good will always prevail. I think we'll be able to survive. At the end of the day, it's a matter of survival. Right. We are, we are at the end of the day, we're animals. We need to survive. So. The other harms of microplastics is cardiovascular disease. Straight up. It causes plaque formation. Okay. Blood vessel disease. We don't know much about the brain yet. But these two, the cardiovascular disease and infertility. But I can tell you a ton of cancers. Right. Cancer formation. These are things that the body doesn't know what to do with. That's why it causes cardiovascular disease. The body tries to. Engulf it. And just sit on it. Because it really has no idea what that is. So we're just going to try. We're going to attack it as if it's, you know, an invader. And it is.
Keith Vance: That's the amazing thing. The amazing thing about the body is it tries to heal itself. Yeah. Like it's, it's an amazing machine. It
Dr. Tareq Khader: is. It is. Yeah. Yeah. So other toxins that we get worried about mainly are heavy metals. Heavy metals are a lot more controllable. What are heavy metals? Heavy metals. So we're talking about lead, talking about mercury. These are the two biggest ones.
Keith Vance: How are we ingesting those practically? Because I don't drink mercury, I don't think. Or fish. Fish.
Dr. Tareq Khader: Fish, tuna. The good thing about this is we can't test for it. Okay. The test is easy. And we usually don't test unless somebody has certain exposure or they have symptoms. These are usually not symptom free. The heavy metals are not symptom free. Like somebody would come in, you do everything under the sun. They're still brain fogged. They still can't get up. They still can't do much. You check their lead level. That is out of my wheelhouse. We send them out. Now to etchelation therapy. So, it's a form of IV therapy where you put a sort of IV in their body, and it etchelates the heavy metal and dumps it out. And it is controllable. Mercury is controllable by, you know, not eating sushi every day, you know. But again, I go back to the thing with testing. Testing is key. If you're able to test for something, good. We're able to test for them. We're able to monitor them. In fact, if I do a test for somebody and their mercury comes back high, Collier County calls me immediately. Like, you know, what are we doing about it? Are we going to send them out? We just need to report it to the state, etc. So, there's a lot of awareness there. Lead is paint. Not currently, previously. So, the old paint, it has lead. And people who live in old houses, people up north who live in old houses, we're lucky enough here that our houses are fairly new. Right. They are exposed to a lot of lead. A lot of detrimental health effects, mainly in the brain.
Keith Vance: How do you ingest lead from paint? I mean, they're not eating paint off the walls. Oh, yeah, they are.
Dr. Tareq Khader: Kids are. Oh. Yeah. And it stays with you. Wow. A lot of people eat soil. Got it. Kids, yeah.
Keith Vance: I just thought of something, and I don't know if you can speak to it or not. If you can't, don't worry about it. But you mentioned sushi. And there's this thing on my social media algorithm about parasites. They say, hey, you know, you worm your dogs, you worm your cats. People in third world countries get wormed, but Americans don't deworm. Is there, do we have parasites? Does that something that we don't know? Do we need to be aware of? If you don't have symptoms, no.
Dr. Tareq Khader: Right? So if you don't have unexplained iron deficiency, if you don't have any unexplained weight loss, unexplained fatigue, bloating symptoms in the abdomen, anything like that, you don't need to worry about it. If you have symptoms, yeah, we test for it. And you can deworm. But Is it common in the States? It's not common. I had does not I do not have a single case. Okay. And we test a lot.
Keith Vance: Well, good. At least that's one thing. We're gonna have microplastics, but at least they don't have worms.
Dr. Tareq Khader: Worms are easy, though. They're easy. Worms, you can't kill them. Though, here's a situation with parasites.
Keith Vance: That's... What sparked my memory was the sushi. The sushi, yeah. That's what sparked my memory about the parasites. So
Dr. Tareq Khader: from here, I want to, you know, probably use that point to move on to the next chapter, which is... Which is? How parasites are blown out of proportion. Now, you would get somebody who would blame every little bad thing about their health on parasites. They drink three drinks a day, eat like garbage, don't exercise. And then yet they come and insist they want to test for parasites, because that's a problem. And I'm like, nah, you know, you got this wrong, right? So this is where influencers are a problem.
Keith Vance: All right. Here we go. Here we go.
Dr. Tareq Khader: You... Let's talk about regulations for a second. Regulations say, if me, a physician, go on social media, everything I say is looked at and reviewed and can put me in trouble. If I, as a physician, go out and say, peptide GHK copper is a great one. You should take it. This is the dose for it. Go for it. Your knees are going to feel better. Your hair is going to grow. You're going to feel youthful again. This could land on the medical board and the medical board can come and take my license. Right? Because I have a license to lose. And I think this is very appropriate. I think that's true. I don't think doctors should be talking about things that are unverified or giving false medical advice or anything like that.
Keith Vance: You live to a higher standard. We trust you.
Dr. Tareq Khader: But Joe and the fire department next door has nothing to lose. You know, goes to the gym. Becomes successful. Gets good muscle strength. Ends up in the cafeteria, in the gym. And they sell him a couple of peptides. He uses them. He loves them. He plugs them in chat GPT. Chat GPT. Spits it out. What are peptides? He goes on social media and he tells you everything about it. Nobody cares. Right? I'm not going to say names here. But there are some very, very prominent influencers that they have products. They have. Supplements. They talk about. I mean,
Dr. Tareq Khader: it's not like health insurance, but they're salespeople. They just know how to sell. They know how to talk. And they make a ton of money doing it, and they have absolutely nothing to lose. and a layperson when they look at their beautiful setup they look at their chart they have 70 million followers and they have this great branding and then they have this company that endorsed them of course I'm gonna listen to them right they're not gonna listen to dr. cater from Naples who's you know talking about simplicity and you know eat your vegetables and you're gonna be fine you know they're gonna listen about
Keith Vance: getting some sunlight right they're gonna listen and going to bed on time yeah they want to
Dr. Tareq Khader: take the shortcuts like oh my god this is got it you know for example there is this this uh peptide called epitalon um epitalon is is not not very available right now so even if i want to give it i want to get it it's very hard to get it is available through research compounds and research pharmacies which are not meant meant for human use you hear people with a straight face go on social media and say this is the fountain of youth and this is the future of medicine who are you to talk about this if i show you a cell and i tell you my point to the mitochondria you will not know where is the a mitochondria who are you to talk about the cellular benefits of a or b or z it is very frustrating because it is a lot of garbage majority is garbage because people who have a lot of time to do this they probably don't you know they don't see a lot of patients right um there are a few few doctors out there that have very legitimate uh podcasts dr huberman for example you know he's legitimate stuff going on um you know peter attia despite um all what happened with him but they have a lot of legitimate you know podcasts and legitimate um you know medical information not endorsing peter attia by any means but people like him they go out and they talk Talk about simplicity, about what the science really says. What does the research say? What does the experience look like? Not what I, you know, I'll give my neighbor an injection and he felt better, hence the injection works. This is not science. This is pseudoscience. going to medical school you are forced to read articles all the time you have to read it you have to know how to look at the statistics you need to understand how to interpret the study what does this mean what does the confidence interval mean what is all the statistic measures and it mean so when people have accessibility to all these studies I'm going to give you an example. During summertime, people
Crosstalk: eat a lot of ice cream. And during summertime, a lot of kids drown.
Dr. Tareq Khader: Can you make a connection between drowning and eating ice cream? You can't, right? But in medicine, a lot of associations are made that way. So if I show you a study and it says, and that's a real study. That's a very classic example. example a very very very prominent influencer with books published with you know um sells all these stuff in glasses and peptides and whatever comes out and says using melatonin causes heart attacks okay or heart failure whatever he said I was when I looked at it I was intrigued intrigued it was like whoa really I looked into the study that he coded the study says we pulled up hundreds of thousands of charts from I don't remember was Medicare or or the Veterans uh um Affairs and we looked at people who use melatonin and we looked at the incidence of cardiac disease in these people so they never met the people they just read charts and they they did you know an insurance run but Keith what is the problem with that study who takes melatonin as a person who cannot sleep right does it did it occur to him that well wait a second maybe because this person has not slept well for the last 20 years is why he had a heart attack not doing why he took that melatonin because
Keith Vance: he's stressed out and he can't sleep exactly so
Dr. Tareq Khader: he's taking the melatonin so taking the melatonin of the heart attack are from the same reason that you're not sleeping well and you have sleep apnea Same thing when it comes to a lot of hormonal stuff and a lot of bad rep stuff that comes out. So, you get somebody who absolutely has no idea what medicine is, who gets a financial benefit out of it, does not know how to read a study, gives you a very false assessment like that. And nobody verifies it, nobody says anything, and he's not in trouble. If anything comes, you know what, I'm sorry, three years ago I was wrong. Right? Understood. So, this is the problem with influencers. But as I said when we started, I think this is a result of the frustration of the healthcare system. Understood. Healthcare system has failed us, has failed many people, only reacted to disease. It's been amazing in treating disease. It's been amazing in treating heart attacks and preventing death from heart attacks. It's been amazing in helping us understand how we can retrieve a clot from somebody who had a stroke so they can live longer, have no problem. But it failed us in stopping the stroke from happening 30 years before, stopping the heart attack from happening, stopping the recurrent pneumonias, stopping the recurrent infections. It failed us by tricking us to know and think that fat is bad for you and carb is good for you. And failed us when it said that, when it taught us what the food pyramid looks like. Yes. And what exercise should be and you should be running every day and you should not be lifting weights because you're going to hurt your joints. And on top of all that, it failed us because it became very expensive and unaffordable. If you look at the lifespan of people, of course, today in 2026, people live overall longer than they lived in 1990. Not 1990, 1900, I mean. Okay. Okay. Okay. So, we're much better at surgeries. We're much better at surgeries and sanitation and antibiotics. It has nothing to do with the rest of the treatment. The rest of the treatment may be added one or two years, but it did not really help us prevent the disease from happening. The last year
Crosstalk: of life is the most
Dr. Tareq Khader: expensive year in your life. When it comes to healthcare. Billions of dollars are spent on the last year of life. Unnecessary testing, unnecessary procedures, unnecessary interventions that added absolutely no quality. It may be added a month or two of life, but with absolutely no quality, patients spend it between hospitals, rehabs, hospice care, away from their family with zero quality. So, all these collectively, they created a failure of healthcare. Health care system and the disappointment in the healthcare system. It's still good when we need it. If somebody has an appendix that ruptured, you rush to the hospital, you're right there. You're going to get in and you're going to get it taken care off. If you broke any, we're very good about arthritis and replacing knees and hips and all that. And that's a whole different talk. But I think we made a lot of progress when it comes to orthopedic surgeries, heart attacks. All these heart centers around us are impressive and saving hearts and saving people's life. and you know fixing strokes and getting rid of you know the the disability that could happen but we still don't know what to do with alzheimer's disease we still don't know what to do with parkinson's disease you know a lot of cancers we still got a
Keith Vance: friend he's five years younger he was diagnosed with parkinson's disease yeah let's wind this down yeah if you are going to grade our current health care system just broad stroke yeah today where are we sitting at how would
Dr. Tareq Khader: you grade it where we're sitting at right now i think i'm a little more optimistic than most people i think i'll give it a six out of ten and the reason i say that is because i experience other healthcare systems the bad things are the good things right let's talk about the bad things and we'll finish with the good notes let's do it so the bad things is it's very expensive yeah very very very expensive and very inflated um that test you did that cost you call it 350 dollars if they bill insurance is going to be in the thousands yeah right so it's inflated it is insurance insurance controlled that's one two autonomy doctors are losing it by the day they don't have control over what they prescribe they don't have control over their clinical judgment example you come to me and you have high cholesterol you're not tolerating i know that statins are not going to good for you you're not going to tolerate it you're not going to be a good candidate it's for it but i need to lower your cholesterol for whatever reason and i think you need rapatha right your insurance I'm going to say, nope, he needs to try statins, he needs to fail statins, he needs to have documentation of that, then we will approve him. Otherwise, you're going to be paying thousands of dollars a month. You hear
Keith Vance: about this all the time. Yeah.
Dr. Tareq Khader: Preauthorization. Preauthorization is a headache to doctors, which basically undermines doctors' authority and doctors' ability to prescribe medications and procedures and testing. And thankfully, I don't have to deal with that with my current model, but when you have seen the patient, examined the patient, and think that this patient needs this test, and you order it, and the insurance calls you and says you need a preauthorization, you speak to a retired physician that has not seen a patient in 20 years, who's getting possibly a commission on every denial he's giving you. To explain to him why it is necessary. It's necessary to do this test, not the test he's talking about, and he wants the test that he's talking about for a once-old reason, because it's cheaper. So insurance-driven, expensive, and one more thing, and I'm not sure if you saw this coming or not, which is we are practicing CYA. Right? We are such a country being... Run by courts and lawsuits and a lot of the medical decisions. I'm talking about close to 100% of your medical decision in the back of your mind. How am I going to get sued? How am I going to get in trouble? Right? You have some healthcare systems that gut around this, where if you work through that healthcare system, you are protected. You actually are not going to get sued. If anybody's going to get sued, it's going to be the state, right? Not you. So you're protected. You're not going to be named on suits, and that gives a lot of peace of mind, but it comes with a price. So the fact that we spend so much on testing that is unnecessary just because we are pursuing a phrase, and that phrase is, what if? What if I miss this? What if I did this? What is your clinical judgment? What if this person is your dad? What would you do? And the answer, if this was my dad, I would, some, not me personally, but the answer would be different for my dad because I know what is right. I know what is the right answer. I know what is the right test. If this was a board question, I know what the answer is. But in the reality world, you're going to order everything under the sun just because you don't want to be blamed one day.
Keith Vance: So I had a friend of mine on the podcast. He and I are both in construction. And we talked about how construction evolved over when we were kids to what it is now and how we spend so much time and energy in construction with what you just talked about. Documentation, contracts, making sure that you cover every loophole for how something might play out. And we talked about how much more productive we could be. And we talked about how much more productive we could be if there was a different system. And you and I could just agree that we're going to work together on this thing and we don't need all of that. You know what I mean? If we could just, I don't think we'll ever get there. I think, especially with AI, you know what I mean? With AI, I can determine every little outcome. I think the contracts get bigger and the CYA gets worse. Yeah. But if we could get back there and focus on you. Being a doctor. Without all the documentation. Just say, hey, Keith, trust me. I got you. I'm going to do the best I can. And just kind of go back to that humanity other than all that other stuff you spoke to. Yeah. You don't see that happening. Hard. Yeah. We've already crossed that.
Dr. Tareq Khader: Lawyers run the show. Yeah. And they protect us, but they run the show. But we've got to give it to the system a little bit. The system. The system is very accessible. This is the positive note. That's a positive note. The system has a lot of checks. To be a doctor, you have to go through so much and you have to pass through so many checks, evaluations, regulations. It is very well regulated. Could be a little bit too much regulated. And it's accessible. You will never go to the emergency room. And that gets seen. I've seen other health care systems where you go to the emergency room and you have to pay up front. You'll never need an emergency. and that will be denied to you just because you don't have the money. If you need an MRI, you're not going to be waiting four or five months to get an MRI. You will not, in other healthcare systems, a lot of people are going to die waiting for their turn to be seen or in turn for them to get a test. So the accessibility, the expense comes with accessibility. So I would give it that positive thing. I think the future, especially with the pressure right now mounting, people are waking up to it. People are pressuring. A lot of people are dumping their insurances. I think the government is trying to put some pressure on the insurance companies. And I think there's a lot of positive changes. I think the insurance is great. I think insurance is a great concept.
Keith Vance: But it shouldn't be driving healthcare. It should not be driving healthcare. The doctor should be making the call. Absolutely. And the insurance should. Absolutely. Supplement your decision. Yeah. And figure out how to make it happen.
Dr. Tareq Khader: 100%. So we have the backbone. I think we just need to take a step back and look at things without the financial aspects of it. Right. So as an insurance company, you're in there for money and business. Right. Understood. But at the end of the day, it all comes down to. Treating people, making them healthier. I'll give you a good positive example. Some insurances, life insurances are giving patients incentives to be healthy. If you go to the gym and you take a selfie at the gym, you get points. If you eat a healthy meal, you send me a selfie. You get a point. If you sign up in this service, you'll get points and you'll get like cheaper things. And people are going. Going into life insurances more and more now. And they're getting incentivized by that. And I see where health insurance is going to do that. Right. So you as a health insurance company, if you want to save money. You should not be saving it by denying payments. You should be saving it by preventing admissions to the hospital. There you go. Right. And I think I'm seeing a lot of that. So I work. I cover the hospital for one big group here in town. And they're implementing it. So they get incentives. From the insurance companies to keep people out of the hospital. To encourage home visits. To encourage primary care visits. To do a lot of things outside the hospital. So I think the next step is adding some sort of food education. Exercise education to the younger population. Where we can prevent. Right now, we are trying to save money next month. Right. By preventing this person with heart failure from being admitted to the hospital over the next month or two. But the same concept, if we apply it to prevent. Keith from going to the hospital. He's 70, 20 years ahead of time. I think this is when we're going to see success. Understood. Yeah.
Keith Vance: You just unlocked a whole nother podcast that I want to have you on about. Yeah. Maybe six months or so. You just unlock something else. But for now, you gave me enough to digest on. Again, thank you for being here. I'm. Proud to call you. I will call you my friend. Yeah. That's my pleasure. I've developed a relationship with you. And I feel like we're kind of cut from the same cloth and the same mindset when it comes to health. You've helped me a lot. I feel confident with where I'm at now. I know where I'm going. I just needed that right person. I need that right person face to face just to develop a relationship with and point me in the right direction. Can't replace people in relationships. You can't. You and I have developed a relationship. I think at the end of the day, life's about relationships. Absolutely.
Dr. Tareq Khader: Well, I appreciate you having me here. It's been a pleasure. You have a beautiful place and you have the right thing going on here. And it's a pleasure to take care of you, but also some pleasure. Yeah. That's okay.
Intro voiceover: Still Strong. Watch me rise my way. Slow growth turns into real change. I found joy in the simple days. In honest working faith. Still Strong. No rush. No rush.