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Coming up on the Get Lean e Klean podcast
On the lifestyle thing, the first thing I do is talk about sleep. That's actually the first discussion I have. Why is that? Because your testosterone peaks first thing in the morning, which is why if you had adequate testosterone, typically guys would wake up with an erection in the morning and feeling energetic and feeling frisky, right? If you're not doing that, that's a signal that your testosterone could be low. It peaks first thing in the morning because the mechanism for producing testosterone, which starts in your brain, your brain secretes a signal called LH luteinizing hormone that cascades downwards. And the so-called LH surge quote unquote, every night is what signals the testicles to produce testosterone in the morning. Well, if your sleep is choppy, you are not getting a strong LH surge.
Hello, and welcome to the Get Lean e Klean podcast. I'm Brian Grn, and I'm here to give you actionable tips to get your body back to what it once was, five, 10, even 15 years ago. Each week, I'll give you an in-depth interview with a health expert from around the world to cut through the fluff and get you long-term sustainable results. This week I interviewed Dr. Michael Turner. Dr. Turner is a graduate of Stanford University, Harvard Medical School, and the Mayo Clinic. He's treated over 10,000 patients since 2009. He practices integrated medicine in his own national concierge practice, providing personalized approaches to help people achieve their optimal state of health.
Brian (1m 31s):
We discussed achieving optimal thyroid function, natural ways to boost testosterone strategies to stay sharp at any age. Dr. Turner's experience with passing the Navy Seal's fitness test and his one tip to get your body back to what it once was. Really enjoyed my interview with Dr. Michael Turner. I know you will too. Thanks so much for listening and enjoy the show. All right. Welcome to the Get Lean ean podcast. My name is Brian Grn and I have Dr. Michael Turner on the show. Welcome to the show.
Michael (2m 3s):
Thank you, Brian. Very glad to be here.
Brian (2m 6s):
Thanks for coming on. And we were just talking a little bit, you're outta Washington and integrative medicine physician. How did you start? What led you down that path?
Michael (2m 18s):
Well, really it was an outgrowth of my personal experiences. So I grew up in Northern California in the Bay Area. My mom was a hippie back in the sixties and worked in a natural food store. So when I grew up, there was minimal sugar in the house. There was an emphasis on reading books, getting fresh air, exercising. My mom refused to buy me video games, that kind of thing. So
Brian (2m 40s):
Oh, your mom, your mom was ahead of her time.
Michael (2m 43s):
She was. She was a lady ahead of her time. Exactly. And then in health class, my sophomore year, I was pretty impacted because one time they had us write down everything we ate in a day, grams of saturated fat, grams of sugar, ingredients and all that. And that was an eye-opener for me. It was a big eye-opener. I had to let myself go a little bit in terms of my eating, you know, being high school and in high school, and exerting my autonomy and such. Right. So when I wrote that down, I said, oh my gosh, I'm drinking a chocolate milk every, you know, recess, you know, lunch break and like this thing's, packing 18 grams of sugar in it, you know, and this Snickers bar, this thing's packing, you know, 50% of my day's saturated fat, you know, what is this?
Michael (3m 23s):
So that was an eyeopener. And at that point I, I started eating clean. We didn't use that phrase, obviously we're talking like late eighties, early nineties, but it was just super low fat tuna oatmeal, whey protein. Started running a lot and then got a little weight bench from my grandpa that I inherited a little preformed Joe Wheater plastic weight concept. And we just stuck out in the garage. I started hitting that hard every day. So, to answer your question, it, it started all the way back then, but it moved forward to what I do today. So I think about my job is to bring the best answer to the patient's problem from wherever that comes.
Michael (4m 4s):
It may come from a more traditional medical side. I went to Harvard, I went to the Mayo Clinic, so I'm well trained in that. But it may come from the naturalistic side, as in my, my personal experience and ongoing education and interest in that.
Brian (4m 17s):
Yeah, I mean, you started early, right? So you were, you were already writing down what you were eating when you were in high school, which I, I think sometimes people don't start doing that maybe till they get into their forties and fifties. I, I, and I, I can see how that can play a role cuz it's like, you don't really know what you're doing, whether it's food or sleep or this, unless like you start recording, you know, what you're actually doing. And I think that can, that obviously played a positive role in your life.
Michael (4m 46s):
Brian (4m 47s):
Michael (4m 48s):
It was, and I, I'm sure perhaps you include something like that when you work with clients, you, you know, you might emphasize something like that. Very important. There's a saying that you don't improve what you don't measure, and there's a lot of truth in that.
Brian (5m 2s):
Yeah, yeah, yeah. Yeah. And when did you, so do you have a, your own practice or do you have other physicians you work with?
Michael (5m 10s):
I have my own practice. I worked here in my town in a neuroscience center. I was recruited back in 2009, had a very successful career working in the neuroscience center. However, I felt it was unfulfilling because all along I had this drive towards health, wellness, prevention, anti-aging. You could put different labels on it. And so I was doing things like checking my patient's hormone levels and talking to them about using an infrared sauna or intermittent fasting, talking to them about optimizing their thyroid, talking to them about making smoothies, you know, alkaline diet, et cetera, et cetera. So I just outgrew the job that I was hired for.
Michael (5m 51s):
And at that point I said, you know what? It's time for me to fly the coop. I need to spread my wings. I'm gonna, life is too short and I don't wanna end my career with a bunch of dissatisfaction and coulda would've shoulda have, you know, so I'm gonna start Michael Turner md.com and do this and it, and I know it's gonna work. And it has and tons of personal satisfaction as well over the last few years.
Brian (6m 10s):
Yeah, that's, that's great. And what would you say, you talked about like hormone optimization and thyroid and thyroid. I just had Danny Rodian, I don't know if you're familiar with Danny Roddy, but he's part of sort of this bioenergetic viewpoint on like just optimizing metabolism and thyroid. And so what, what type of, yeah, what type of things that do you look into as far as hormone health and, and optimizing, you know, thyroid?
Michael (6m 40s):
Sure. Well, a lot of times people would have a chief concern, or in medical language, we use chief complaint. A lot of times people will have a chief concern of low energy fatigue, right? They're drinking energy drinks, they feel like they need to take a nap. They're feeling sluggish at work. They got no energy for their spouse when they come home at the end of the day at that kind of thing. So that's typically the symptom that comes forward. Now, underneath that, then I explain there are two main hormonal systems in your body responsible for energy regulation. Your thyroid, which your T3 level, which is your active form of thyroid directly influences mitochondrial number and activity. So if you are lacking t3, you will have less and less active mitochondria.
Michael (7m 21s):
And the converse is also true. Besides that, then we have adrenals, right? Your adrenal hormone system is hugely responsible for feeling energetic, not only cortisol, but also D H E A. Besides that, then we have the sex hormones. For example, a guy with low testosterone is going to feel sluggish. Sometimes a postmenopausal woman, for example, low estrogen or progesterone, or low testosterone, even in a woman, because women need testosterone, just like guys need estrogen. Obviously the ratio is different, but important to pay attention to that. So we start working on those three parameters. As to your question about thyroid, it gets down to really listening to the patient and doing some thorough lab analyses and putting that together towards an optimal understanding.
Michael (8m 8s):
So for example, many patients will come to me and say, doc, I'm pretty sure my thyroid's off. You know, my mom has thyroid problems, my aunt has thyroid problems, my sister has thyroid problems. I'm feeling tired, I'm depressed, I'm sluggish and I'm losing my hair. But my primary care check the Ts, H a K a thyroid stimulating hormone, and said it was normal. And where do I go from here? Right? I don't know if you've heard this story or seen this. Yeah,
Brian (8m 37s):
Michael (8m 39s):
Yeah, yeah. And so, yeah, so the answer is you have to check a few other labs besides just the tssh, but then also you have to consider maybe this person's TSH is quote unquote normal. Okay. But maybe if we shifted it from the, you know, ex the high side, in the case of tsh, which would actually indicate a low thyroid state, let's just say we dropped the tssh a bit by giving them some thyroid or stimulating their thyroid, Glen, to put out naturally, which there are ways to do that. What if we just slid them along this continuum of normal from one side where they're at to the a better side of normal, how much better might they feel? And it's tremendous person will come back and say, I'm losing weight.
Michael (9m 21s):
My hair stopped falling out. And we didn't do anything extreme. We just took them sort of from one end of the bell curve to the other one. So still within physiologic limits and reason. So that, that's, that's very common situation.
Brian (9m 31s):
Yeah. And do you prescribe thyroid for a lot of patients?
Michael (9m 37s):
Yes. Yeah. Absolutely.
Brian (9m 40s):
What natural ways could individuals maybe help stimulate thyroid and, and get things going?
Michael (9m 47s):
Sure. So there are some multi ingredient vitamin and supplement formulations, which I'm a big fan of. One of the best ones is from Thorn. If you've heard of Thorn Research, T H O R N E. They have a product called Phyto Zone that is tremendous. But essentially, those products provide things like selenium, vitamin C, zinc, certain minerals and vitamins that are involved as co-factors or as part of the process of your body converting pre thyroid to active thyroid, right? The precursor thyroid is called t4, the active is t3. So sometimes there's a biochemical hangup there where your body is not well converting T4 over to t3, and this would give you some of the substrates to help do that.
Michael (10m 35s):
Essentially, that's on the hormonal side. On another side, actually, and this is thinking outside the box a little bit, but something I've started to recommend that has been helpful is the idea of infrared light. You may know infrared light stimulates metabolism, stimulates blood flow, stimulates mitochondrial activity as well. You can get a handheld infrared wand and actually hold it over your thyroid. And because the thyroid's a superficial structure, easily localizable, I've had patients have some tremendous success holding infrared light, right on their thyroid, 10, 15 minutes a day and taking the thorn product that I mentioned that's on the conservative side.
Brian (11m 10s):
Yeah. You know, I keep hearing, I keep hearing red light come up with, with, with a lot, with a lot of my guests. Yeah. I actually just got one for myself, so I haven't used it a ton yet, but just started using it. So yeah. That's interesting. It, there's been quite a bit of research behind red light, huh?
Michael (11m 29s):
Absolutely, yes, absolutely. Interestingly, some of the research when I first started hearing about it had to do with musculoskeletal healing. Okay? So physical therapists were using it for tendonitis, for example, if you can imagine having golfer's elbow or tennis elbow, right? Interesting. And they're putting this infrared light on there, or near infrared light and stimulating healing of this tendon. And the mechanism behind that was increasing blood flow, increasing mitochondrial activity. As I mentioned. What was interesting is as physical therapists were starting to use this superficially on the body, they also noticed that patients were losing body fat.
Michael (12m 12s):
Okay? So if, if you can imagine if there, if I'm rubbing this wand around your abs because you've got, you know, a pulled ab muscle or bruise or something I'm trying to rehab, all of a sudden fat's melting away off their abs. And so that launched a, a whole bunch of research in a period of time in which these handheld, superficial infrared devices were marketed as fat loss. And there are still some out there that you can find, which is valuable, legitimate use of them. They do, they promote some visceral fat loss. Interesting. And then beyond that, now it's moved much more towards the idea of whole body infrared light. So you can sit down in a light bed, almost like you can sit in a tanning bed and you can get whole body infrared light for 30 minutes, 40 minutes, something like that.
Michael (12m 55s):
What might that do for you? Well, absolutely improved energy because of improved mitochondrial function. So that's one of my favorite techniques or hacks, if you will. If someone's really suffering from chronic fatigue, aside from the things that I mentioned, getting their hormones right, et cetera. I say, let's look at whole body infrared light. And I have some people go to their local tanning salon, which now most of them will have infrared light booths sitting in there for two, three sessions a week. They feel great.
Brian (13m 19s):
Hmm. Well, let's shift to testosterone. Is that, do you find, cause a lot of individuals on, on that, listen to my podcast, middle-aged men, you know, this is sort of a hot topic. What, what are your thoughts around sort of boosting testosterone maybe without, you know, drugs, thoughts around that?
Michael (13m 39s):
Absolutely. Yeah, sure. A really important concept, just to put an exclamation point on that, let's talk about the aging process of man's anatomy. Okay? How, how do, where does the aging process and how does it interact with your testicular function? And the answer is that you have one testosterone producing cell that dies, goes offline and never comes back. It dies every four seconds. Okay? So guys are losing one testosterone producing cell every four seconds, irreversibly, unfortunately. Now, thankfully, there's a lot of redundancy down there in terms of the number of cells that we start with, right? But this is a problem. And so typically beginning in your thirties, you start to lose 1% of your testosterone a year.
Michael (14m 24s):
Besides that, that's on the individual level. But besides that, on the societal level, we know that there's something wrong. It could be the endocrine disrupting chemicals in the water, right? It could be the female hormones that don't get taken out of municipal water supplies very well and recycled. It could be simple obesity, but in any case, the average male testosterone level, this is based on some cohort longitudinal studies, is about 30% lower than it was in the 1980s. That's concerning, right? That's not, that's not genetics, that's not ev evolution, that's none of that. This is something since the 1980s is causing across the board lower levels of testosterone, 30%. So to your point, it's definitely a concern on the lifestyle thing.
Michael (15m 7s):
The first thing I do is talk about sleep. That's actually the first discussion I have. Why is that? Because your testosterone peaks first thing in the morning, which is why if you had adequate testosterone, typically guys would wake up with an erection in the morning and feeling energetic and feeling frisky, right? If you're not doing that, that's a signal that your testosterone could be low. It peaks first thing in the morning because the mechanism for producing testosterone, which starts in your brain, your brain secretes a signal called LH lutin hormone that cascades downwards. And the so-called LH surge quote unquote, every night is what signals the testicles to produce testosterone in the morning. Well, if your sleep is choppy, you are not getting a strong LH surge.
Michael (15m 51s):
Right? And in fact, they've done some studies, I, I don't wanna misquote exactly, but they show that the difference between a guy who gets five hours of sleep a night and a guy who gets eight hours of sleep is like a 30 or 40% drop off in their tea that next morning. So that's a big concept. So actually start there. The next thing I talk about is losing weight. So simply getting lean helps boost testosterone. Why is that? Because of an enzyme called aromatase. And aromatase is a negative concept from the guy's point of view as regards, testosterone aromatase is an enzyme that takes part of your circulating pool of testosterone, siphons it off, and creates estrogen from it. Now, that's, that's part of our god-given physiology that's necessary to a degree, as I said, guys need estrogen, but too much aromatase activity will equal an imbalance.
Michael (16m 40s):
Then testosterone dropping and estrogen rising now turns out that aromatase is preferentially concentrated in fat cells. So simply getting fatter means you have overall more burden of aromatase enzyme activity in your body, your T will drop. The opposite is true. Getting lean reverses all of that. So that helps all by itself. The other thing I talk about is avoiding alcohol. You may be familiar with that idea, but alcohol disrupts testosterone synthesis, very negative. Keeping up your healthy fat intake. So I talk about the concept of healthy fats, talk about exercise strategies. The idea with boosting your testosterone is to be doing some compound movements and some heavy movements, more like a five rep times three set cycle or something like that.
Michael (17m 28s):
I just tell guys, imagine, you know, imagine the, the idea of testosterone boosting and exercise. Imagine the old day we didn't have gyms and stuff. It would be you splitting wood, it would be you lifting a wheelbarrow of concrete and moving the thing somewhere, right? It would be you hoisting up some lumber and building a barn or something like that. So you're using your whole body and you're, you're on the heavier side of exertion intermittently with some rest period, something like that. So definitely not sitting at a machine doing bicep curls, you know, we're talking doing Olympic lifts, kettlebells
Brian (18m 8s):
Michael (18m 9s):
Brian (18m 9s):
Yeah. Yeah. Is that something you implement into your routine? I've seen some videos of you online doing some stuff, moving some weight.
Michael (18m 17s):
Yeah. Yes, absolutely. Yeah. At different times. Yeah, absolutely, Brian, at different times. I, interestingly enough, my wife came to me a number of years back. She says, I think you should get your testosterone level checked. And I, I, I go, I tried not to take it personal.
Brian (18m 34s):
Right, right. You know, like she's just looking out for you. What would give that
Michael (18m 39s):
Exactly, what would give you that idea, honey? My gosh. Right. So she said, I think you, I think you should get your levels checked. And sure enough, they were on the lowest side. I was about 38, 39 years old at the time. They're low-ish. I've done things over the years to bring them up. There's different ways we can talk about that. Some natural, some medications, some straightforward testosterone therapy. I've been on it back and forth now, but it's been tremendous. It's, yeah, helped me with energy, fat loss, muscle gain, all the good stuff that, you know, a guy would want to see. So you have, and as far as my personal
Brian (19m 12s):
Work, Hey, go ahead. Yeah, go ahead.
Michael (19m 14s):
Oh, I was just saying, as far as my personal workout routine, yes, sometimes I do more of an emphasis on strength training and things. Currently I'm, I'm a big fan of yoga and I'm actually doing a lot of outdoor swimming, so, oh, just free water, open water. Swimming is my big focus lately.
Brian (19m 27s):
That is awesome. And that is not easy. I, I imagine open, open swimming. I mean, I, like, I lease to swim a lot, but I've never done that much open, you know, open water swims.
Michael (19m 39s):
Yeah, it's a challenge. I greatly enjoy it. I like the scenery and every swim is different. You know, you're swimming in a different lake or a different stream or a different beach somewhere. Sometimes it's cold water, warm water. Sometimes the water's murky. Sometimes you, you're seeing animals in the water. I mean, there's a whole bunch of variation to it. It's always a little bit of a mental challenge too. It's always a, there's always a little edgy feeling, right? So for example, I was in Hawaii, everybody else is on the beach, open water swimming. You dive under the way, if you go way out, you go past the surfers, you go past everybody. Wow. You know, there's, there's, there's nobody out there. The lifeguard's not gonna save your backside if something happens. So mentally, you have to get in the zone that I'm gonna take myself from point A to point B or die trying literally.
Michael (20m 21s):
And it's all on me, and I just gotta get there. And I can't just get tired. I can't quit, you know, I've gotta just push on and, and I actually like to take myself to that zone, although it's a little discomforting, definitely. But it's strengthening in the
Brian (20m 34s):
End. Well, I noticed you, you did the what? The Navy Seals fitness test?
Michael (20m 39s):
Brian (20m 39s):
When, when did you do that?
Michael (20m 42s):
That was 2021. Oh, okay. I believe I did that in 2021. Yeah. So, as you may be familiar, I got inspired. I was looking around on YouTube. There was a video of these two bodybuilders from England actually, who had attempted this Navy Seals fitness test, which is the, require the screening requirements to be accepted into Navy seals basic training, a k a bud, S B U D S. And it was a tongue-in-cheek in humorous video in the end, right? Because the bodybuilders having done no training for this thing, did decent at the pull-ups and the pushups, middle of the road with their abs on the sit-ups.
Michael (21m 21s):
And they tanked on the swim and tanked on the run because just didn't have the cardio and the technique, et cetera. And it's all about watching them suffer, you know, on this video and having some chuckles at their misfortune. Right? But I got inspired and I said, I'm, I'm always looking to set a fitness goal for myself. And I said, well, what if I, what if I did this? And, you know, my situation's a little different. I'm not a professional athlete. I'm not a even former college athlete. I'm not a professional YouTube fitness guy. I don't get paid to just sit there and train all day. I'm a doctor, I'm a father, I have a business, I have a mortgage, I got responsibilities, plus I am, at the time I was 45 years old.
Michael (22m 3s):
So I said, is it conceivable that a 45 year old guy in my situation with all those constraints I just mentioned, could get incom, competitive qualifying navy seals shape? I don't know, but I'm gonna find out. And that was my, hmm. My drive that year.
Brian (22m 18s):
Yeah, no, I, I think that's great. I mean, having something to work towards, right? Like, it doesn't, whether it's something like this or like, you see a lot of times with people, if they have like a wedding or something coming up, it's like you have something to work towards that that's the motivator enough to, to just take action. So that's, yeah.
Michael (22m 36s):
Brian (22m 37s):
That makes a lot of sense. And yeah, I was, I was looking at the test itself. Is that, so it's run 15 miles in 10 and a half minutes. Is that the right one that I'm looking at? Swim 500 yards in 12 and a half minutes, or was yours different than this?
Michael (22m 53s):
No, no. You're sounding right. Although I don't think the run was 15 miles. I think it was 1.5 miles. There might be a decimal.
Brian (22m 58s):
Oh, oh yeah, yeah. You know what, run 1.5 miles. Okay. 10. There we are. 10 pullups in two minutes, 50 curl ups in two minutes. That might be tough for me that the curl ups 50 pushups in two minutes. I, I can do that. 500 yards swim and 12, the swimming, I'd probably have to train a little, I haven't swam in a while, but obviously depends if you're doing it in open waters, a lot more difficult in open waters than it is in just a controlled pool.
Michael (23m 27s):
True, true. The test is typically done in a controlled pool, so that's nice.
Brian (23m 30s):
Oh, okay. Yeah. Maybe I'll give this a go. You, you inspired me.
Michael (23m 35s):
Yeah, considerate. Yeah. Yeah. If you're serious, I can throw down some of my tips for it, but it was, it was fun. It was gonna, you know, by definition make you well-rounded in some of your intentions
Brian (23m 45s):
With Yeah, I like, I like that. I like that. And you mentioned testosterone, you, you know, obviously natural ways. And then you mentioned that you've gone out, have you gone on and off with T r t or, and things like this? What, what type of, how's that been going?
Michael (24m 2s):
Ah, it's, it's been going great. So at times I've been on Clomid, which yeah, if you're familiar with the idea of T R t, right? So that works on the whole idea of that lutin hormone surge that I mentioned that your brain sends out every night. The signal lh, surge Clomid taken right before bed creates a larger LH surge every night. I describe it as ramping up your internal circuitry of production. So if you take this med, it ramps up your internal circuitry of production, your testosterone levels of boost the next morning can work very well. And the nice part about that is it does not inhibit sperm formation. Whereas if you give someone external testosterone, it shuts down sperm production. Now it increases sex drive and increases erectile function.
Michael (24m 44s):
But as far as fertility, it shuts down sperm production and acts like male birth control. Clomid avoids that problem and therefore is my go-to for younger guys. The only problem with clma is there's a cap on high, high, you can take a person's testosterone. Usually it's about two or 2.5 x. So when you look at the scientific literature, all the studies that talk about clma, they usually either use 25 milligrams a day or 50 milligrams every other day. All of those studies, you can see the boost in testosterone, but it's only two to 2.5 x. So if you got a guy who's really, really down low on his level, it's just not gonna get him there. And you have to have a, a discussion about the bigger guns.
Brian (25m 25s):
Yeah. Other things. And, and Clomid it, you remind me cuz I had Rob Wolf on, I don't know if you know Rob Wolf, he was a big paleo guy, but back in the day, yeah. Now he owns Element, that salt company, but he talked about Clomid a little bit as well. And, and when you talk about lower levels, are you talking like, like, I mean, I, I know it depends on the age of the individual and there's probably some underlying factors as well, but like less than 300 for as far as testosterone's concerned would, is that when you maybe start considering stuff like this?
Michael (25m 58s):
I'm a little more aggressive than that actually. So that would be a conservative number in my mind. Even just generally amongst the medical establishment. If you're 300 or south, the doctor would reasonably con be concluding at your testosterone levels low. Now we can talk about per age demographic, you know, what's reasonable and how the doctors should make decisions, but as to give a number, 300 or south is obviously low. I've re repeated guys either way, all the way up to maybe mid 500 s or so, because my concept is I don't want you hanging out at the lowest possible end of the spectrum. Let's take you up to the higher end of the spectrum. Right? And I'm not, I'm not talking about surging past the upper end of the spectrum.
Michael (26m 40s):
I'm not talking about bodybuilders abusing drugs and, you know, testosterone levels of 2000 and things like that. No, I'm just saying, let's take you up to the higher end of normal and let's let you sit there and let's see how much better you feel. And the answer is, guys feels tremendous. So I'll, my goal for guys maybe 900 to 1100, and so if a guy's at 500 or five 50, we can double that safely still and he'll feel great
Brian (27m 3s):
Once you do Clomid. Is this something that you, you said you take it every, every day or every other day. Is it something that you would have to be on in for forever or could you be on it for, you know, maybe a few months or a few years and then come off it and then get, you know, I don't know. I'm curious.
Michael (27m 21s):
Good point. It's typically going to be a longer duration concept. Yeah. It is going to be a longer duration concept. Typically, you can come off it at some point in the future. The worst thing that would happen is your body just reverts back to its old internal circuitry state of your previous testosterone level. But, you know, sometimes there's, there's an idea of ramping things up and then it sort of kickstarts a process, let's just say, right? Your, your, your body, it, it fires something up and then maybe you're sleeping a little bit better, maybe you're exercising a little harder and maybe you said some visceral fat, right? So now when you get off the Clomid, things are dialed in better so that that's a possibility. Yeah. But in general, it's definitely a month's timeframe commitment when we get going.
Brian (28m 1s):
Okay. And why don't we talk a little bit about like healthy brain? Hmm. Yeah, I, I think, you know, it's like I've had some, gosh, I've had some individuals talk, we, we touch on the brain and Dr. Tommy Wood I've had on, we talked about that and what, what things do do, like recommend for individuals. And I think it's something that gets left behind a lot. We always talk about, oh, resistance training, lifting, you know, lifting heavy and this and that. It's like, and am I, I'm, I'm at fault myself as well. Like, I try to do things to stimulate, you know, brain activity. But what, what type of recommendations do you make around that?
Michael (28m 43s):
Yes, several. The first one to your point is exercise. So if we had to just pick one thing to do for your brain. Yeah. If I had someone come in and say, Dr. Turner, I'm just feeling not mentally sharp. My dad came down with Alzheimer's. I'm, I'm, I'm having trouble with some word finding. I get confused sometimes. My short term memory's not there. Maybe they had covid, you know, on top of that, which really set them back and they have a dire concern for brain health. And I can tell them only one piece of advice. The answer is exercise. Most people don't quite understand why that is. So, but it's very powerful on several levels. First of all, blood flow. So anything that increases blood flow to your brain is going to en enhance your cognitive ability.
Michael (29m 25s):
For example, I was really struck about 10 or 12 years ago, there were a series of articles written in the New York Times by their health reporter about exercise and how it affects the brain. And it was fantastic reading and that caused a segue into the science behind it, et cetera. But there have been a bunch of studies done of a similar type and basically they'll do some test of memory and cognition, such as show you 20 random na faces and then 20 random names and you have to pair them and remember them and they'll show you these. And then they divide the groups. One group just sits in a chair, let's say, and stares out the window. The other group gets on an exercise bike and rides at a mild to moderate pace for a half an hour.
Michael (30m 7s):
Then they come back and they retest you. And what do they find? Invariably that group that did exercise is demonstrating better recall, better cognition. Your are actually smarter. Your IQ goes up, your cognition goes up in the hours after you exercise for at least several hours afterwards. And part of that can be explained simply on the basis of blood flow. The metaphor I use for patients is imagine you have a dimmer switch, right? It's like a dimmer switch on your wall. You wanna throw that dimmer switch to full on representing full blood flow to your brain. Besides that exercise also boosts release of something called B D N F.
Michael (30m 46s):
Most patients haven't heard of this. Vitally important to understand, it stands for brain derived neurotrophic factor B D N F fan, phenomenal molecule. This directly strengthens neuroconnections in the brain, but especially in areas of memory learning cognition, I call it miracle grow for your brain. All right, so you sprinkle some BDNF around these neurons, they plump up, they get healthier, their connections are strength, and turns out then that exercise boosts BDNF levels directly. We know that. So that's phenomenal. There are other things that boost BDNF levels as well, including certain supplements like resveratrol, which is good for the brain.
Michael (31m 27s):
So to brain health though, I start with a discussion about exercise after that I talk about principles of oxidative stress and reducing oxidative stress in your brain. I talk about principles of inflammation and reducing inflammation in your brain. And then we can talk about principles of keeping your brain active. Use it or lose it principle. Sure. For example, learning a new physical skill is actually a mental challenge and is very good for your brain. I'll use the concept of learning how to dance. Let's say you take up country line dancing or you know, swing dancing or something like that, and you are looking at this person modeling something, you're trying to recreate that yourself three dimensionally.
Michael (32m 13s):
You're listening to the rhythm of the music, you're matching that up and you have to feel your partner, their weight, their energy, their distribution, and you have to be in sync with that, right? Yeah. And so it's calling on multiple parts of your brain to pull that all together and to get that smooth. So that's a, that's actually a neuro neurologic connection, phenomenon and challenge to learn that new three-dimensional exercise pattern set to music set with feedback to another individual, for example. So if you learn a new pose in yoga, you keep falling, you keep falling, you keep falling, finally, you don't fall anymore. You, that was a brain strengthening concept, again, integrating multiple sites of your brain and then obviously things like learning a new language, you know, reading books, creative endeavors, that type of thing.
Michael (32m 59s):
But keeping, keeping the nerves firing and, and connected and giving them intentionally something to do that's new.
Brian (33m 6s):
Yeah, and like I've, I've been doing piano a little bit and I recently just took up guitar and it, it, it's not, it's not easy to take up an instrument, you know, as an adult, but I think you learn to appreciate it a little bit more and it's a challenge for sure. But, but yeah, you definitely appre, you know, like watching people who are really good at like guitar, I'm like, wow, it's pretty amazing what they can do.
Michael (33m 36s):
Absolutely. My goal as an adult is to become successful on the accordion.
Brian (33m 41s):
Michael (33m 42s):
And I have to say, Brian, this goal has been nagging at me for probably 12, 14 years. I bought an accordion when I was in residency at the Mayo Clinic in Minnesota. It was a estate sale. And this guy, I believe was actually a professional accordion musician. This thing is beautiful. It's got pearl inlay and everything gorgeous. Gigantic accordion probably has, you know, 75 buttons on one side, et cetera. Wow. Well, I got inspired, I started learning a little bit of accordion, then I got too busy and then I, you know, had kids and more kids and this and that. So this thing sits there, it's been nagging at me this whole time. And anyway, yeah, I I'm, I'm not going to leave this earth without dedicating myself at some point to getting decent on this accordion and I'm gonna have a lot of good brain training doing it.
Michael (34m 26s):
Right, because to your point, you're looking at little symbolic squiggles of ink on a page to translate that into the correct sound that you want to hear to translate that into the correct three-dimensional movement that you need to make to do that all quickly. Maybe to sing along with it. I mean, come on, there's your brain. Yeah. Learning. Yeah.
Brian (34m 46s):
Well, you know, you, you got what, you have five children, so you could start a band.
Michael (34m 50s):
Brian (34m 51s):
Michael (34m 52s):
I guess so. Exactly. We got a polka band.
Brian (34m 59s):
What else, what other things do you find yourself working on individuals with? I know you talk a little bit about, you know, fasting and, and obviously I, I don't know, are there certain sort of principles that you, that you like to sort of follow or have your patients follow when it comes to, you know, eating and mealtime and things like that?
Michael (35m 19s):
Sure. So someone wants to come and talk about weight loss as an agenda, which I do quite often. Some of my core weight loss principles, but one of them would be intermittent fasting, which I know you're a big fan of. I've seen your website, I've seen the program. It, it's great metabolically it makes a lot of sense. So that's one thing I talk about. I talk about either an eight hour or a six hour eating window. Also making sure that eating window is solidly during daylight time, right? In other words, a hamburger, let's just say, or a bowl of chili or something is not the same at 9:00 PM as it is at 4:00 PM not even close. It's not, there's a huge distinction there metabolically in terms of fat storage, energy expenditure, et cetera.
Michael (36m 4s):
So I talk about intermittent fasting, I talk about low carb and low sugar. I talk about fat as an alternative source of fuel towards carbs. Now I know you had a guy on not too long ago, Dotty and was talking about this, but from, from the weight loss viewpoint, absolutely. The low carbon, the low sugar concept is the way to go. I'm not always saying you're gonna feel tremendously more energetic if you're training for a triathlon or something, right. That we have to moderate that idea. But if you're Joe Guy with an office job and you wanna lose weight, that's, that's where you need to go. Because basically carbs or fats are alternative sources of fuel. And if your body is shifted over to carb burning mode, metabolically enzymatically, there are changes that occur in your cell.
Michael (36m 50s):
If you're shifted over to carb burning mode because you're, you have a predominance of carbs in your diets, then you're shifting away from fat burning mode. In fact, you're in fat storage mode, right? Which is the exact opposite of where you'd want to be. Whereas if you start to starve yourself with carbs, your body kicks into fat burning mode. And so that's where we wanna stay. Not to mention a healthy fat is more satiating, it's more satisfying and more filling than a carb. We all know the feeling of eating a carb and feeling hungry, you know, almost immediately after 15, 20 minutes, something like
Brian (37m 26s):
That. Well, and you know, I'll say just from my experience, like not all carbs are equal, right? Like, I mean, I think if you're talking about highly processed carbs compared to like a whole, like fruit Yes. Or you know, like, you know, maybe a, maybe vegetables or, you know, cooked vegetables. I would say sometimes raw vegetables can be tough on the gut, but those play a diff little bit different role than obviously something that's highly processed.
Michael (37m 51s):
Yes, absolutely it does. Yeah. My favorite is unprocessed oatmeal, essentially. So,
Brian (37m 58s):
So you make your,
Michael (37m 58s):
I get the old fashioned oatmeal and I don't cook it, I throw it in a bowl like it was cold cereal. Oh wow. And yeah. And then couple walnuts on it, if we really need some flavor, a little bit of Greek yogurt, maybe drizzle a little molasses on it. Great. You, you get used to it, you know, healthy feeling. Yeah. I'm a little extreme on some things, but it's been working for me over the years. Yeah,
Brian (38m 18s):
Yeah. And, and on that point, what I, what is like, I, I'm a big routine guy. Do you have certain routines? I, I mean I know you, you know, you have your own practice, you got five kids, you know, how can you, what type of routines do have you put into your life, whether morning, evening, to sort of set you up for success?
Michael (38m 36s):
Wow, great question. I've thought a lot about that myself too. I'm an overachiever. I'm always trying to look at new and different routines and trying to feel as healthy as I could possibly feel. So they've changed over the years, let's just say. But yeah, right now, definitely my routine, my ideal morning would, would start with me drinking a bunch of water. First off, not eating. Cuz I'm in my intermittent fasting zone. I'm not gonna eat till 10 or 11:00 AM ideally. So bunch of water, taking my supplements, then sitting and getting my mind right for my day. Actually a meditative concept at this point, right? A mental strengthening concept. And I like to look at nature. I'll typically look out my window and just pray and think about my day and put some positivity in my mind.
Michael (39m 22s):
Sometimes I'll read my Bible. It's the idea of getting my mind in a positive zone, right? And this is hugely important because our minds, and I'm talking particularly our subconscious minds, they're very influential and they're very Directable. They're very easily influenced, you know, to one direction or another. So for example, you think of a dream, you might have watched a disturbing movie the night before and all of a sudden you're having some disturbing dreams, right? Yeah. Why is that? Right? So it's important to start your day consciously, which then would become subconscious with some positive scripts, let's just say could be affirmations, right?
Michael (40m 5s):
Mantras, whatever. Getting something positively in my subconscious mind for the day. That's huge. And then beyond that, most days, assuming I have time, I'll work out and especially with a focus towards cardio, because I'm in that fastest state. I know it's gonna be synergistic fat burn at that point. So that's typically my starting point in my day. But overall, when I, yeah, go ahead.
Brian (40m 27s):
No, I was just gonna say, so do you, do your workouts midday or do you typically do them in the morning?
Michael (40m 34s):
I've done different ones depending on demands of work, et cetera. But my preferred time is the morning, first thing in the morning. I tell patients, especially as regards weight loss, you're going to get a synergistic benefit. You're gonna get a better return on investment for the same exact workout done in the morning on an empty stomach versus done later in the day. Last time I checked the literature and such on this, it was about two x. So from a fat loss perspective, for you to do the same workout, you're getting a two x return on investment in the morning. Another way of saying that is you could do half the amount of time and get the same benefit if that's a concern for you based on schedule and demands, et cetera.
Brian (41m 13s):
Yeah, I always say the best time to workout is the time where you know you're gonna do it. So if that, if that's first thing in the morning, yes, great. Right. If it's, you know, even if it's later in the evening or you know, if it works, yes it works, right? Like especially you know, with your, with a busy schedule, I've shifted, I've been, I used to do mornings now I typically do middle of the day. I like to break up the day a little bit.
Michael (41m 35s):
Sure, yeah. Understood. I've done, I've done a lot in times past, at the end of my day. So between being at the office and coming home, it's a nice break, you know, mentally, physically, de-stressing a little bit, have a little bit of personal time, you know, and then hit the door cuz you've got family responsibilities at that point. So that's been a nice bridge. So it goes back and forth. The, the other beauty of the morning though is that it opens up the possibility for a two a day workout. Oh, that's the cool thing. So yeah, so you get that morning workout done, number one, you already feel great cuz you got your workout done. So no matter what else happens during the day, the workout got there and that's got its own, you know, jazzy feeling. Right. But besides that, it opens up the, for the possibility of it two a day.
Michael (42m 16s):
So maybe I focused on my cardio in the morning and then look, voila, I got a little bit of time between work and hitting the house in that evening zone. I'll go back, I'll lift some weights, I'll do some yoga, I do something a little different.
Brian (42m 27s):
Yeah, I hear that. Yeah. And I know, so the morning eve, anything in the evening you do to wind down? I know you have five kids. Is there anything that, that you do for, to help them, you know, create, instill healthy habits for their life? Like, like your mom did with you?
Michael (42m 45s):
Right. Well, thank you for mentioning. Yes. So full disclosure, my kids are grown now for the most part, so, okay. Yeah. So I've, I've got a little bit of a baby face. I think you might be shocked if I told you how kid old my kids are, but they're all in their early twenties. Okay. They're out of the house, they're on their own. My youngest child is 18 and lives with her mom in a different state. So, okay. When I come home at the end of the day, there's not a house full of children at this moment. But to your question, back when, yeah. You know, I, I made it a point of tucking the kids in bed every night, and that was hugely important as a parent, you know, that idea of tucking, I ha I had to tuck in every night. My mom came to my bed every night, my little lap dog, Mickey jumped up on my bed, curled up in my arm, and we were gonna go to sleep every night and every day ended in this very soothing, ritualistic way where my mom was in there talking nicely to me, praying over me, saying goodnight, walking softly out the door.
Michael (43m 43s):
Right? Hugely comforting and beneficial psychologically, even physically, I'd say for a child, right? So I did that same thing for each of my kids, and sometimes I was complicated. You got five kids trying to do five tuck-ins. I had to divide and conquer with my wife, as you can imagine.
Brian (43m 58s):
Yeah. So, yeah. Oh, that's great. That's a great tip. Well, we'll finish up with one last question. I, I asked pretty much all the individuals that come on my podcast. What, what one tip would you give, you know, maybe a middle-aged male who's getting up there and wants to get his body back to what it was maybe 10, 15 years ago. What, what maybe one tip would you give that individual to get them going?
Michael (44m 25s):
I'll throw out two
Brian (44m 26s):
Tips. Okay, sure. I'll let you
Michael (44m 28s):
Do that just because I can't, I can't help myself there. Thanks. The first one is get your testosterone levels checked and then take the steps to optimize them. Hmm. That's a power pack concept. That return on investment on that is huge. That's number one. But then number two I would say is on the mental side, which is actually you talked about wanting to return to some prior levels of health and wellness and vitality, which is true, which is good. That's a great motivation. However, I would say we have to learn to moderate ourselves as we hit middle-aged. I'm 47 years old, for example. My workouts aren't going to look the same as I did when I was 27. If they did, I would probably hurt myself.
Michael (45m 9s):
So I, I have to learn how to be the best version of me at this present time, not compare myself to my 27 year old self. The que the only valid, relevant question is what would it look like for me, Michael Turner to be as healthy as possible at age 47? Not comparing myself to anybody else who may have different genetics, right? Not comparing myself to my 27 year old self just today. What would it be like to feel in a state of optimal health in my body? And so that, that definitely requires some moderations, letting go of certain expectations, all that. Otherwise you get guys where they'll hit the gym so hard and then they're sore and then they're feeling frustrated and then the rotator cuff got hurt and we got setbacks.
Michael (45m 50s):
You know, they're, they're not aging gracefully, let's just say. So it's a, it's a balance. It may almost seem like I'm saying two different things, but actually need to be held an intention in balance together.
Brian (46m 0s):
Yeah, that's actually a great point because obviously as you get older, it's like you, you wanna continue down this road of health and vitality, but you, you know, you can't do what, you really can't do what you did when you were in your twenties and the last thing you wanna do is get hurt. Yes. I think, I think like, was this, like a few months ago I was doing some heavy squats and then, you know, just didn't feel right and I was like, you know, why don't I don't need, I don't, you don't need to do heavy squats to get a positive benefits of lift weight lifting weights, and you could do a lot of single like work and with less weight. Yes. And, you know, and it should be just as effective. So I love doing single leg squats and things like that that put less load on your spine and your back that you maybe could have done when you were in your twenties and then you thought nothing of it.
Brian (46m 49s):
So it's, it's a good, it's a good point. Great.
Michael (46m 52s):
Just to piggyback on what you said there, Brian, I'll, I'll give you an anecdote. It was about, I think this was 2018, so five or so years ago, so about 42, 43 at the time I'm in the gym and I'm doing some heavy to be deadlifts, basically trying to do PR on some deadlifts and doing some sets. And I get into my second set and my goal is to do 10 reps. And I've had back trouble a little bit off and on some disc injuries in my back. Again, all my injuries are self caused basically from working out too hard or inappropriately. Right. I've never actually had a sporting injury.
Michael (47m 33s):
I've only had injuries from me being in the gym, being stupid essentially. Yeah. Well, so I had some preexisting disc problems in my back. I'm doing my set of my personal deadlifts and right around it was reps number seven, my back twines. And I have this thought, this distinct thought, it was like the voice of God in my mind it said, if you keep it up, you're gonna blow up a disc and pinch a nerve. And as that thought went through my mind, I was like, no, get that thought out. That's negative thinking. I gotta stay focused, you know, I gotta stay dialed in. I'm setting a pr, like I gotta stay dialed. Right. Next rep, same thing. My back twin is a little bit Brian, same exact thought.
Michael (48m 14s):
If you keep it up, gonna blow up a disc, pinch your nerves. And I had the same response, no, I can't do that. God, stay positive. Gotta push through this on the ninth rep, that's exactly what happened. My disc blew up and I pinched a nerve. My back seized up. It was like somebody took a hatchet and just sunk this thing in my spine and left it there and walked away. That was the concept. I couldn't even fully straighten up. I collapsed back on the bench, it took me half an hour to get from the bench right to the locker room. It took me half an hour to get from the locker room to my car, et cetera, yada yada. Turns out I blew up a disc pinched my left L four nerve. My left thigh got so weak I couldn't go upstairs. I had to have neurosurgery in the subsequent months and I had to rehab myself all the way back from that.
Michael (48m 55s):
Brian (48m 56s):
Michael (48m 56s):
Yes. My first, yeah. Yeah. Moderation and awareness and dwelling safely with your body, especially as you go past 40 is
Brian (49m 5s):
Huge. Yes. Awareness, listening to your body and, you know, not, not just putting it a aside. I feel like there's days where like, you know, maybe you don't feel like, like maybe it's a leg day or a lower body day, but you're just not feeling it for that. Right. Then, you know, skip it. It's like, it, it, it, you're must, you're much better off doing that. Yes. And you'll cut you. What I notice is when I do focus on recovery, my, my next workouts are that much better. And I think that's huge. Yes. Yeah.
Michael (49m 34s):
Brian (49m 36s):
Well this was great. This is great. Thanks for coming on. Where's the best place for people to learn about you?
Michael (49m 45s):
Thank you. Well, my sub, which is Dr. Turner, Dr. Turner, dr r turner.sub.com is great because people connect, can connect with articles that I published as well as podcast episodes that I've done.
Brian (49m 59s):
Michael (50m 0s):
And there's a link.
Brian (50m 2s):
Yeah, go ahead.
Michael (50m 3s):
Yeah, there's a link from there to my main webpage as well, which I'll just mention if someone wants to get in touch with me personally towards consultation, setting up a wellness package and working together in a program. That's Michael Turner md.com.
Brian (50m 17s):
Great. Yeah. And I noticed you do have your own podcast, is that right? Yeah. Yes.
Michael (50m 22s):
Yeah, absolutely. Enjoy it, you know, look into add new episodes and flesh that out a little bit further and just bring great people on and, and have great discussions.
Brian (50m 33s):
Awesome. Well, I, I appreciate you coming on Dr. Turner, and thanks for dropping all, all the knowledge on us and definitely I'll leave notes in the show notes, notes, notes at the bottom to of as far as where to go to find ya. And, and I appreciate, I appreciate you coming on the podcast.
Michael (50m 52s):
Okay, sure. Brian, thank you. I enjoyed it and I appreciate you having me.
Brian (50m 55s):
All right. Thanks so much. Thanks for listening to the Get Lean EAN podcast. I understand there are millions of other podcasts out there and you've chosen to listen to mine and I appreciate that. Check out the show email@example.com for everything that was mentioned in this episode. Feel free to subscribe to the podcast and share it with a friend or family member that's looking to get their body back to what it once was. Thanks again, and have a great day.
Dr. Turner is a board-certified physical medicine and rehabilitation specialist with more than a decade of clinical experience.
Dr. Turner offers a comprehensive range of services, including Sports Medicine, Anti-Aging Medicine, Men’s Health, and testosterone therapy. He also provides innovative regenerative medicine therapies like platelet-rich plasma (PRP) and prolotherapy injections to help patients optimize their health and wellness. He frequently works with patients suffering from fibromyalgia and chronic fatigue.