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episode #224

Interview with Dr. Michael Twyman: Heart Disease Prevention, Red Light Therapy and Boost Nitric Oxide!

February 6, 2023 in Podcast


This week I interviewed Dr. Michael Twyman!

He is a board-certified cardiologist who focuses on the prevention and early detection of heart disease. He utilizes the best of conventional and functional medicine to get to the root cause of the patient’s cardiovascular issues.

We discussed his four pillars of optimal health, applications of red light therapy along with:
  • What you can do, starting today, to help prevent heart disease
  • The important role nitric oxide plays in the health and how to boost it naturally
  • The importance of grounding and the best ways to do so
and his one tip to get your body back to what it once was!

Brian (0s):

Coming up on the Get Lean EAN podcast,

Michael (3s):

Just make sure the place where you're sleeping is as electrically quiet as possible. So get your gear out of your bedroom. It should be like a dark sleep ca. There should not be light in there. You ideally shouldn't have your phone in there. If your phone's in there, it should be, you know, at least 12, 15 feet away from you. Ideally an airplane mode. But if somebody's gotta reach you, you know, keep it as far as way as possible from you. You know, I turn off my wifi router at night. I haven't set up that just automatically shuts off. You know, before I had that feature, you know, I just had it plugged into a wall that had a red lamp, and if the red lamp was on, I knew that the wifi router is on and at night ass flipped it off. But now my one automatically goes off. So just make sure that your bedroom is electrically silent so your body can fully recover.

Brian (43s):

Hello and welcome to the Get Lean ean 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 Twyman. He's a board certified cardiologist who focuses on prevention and early detection of heart disease. He utilizes the best of conventional and functional medicine to get to the root cause of the patient's cardiovascular issues. We discussed his four pillars of optimal health applications of red light therapy, along with ways to prevent heart disease, how to boost nitric oxide, naturally importance of grounding and is one tip to get your body back to what it once was.

Brian (1m 34s):

Really enjoyed my interview with Dr. Twyman. I know you will too. Thanks so much for listening and enjoy the show. All right. Welcome to the Get Lean e Klean podcast. My name is Brian Grn and I have Dr. Michael Twyman on welcome to the show.

Michael (1m 49s):

Thank you for having me today.

Brian (1m 51s):

Thank you for coming on. And Michael, you are a board certified cardiologist. And I, I was reading you have your, you've had your private practice since 2012, is that right?

Michael (2m 2s):

I've been out of practice since 2012. Been started my own solo practice back in 2019.

Brian (2m 8s):

Got it. Not too many people are opening up their own private practices anymore. Right.

Michael (2m 13s):

No, I'm, I'm definitely a unicorn in that aspect.

Brian (2m 16s):

What, what got you into learning about the heart and just, you know, going down the road of cardiology and I know now you're getting it, you're into biohacking and things like that. What sort of led you down that road?

Michael (2m 26s):

So I privileged know, wanted to be a physician since I was in the fourth grade. I just didn't know which kind. And then medical school, they exposed you to different specialties and you kind of figure out like what you might like and then you do some more rotations and really dialed into cardiology. You know, pretty laid into my kind of third year of medical school. Just fascinated by how the heart works and just, you know, the day-to-day was never boring. I mean, you had emergencies, you had, you know, procedures to do, you had imaging to look at, you know, we had office visits. So it was all fascinating to me. And, you know, eventually it kinda got more, more interested in the prevention side thing. So a couple years ago decided to focus more on that.

Brian (3m 3s):

Okay. So are you doing like less surgeries now and more just on the preventative side?

Michael (3m 8s):

Yeah, I stepped away from the hospital life back in 2019, so I've not set back since that time. So no, no invasive procedure. Just all, you know, consultations and some non-invasive testing we do in the office.

Brian (3m 21s):

Yeah. And, and that's gotta be unique in it. It's an own in, in its own sense. And because to go from that then go on to the preventative side of things. Were you, was this sort of a, you know, you're putting a lot on the line there. Was that a nervous sort of adventure that you, that you started? Yeah,

Michael (3m 38s):

Definitely. Definitely. You know, I had some, some business background when I was in the, the military. I got my MBA because, you know, they decided to make me in charge of the whole department when I was like 28 years old. Figured like maybe I should learn some business skills. So had some entrepreneurial bent in me and then eventually figured out enough kind of coaching from some, you know, smarter business coaches than myself who kind of said, okay, this is the way to kind of go out there and launch it on your own. So, you know, and you know, haven't looked back since that time.

Brian (4m 10s):

And what, what did you learn from just doing surgeries and, and being, you know, being in the hospital to your practice now that can, that helps a lot of the patients.

Michael (4m 18s):

Sure. I mean it's night and day what I do now, but, but I think it is very useful because you know, I could see, you know, the worst cases, you know, unfortunately I had many patients, you know, pass away in front of me or suffer major heart attacks that we had to kind of rescue from the brink of death. So I know how bad it can get and then you can come reverse engineer and say like, well if we had you 10 years before this, you'd never be here on our cath labbe table or we wouldn't be here in the icu. You know, wishing you had met me 10 years earlier.

Brian (4m 45s):

And what are some, you know, high level things that people can do just as far as preventative so they're not necessarily, you know, going down that path that you mentioned?

Michael (4m 53s):

Yeah, I'm a frequently joke that, you know, you don't wanna meet your cardiologist on the way to the cath lab. I mean, yes, I'm a little bit of anomaly, you know, if you have a very good primary care doctor, they can, you know, focus on some of these same things. You don't absolutely need a, a preventive cardiologist, but it's more complicated than just, you know, do you have bad cholesterol, which is a term I really dislike using cuz there's no such thing as bad cholesterol. Right. And you know, if you get to a cardiologist and you have symptoms, well you're down the pathway of they're gonna do a stress test on you. If it's abnormal, they're going for an angiogram plus minus you're gonna potentially get a cardiac stent or you know, if it's worst case scenario, they're gonna send you for bypass surgery. So you don't wanna wait until you're having symptoms. You wanna look way before that.

Michael (5m 33s):

And there's something I always focus on in my practice is looking at endothelial health. Endothelium is inner lining of your arteries. It's one cell thick. You're able to take out all your endothelium but be the surface area of six tennis courts. So it's one of your largest organs that you don't even know about. But from a cardiovascular standpoint, it's the first thing that gets damaged before the plaque starts building up. And this can happen in your teens and twenties so you have a decent amount of time to intervene before you're gonna have a problem.

Brian (5m 59s):

And what type of markers or tests could people run to sort of get on the preventative thing side of things?

Michael (6m 6s):

So I usually kinda lump it into three buckets. One is the endothelial health, second is inflammation, oxidation, and the third is the lipoproteins. So the endothelial ones you, there's not a lot of testing that you can do at home per se, but the two that you potentially could do is just your blood pressure. If you have normal blood pressure, which generally should be less than 120 millimeters over 80 millimeters of mercury, then you likely have healthy endothelial function. But if you're starting to have blood pressures in the one 40 s, one 50 systolic is a younger guy, that's a early warning sign that something's going on with the endothelium and the endothelial glycolic, which is the protective coating to the endothelium. Hmm. That thing you do at home. They're different companies that made these little test strips.

Michael (6m 47s):

So for the bureau watching videos looks kinda like limus paper. You know, you put the saliva on the strip, if it's white, you have low levels of nitric oxide, likely if it's bright red you likely have higher levels of nitric oxide, nitric oxides, the gas at the endothelium releases that helps the artery relax. So that keeps blood flow normal. But nitric oxide basically affects like a non-stick surface when there's high enough levels, the lipoproteins, which are fairing your cholesterol through the system, they don't tend to stick to the arteries and you don't start that cascade or plaque will start building up if you have healthy nitric oxide levels.

Brian (7m 22s):

Yeah. You hear nitric oxide a lot of times with like body building and even like, you know, erectile def dysfunction and things like that. What type of things could people do to help, you know, get that blood flown and, and create, you know, higher o

Michael (7m 37s):

Sure, so from the non supplement, non-pharmacological, you know, realm, you know the best one is exercise. Sure. As you, you know, increase blood flow to your muscles, the blood is going to transduce the endothelial glycolic in English, the blood's rushing down into your limb, it tickles the endothelium that tells the artery, hey, blood flow's coming, at least nitric oxide so we can accept this big volume of blood coming down to this muscle. So that is one of the best ways to boost nitric oxide levels is this, you know, routine exercise. Second one, it's uva a sunlight today, you know, it's snowing here where I'm at in St. Louis, but even today there's U V A, you know, waves that make it through the atmosphere.

Michael (8m 18s):

So when UVA wavelengths hit your skin, it will liberate nitric oxide from your blood vessels on the surface. So this is one of the reasons why your skin starts turning pink initially is cuz nitric oxide is getting released and your vasodilating the arteries. So that's a free one is sunlight on your skin. And then from a dietary standpoint, it's the dietary nitrates. Those are most commonly found in dark leafy green vegetables. Also, beads will have nitrates as well.

Brian (8m 47s):

And yeah, you mentioned sunlight. I know you've gotten just exploring your webpage, you've gotten into photo biomodulation,

Michael (8m 56s):

Correct? Yeah, mouthful.

Brian (8m 58s):

Yeah. Yeah, it's a mouthful how to practice that one. What type of applications and maybe explain people a little bit about red light and how that can apply to this.

Michael (9m 5s):

Sure. So photo biomodulation, you know, using light therapy to change your biology. So it was initially discovered in the 1960s accidentally they were trying to study cancer and rats. And when they actually were using these red ruby lasers on these rats, they were growing thicker coats of fur. And they, that was the first, you know, use case was, you know, hair re growth. But now there's, you know, hundreds of use cases for light therapy, red light therapy specifically. And you know, from a, you know, most use case it's mostly musculoskeletal. So you know, athletes will use this before they exercise. They precondition their muscles with it.

Michael (9m 45s):

It puts energy into your mitochondria, the organal in your cells that make at t p. And if you have more energy, you're able to go longer. Doesn't necessarily make you stronger, but you generally have more endurance. And then the other best use case for it is, you know, post exercise, it just helps decrease inflammation, decreases pain. And so people have decreased the delayed onset muscle soreness so they recover faster. They're able to go back and hit it hard again sooner. So a lot of the professional sports teams and Olympians are using these type of devices.

Brian (10m 16s):

Is this something you use on a daily or weekly basis?

Michael (10m 19s):

I personally use it daily now. I, I'm kind of a, you know, biohacker nerd. So I have a lot of these devices to my access. So I have, you know, portable ones. I have, you know, half size ones. I have an eight foot tall one in my office, you know, researching, you know, potentially getting a, a, you know, bed type of device. But you don't need all of these things you can get by with, you know, a two, $300 panel and you know, that works for most people. You know, so you're just kind of spot welded, whatever you're want to be treating with those type of panels.

Brian (10m 47s):

And other than, I don't even wanna say it again, other than red light for therapy, what else do you use? I I actually, I'm, I'm, I've put a infrared sauna in my basement. Is this, do you use any hot or cold therapy for yourself?

Michael (11m 2s):

Correct, yes. The, the sauna uses, you know, even in covino cardiology, they, they understand the benefits of sauna therapy has a much bigger culture in Japan and Finland obviously, but the data is pretty strong, especially on the, on the fin side. You know, there's a study that came out a couple weeks ago that showed that men who are using saunas three to four times a week for at least 20 minutes of kind of like a rolling sweat, they had upwards of 40% less heart attacks than people who did not use saunas. And there's multiple reasons why this is likely beneficial. The main ones are that it's going to help with, you know, basically it acts like exercise to the body. You're increasing your heart rate, it'll help your body produce nitric oxide.

Michael (11m 42s):

You know, you're gonna have, you know, detoxification happening. So you're gonna sweat out heavy metals and plastics you've been exposed to. It's gonna activate heat shock proteins. Those proteins go then and fix other proteins that have been damaged. And then kind of more the, you know, the quantum biology nerds, you know, it's going to improve the exclusion zone water that surrounds your cells. You know, the structured water. So the infrared light expands the exclusion zone and that exclusion zone water is another repository for energy. So it's not just about attp, it's the water in your body storing it as energy.

Brian (12m 17s):

Hmm. Yeah. So sauna, great benefits. Do you do any cold therapy? Anything with

Michael (12m 24s):

Cold? Great. So yeah, I didn't get into that part. Yeah, in two weeks I'm actually going to Finland.

Brian (12m 29s):


Michael (12m 29s):

My god. And yeah, there's access to go jump in the, the Arctic Ocean. So I'm gonna definitely partake in that. So yeah, cold therapy is beneficial even in conventional cardiology we used it targeted temperature management is what it was called. So if a patient much like that, Buffalo Bills player who had his second cardiac death event on the field, I'm not a hundred percent sure they did this to 'em, but it's likely they did. As you usually will cool patients down for the first 24 hours after they have a sudden cardiac death that slows the metabolism down, it decreases inflammation and there's been data that it helps improve neurologic function. So anybody who had an out of hospital cardiac arrest, we would either do these cooling blankets or these intravenous tubes that would put cool saline through their system and cooled them down for over a day or two and then you'd warm 'em back up and they usually did better.

Michael (13m 20s):

So there's definitely benefit in, you know, the conventional world that kinda the biohacker way to do it, you know, it's boosting dopamine, you know, it's mental toughness, you know, decreases inflammation. And again, for the kind of the quantum nerds, it helps the mitochondria by decreasing the respiratory proteins, basically shrinks 'em closer together so that you can pass electrons through them faster. So the faster you pass electrons through your mitochondria's respiratory chain, the quicker you make energy.

Brian (13m 49s):

Yeah. I've also put a coal plunge, although living in Chicago and you're in, you know, you're in Missouri so you're got cold weather as well. You could definitely just go outside right now and lay in the snow.

Michael (14m 0s):

Correct, yeah. You don't need one of these fancy plunges. Right. You know, you can just do cold water, you know, exposure in your shower bathtub, shower's actually pretty hard because of the air, you know, we have uneven distribution of the the temperature, but you know, for somebody who's just starting out Yeah. Does go outside with less clothing than you would normally put on. And then, you know, when you start getting cool, you head back inside and then you just build up your tolerance then.

Brian (14m 24s):

Now I, it sounds like you've gotten really into the biohacking side. What sort of led down that road? Is this something that you apply in your practice now for your

Michael (14m 31s):

Patients? I now, yeah, for those watch in the video I'm wearing the, the, the hallmark biohacker, you know, blue blocking glasses. So, you know, back in 2017 I was taking a long trip over to Asia, you know, one of my hobbies is kind of international travel and that was like gonna be a long trip as a 14 hour flight from St. Louis to over to Thailand. And we're actually gonna do another hop over, you know, the day after that to Bhutan, which the, the world's happiest people reside in Bhutan. And most people may not know exactly where Bhutan is located, but it's sandwich between China and India. But I knew the jet lag was gonna be pretty significant, you know, flying that far. So I knew a little bit about melatonin and some other things, but you know, to start researching, you know, well how can you help mitigate jet lag?

Michael (15m 13s):

And came upon some articles talking about these blue blocking glasses and I didn't really read the articles too much, I just bought them warm on the plane and I always looked insane on the plane. I had the hoodie on to block all the light, you know, I literally looked like the uni bomber sitting on the plane and you know, they didn't kick me off somehow. And then yeah, kind of go over to Thailand and the jet lag was present, but in my estimation was maybe about a third as bad as it should have been. And so then I had a great trip and then when I got back to the states, I just really went deep down the rabbit holes. Okay, how did that actually work? And then stumbled upon circadian biology and then you know, one thing led to another and you know, got into red light therapy and just keep stacking all the, the biohacks that I learned.

Brian (15m 50s):

Now did you say you ended up going to Bhutan?

Michael (15m 53s):

We did, yeah. It was excellent.

Brian (15m 55s):

What did you learn, like you said, the happiest place on what is the happiest place on earth?

Michael (15m 59s):

Happiest people on Earth? Yeah, now sometimes it goes back and forth. I think the fins are also pretty happy, but partly I think it's just that they're still a strong, you know, historical culture that they had there. They were, I think the last country on earth actually get television. I don't think they had television until like the mid eighties or maybe in the nineties. So it's just, you know, stepping back in time, you know, it's another worldly type of experience and yeah, you were treated like family when you got there. Yeah, I'm not Buddhist but it was a very peaceful place to be. So if you ever have access to, you know, going to Bhutan, it's definitely worth the, the hall over there.

Brian (16m 34s):

Yeah, I always thought New Yorkers were the happiest people

Michael (16m 36s):

In the world. Yeah, I'm sure

Brian (16m 40s):

I've heard you talk about grounding and yeah, look, maybe explain to the listeners a little bit about grounding. This is something I probably don't do enough. I mean granted now it's not that great to just walk outside, but I guess you could just ground by putting your hands on a tree, correct? Right. So maybe explain to people about grounding and how they can use that.

Michael (17m 1s):

Sure. So before you know, we had shoes with rubber souls. We were always pretty much connected to the earth. Yeah. Every other animal other than us is generally connected to the earth and sleeps on the earth or sleeps in the tree connected to the earth. So the earth is negatively charged. The earth has more electrons than you do. So when you're standing on the earth with, you know, bare hands, bare feet, the flow of electrons goes from higher source to lower source. So they flow into you so electrons, they help, you know, lower inflammation, they help get into your mitochondria so you can make energy out of those electrons. It will help thin your blood. It's called your sayta potential. So you want your blood to be like red wine, not so much like ketchup.

Michael (17m 42s):

When you're, you know, not connected to the earth, your blood tends to get stickier. So this helps thin the blood naturally. Yeah, it's anti-inflammatory. It helps balance your autonomic nervous system. So you have a fight or flight response, your sympathetic branch, you have your autonomic side, your parasympathetic your rest relaxation response. So when you're standing on the earth barefoot, you're activating that parasympathetic side. So many people, if they've had the experience, you know if you go to the beach and you know you got your feet in the sand, you may notice you're not really that hungry. You know, you probably eat less food those days cuz you're literally getting energy from the earth. You don't have to then eat the energy from food sources then.

Brian (18m 22s):

That's another way of saying it. I've, I'm curious, what do you do to ground? Do you believe much in these grounding mats or do you think that's a little bit,

Michael (18m 32s):

You gotta be a little bit careful with them depending on what you plug them into. Because if you don't know if your own home is grounded, then you might call some issues actually attracting non-native EMF to you. But if you know you have a grounding mat and it has a, you know, copper wire and it's out your window into the ground, not opposed to that. I don't personally do that at this point. You know, my own experiences. I was using a grounded mat a couple nights trying to sleep and had really, really weird dreams personally. And I don't usually have weird dreams, so I was like, I'm gonna stop using this. But when I'm outside, you know, I barefoot as much as I can be or I have different shoes that have copper plugs or other transducing materials or just go old school, you can wear leather sold shoes and you're still conducting through them then.

Brian (19m 13s):

Okay. And you know, just getting back to the preventative side of things, what kind of, I, I know you talk about a little bit on your YouTube channel, like you talk about four pillars of optimal health, perhaps maybe we'll touch on those. Those are great things that come up a lot on ipo. I know you mentioned stress management, H R V perhaps maybe talk about H R V a little bit and stress management and how that can be, you know, a preventative, you know, way to, to avoid having issues down the road.

Michael (19m 43s):

Sure. Thank you for bringing up. Yeah, I, I usually kinda talk about with my patients that there's four pillars of optimal health and if you ignore one of them, the stool sometimes is gonna fall over. So everybody tends to, you know, initially gravitate towards nutrition and exercise and I don't, people, you know, they're not that they're not important, but there may be number five and six down on the list, important things to talk about. So, you know, one pillar is stress management, the second other one is sleep. So the stress side of things, you know, everybody has stress, everybody has physical stress when they exercise, everybody has mental stress. But how well do you bounce back from it is really the question. You know, I, I'm, you know, in a high rise building there's a highway behind me and I usually use analogies.

Michael (20m 23s):

You know, if you get cut off in traffic on this highway, you know, everybody kinda gets pissed off initially, but are you still pissed off four hours later still talking about it? Okay, right. That's a problem. So how fast can you basically pull down that sympathetic tone and ramp up the parasympathetic tone And one things you can do to kind of measure that is your heart rate variability. So heart rate variability is, you know, the nerdy way to say it's the r r interval on an ekg, it's measured in milliseconds. So it's the distance between consecutive heartbeats and it should change as that autonomic nervous system is being stimulated. So it's kinda like your early warning sign, the more variable your heart rate variability, the better you're able to handle that stressor. So there's different devices that can measure the heart rate variability and I've tried multiple of 'em.

Michael (21m 5s):

The one thing is that they tend to rhyme, but the numbers generally are not the exact same. I've tried being the bio hacker and wearing two or three monitors at the same time and the numbers are different. They tend to rhyme. So just pick whatever device you're gonna use and look for your own baseline heart availability. And if it starts dropping 10, 20% from your baseline, then you gotta look into it. You know, are you over training, are you getting sick, you know, what else is going on that's kind of breaking your heart rate variability.

Brian (21m 30s):

And on that note, is there, cuz I've tried the whoop, I've never done like ordering are, is there a certain like wearable that you prefer that you think you'd recommend or

Michael (21m 40s):

It really depends on what the, the use case is for the person. You know, I, I had the gin one worrying that looked like a mood ring. It was ginormous. I had the gin two and then I've tried whoop for a while. I'm currently using a, a bios strap also a cardio mood from Switzerland. Kinda like the bio strap cuz it also has your pulse oxs, it does some measures of arterial elasticity, which is kind of, in my world, early warning signs are the arteri starting to get stiff, which can mean you have low nitric oxide levels. So I kinda like this bios strap right now, but the things that are important to me is that any device that you have on you personally, I think you should leave it in Bluetooth off mode or airplane mode because you don't necessarily want your mitochondria that are in your body being ping by Bluetooth repeatedly throughout the day.

Michael (22m 29s):

Especially when you're sleeping, you want your body to be able to recover. So I keep my tough in airplane mode, it's recording locally and then I download the information the next day.

Brian (22m 38s):

Got it. Yeah, I've tried the wearables, I mean I had the whoop, I think it was good for, you know, a couple weeks or a month and then I was like, okay, you know, like I, I feel like I have a pretty good feel for how my sleep was, you know, how I, you know, if I need, if I've recovered, recovered enough. And you talk about like stress management, I usually can tell if I need to like go to yoga Yeah. Or do something. You know, you can sort of tell like just by little things if little things might just slightly irritate you normally. And they normally don't. They're like, I always think to myself like, you know, I could probably either do something, maybe jump in the cold or, or do like a, you know, a an hour yoga class or something.

Michael (23m 14s):

Right. Yeah. I might think they're useful but you know, I don't want people to get like, you know, super paranoid that the results are not perfect every morning. You know, there's definitely been studies where they've taken people and blinded them to their own results and they had actually slept well. They told 'em, Hey, your sleep is horrible. And they went out and performed horribly at basketball practice and the converse, there's people who slept band that said you did great and they did great at basketball practice. So. Right. You know, I tend to use the game of like where the device and guess what the results are gonna be then look at your data and like yeah, that correlates you kind of then eventually, like you said, know when you're kind of, Hey, I didn't sleep as well as possible, or Hey Mayo, I'm getting sick and you know what the data's gonna show.

Brian (23m 52s):

Yeah, I agree with that. And what about thoughts on like, 5G and or do, do you do anything to, gosh, we're surrounded by computers and I, I, I have a few things that I've used and, and you know, I guess it's tough to tell if, if they're working or not, but you gotta sort of trust the process I guess, and trust the manufacturer. What, are there any type of, I think the one I've had, I've added to my house a little bit, it's called Aris Tech, if you've heard of that company, that brand. Okay. Are there any, anything around that that you use?

Michael (24m 25s):

I mean the, the inverse square laws the most common thing I use that's the physics term is just the further away you're from the, the radiation source, the, the, the less radiation you receive. That's what I use all the time. When I was in the cath lab, we stood away from the II to ionizing, you know, camera that was taking the pictures while we're doing our angiograms. But you know, your, your question about 5G is complicated because there's no consumer facing meters that you can use to say what is your exposure. If you're in a big city, you're being exposed and unless you're living in a lead line room, you know the 5G is getting through your walls and any of your, you know, traditional fairday type cages. So the major issue with non-native MF is that it opens up the va, the voltage gated calcium channels in your cells and calcium rushes in that causes inflammation, causes reactive oxygen species, less energy's made, you know, it's a cell danger response.

Michael (25m 18s):

So, you know, sicker people who have a lot of inflammation, a lot of oxidative stress, they probably need to be more careful with their exposure. If you're, you know, generally a healthy young guy, you know, great energy levels, great, you know, sex drive, great sleep, it's probably not affecting you as much at that point.

Brian (25m 34s):

Okay. I do have like my phone right here, it, there's something called safe sleeve. It's a nice company. They make a bunch of different, you know, covers I guess that that that you know, will block the, the 5G from the phones. So

Michael (25m 48s):

Possibly, possibly, but possibly, yeah, I mean I mostly, yeah with the phone the, the trick is, you know, talking to it when it's in like speaker mode or using an air gap headset so that, you know, it looks kinda like a stethoscope. There's an air tube and then there's like those speakers below it and then you know, my office, you know, home, everything's ethernet so try to hardwire everything. So yeah, you just have to kind of like do the big actors, you know, if you're only doing one place, just make sure the place where you're sleeping is as electrically quiet as possible. So get your gear out of your bedroom. It should be like a dark sleep ca there should not be light in there. Ideally shouldn't have your phone in there. If your phone's in there, it should be, you know, at least 12, 15 feet away from you ideally in airplane mode.

Michael (26m 30s):

But if somebody's gotta reach you, you know, keep it as far as way as possible from you, you know, I'd turn off my wifi route at night, I have it set up that just automatically shuts off. You know, before I had that feature, you know, I just had it plugged into a wall that had a red lamp and if the red lamp was on, I knew that the wifi router was on and at tutus flipped it off. But now my one automatically goes off. So just make sure that your bedroom is electrically silent so your body can fully recover.

Brian (26m 54s):

Yeah and I can't imagine nowadays you see all these people with like their, the AirPods in their, I mean in in their air the whole day. Literally. I never, yeah I never wear 'em. But it can't be good. I mean

Michael (27m 12s):

No, very unlikely that it will be good and you know, and a lot of the issues are that, you know, because they don't quote heat up, they're not like microwaves. We're gonna see immediate cell damage. But it's that low level opening up with that, the voltage gated calcium channels that's causing the problem. And if people you know wanna go fact check it, go look at the NTP study that was released by the government a couple years ago. They were using two G and 3G signals in mice and rats and it definitively caused heart sarcomas and rats and rats, you know, have more complicated option system than humans do. So if it was causing cancers in rats, it's possible that it's causing it in humans as well.

Michael (27m 55s):

They just haven't done the long-term studies for people. So it's always kinda like the precautionary principle. So if there's more likely to do harm than benefit, you probably wanna stay away from it.

Brian (28m 4s):

And that's the N P T, is that right?

Michael (28m 7s):


Brian (28m 8s):

Ntp, okay. NTP study. Okay. Okay. So we got stress management, we got sleep, which you mentioned already. You know, I like you said, cool dark space, you know, keep electric devices away. I ideally airplane mode and the other two pillars. Let's hit on those.

Michael (28m 26s):

Sure. Which one will you do first? Exercise and

Brian (28m 28s):

Nutrition. Yeah. Resistance training

Michael (28m 31s):

For sure. Yeah. Big part of what I recommend patients now, I mean, yeah first start with, you know, telling people like you know, what is your exercise time budget because you know, I'm not somebody who's a professional athlete. I'm not asking people to work out 10 hours a week. You know, you know it's what time do you have available to work out, you know? Right. Traditional medicine recommends at least 150 minutes a moderate activity that should be doable for the majority of people for the week. You don't have a super busy in the hospital, you just had to prioritize. It's like I got to the conclusion it's like if I don't take care of myself and I break down, I can't take care of these hundreds of patients that you know, you know need me. So you just have to budget the time. There's just not another way about it.

Michael (29m 11s):

But you know, first the pillar is resistance training because you have a good friend, Dr. Gabrielle Lyon, you know, she focuses on something called muscle centric medicine and you know, you age better when you have healthy muscles. Your metabolism is mainly driven by how much muscle mass you have. You know, when you're a young guy you don't put much stock into it. Yeah. You're able to put on muscle pretty easily when you're in your twenties and thirties. But once you're 40 50 it's really hard to hold onto it and it's definitely harder to gain it back if you start losing it. So you have to continually have a battle plan like how do I not lose this muscle mass that I have? And that's gonna be the resistance training, ideally at least three times a week doing whatever type of resistant training you feel comfortable doing.

Brian (29m 51s):

Yeah, I'm a big fan for sure. And what about, let's talk nutrition. I know you talk about seasonal eating and timing of meals.

Michael (29m 59s):

Sure, yeah. Nutrition is complicated and there's no perfect diet that everybody should be following. You know, it comes down to, you know, what is that person's goals? Is it weight loss, weight gain, you know, are they already insulin resistant? You know, I always start with mitochondria. Mitochondria, the organal in your cells to make energy for you. They would break down the fats that you eat. They are what break down the carbohydrates that you eat. You know, they break 'em down into electrons and then those electrons fuel the process and the mitochondria that makes a t p water, heat and carbon dioxide. So you're actually eating for the electrons that's in the food. So you inherit your mitochondria only from your mom. So the healthier your mom was and the healthier her mom was, those are basically your starting battery packs of mitochondria.

Michael (30m 45s):

You're gonna do better if they're very sick. You basically have engines that don't have good spark plugs and it doesn't matter almost how well you eat because the engines are broken. You have to focus on tuning up the engines and that's through the things we're talking about. Exercise, proper sleep, get healthy engines, then the fuel makes a bigger difference. So I always start with circadian biology. You know, eating is supposed to be done during daylight hours, that's when your body's primed to digest that information from mother nature. So I usually recommend patients eat within the first hour, the sunrise when their local environment is, and stop eating at least three hours before they're playing bedtime. After that the macronutrients we can kind of play around with.

Brian (31m 26s):

Yeah. Yeah. And, and that's, that can be a little bit difficult, especially if you're in the Midwest like you are and it gets dark at like five. But I typically tell my clients the same thing is like, you know, giving yourself three, three hours before bed to f you know, finish that last meal and

Michael (31m 46s):

You talk about circadian biology said that your liver and gut basically shut off for the night and your body starts going into repair mode. So you can do this autophagy, you're repairing the cellular, you know, process that happened during the day. You know, I usually talk about it being like about the day the dishes are getting dirty at night, you put them in the dish washer and then in the morning got cleaned dishes. Well if you don't sleep well you don't have clean dishes in the morning.

Brian (32m 8s):

Yeah. And do you have like a sleep routine or a morning routine? I'm a big, big routine guy. What type of things do do you like to do to either finish your day or start your day?

Michael (32m 17s):

I don't have as strong of an evening routine other than I'm just really good with my light hygiene. I mean Right. You know, my place is, you know, very circadian friendly. It looks like a submarine. I'm gonna have all sorts of red lights, red light panels. So like my mesis receptors are not getting pinged all night. So I generally fall asleep between nine and nine 30 pretty much naturally. So I just try to wind down the technology, you know, at least the stimulating ones an hour before bed maybe I'll watch, you know, a Netflix show or something like that for about half hour, hour before bed. But I'm not, you know, reading the news or something that's gonna kinda like get y'all pissed off and go lay down. But I have a pretty routine routine in the morning. You know, it's not super like, you know, fancy it's, you know, I'm up by 5:00 AM I go start the coffee pot, you know, basically heating up, go meditate for 20 minutes, then go make the first cup of coffee, read in the morning time right now reading some stoic philosophy.

Michael (33m 9s):

Read for about, you know, 20, 30 minutes then right now St. Louis sunrise about seven 15 in the morning. So usually outside walking by six something outside for 45 minutes or more. And then sunrise get at least 10, 15 minutes of sunlight in my eyes in the morning time to set that super cmac nucleus and then have breakfast. I'm usually very protein forward breakfast and then I'm in the office by 9:00 AM.

Brian (33m 34s):

Okay. And yeah, I love the, the starting with the morning walk, I have a couple dogs so I'm always up and out. Do you have dogs or just go out, out walking on on your own. Okay,

Michael (33m 43s):

Go, go out walking with my wife.

Brian (33m 44s):

Yeah. Okay. And is your wife into all this?

Michael (33m 48s):

She's gotten into a lot more of it. She definitely likes the, the cold morning walks with me mean just, yeah it's a mental kind of boost. So yeah, she's okay with all the red lights home cuz her sleep improved after we started doing that stuff.

Brian (33m 58s):

Yeah. And I know you've talked a little bit about caffeine. What, what are your thoughts around caffeine and, and how you can sort of utilize it?

Michael (34m 7s):

Yeah, caffeine's a, it's a complicated topic, you know, I know it's in a lot of, you know, the bodybuilder stacks and such, but from a cardiovascular standpoint it's not as simple simplistic as this, but you really wanna know are, you know, fast or slow metabolizer of the caffeine. Cause if you're a slow metabolizer of the caffeine, it's gonna stick around in your system longer and it's potentially gonna affect your sleep onset. But it's also gonna tend to raise your blood pressure, increase your heart rate and people who are slow metabolizers, they have increased cardiovascular risk by consuming that much caffeine, you know, more than a glass or two a day. So there's, you know, you can get down 23 me, you can get through some other genetic companies but there's a gene called C Y P one A two and it does other things other than caffeine, but it will tell you if you're a fast or slow metabolizer caffeine, if you're fast, you're generally gonna be able to tolerate it without really affecting your sleep.

Michael (35m 1s):

I pretty much, this isn't perfect but you sort of will know if you're a fast metabolizer because you know, when I was in college, you know, doing all nighter studying, you know you're pounding the mountain dew or whatever and it really never made me like, you know, not be able to fall asleep. And so I don't currently drink caffeine past like 9:10 AM most days. So I wouldn't bother me if I tried in the evening but, but you really wanna know if you're a faster slow metabolizer that determines if caffeine's good or bad for you.

Brian (35m 28s):

Yeah and I, I'm just, it's funny you mentioned Mountain Dew, isn't it crazy what you used to drink back in the day?

Michael (35m 34s):

I had a soda machine in my house at one point. I mean I was a, I was was an

Brian (35m 38s):

So, oh really? Wow. What about, let's talk a little bit about supplementation and are there certain supplements that you like for yourself or that you recommend?

Michael (35m 50s):

So it's kind of a broad topic and it's more based off of the individual who's sitting in front of me, but it's in the name supplement. You know, are you supplementing what is already going on in an optimal lifestyle? You know, so if somebody's already eating clean, they're already exercising appropriately, you know, they've managed the stress, they're sleeping there seven and a half, eight hours a night and then they still have deficiencies, then that's when you start talking about supplementing things. But I always do it based off of blood work and other testing. You know, again, back to the kind of three buckets, you know, from a cardiovascular standpoint, you know, do you have endothelial function that's optimized? That's mainly about nitric oxide and there's different companies that make comp supplements that can help augment nitric oxide. If you have low levels then inflammation, there's different things, you know, omega-3, curcumin, you know, those are some of the bigger ones I use to lower inflammation.

Michael (36m 37s):

And then lipoproteins sort of depends on what's going on with your arteries. If you have a lot of plaque in your arteries, you already had a heart attack, already had a stroke, you got a stent, then you got probably, you don't consider using pharmacological agents to really kind of put the fire out in their arteries of that case. So it's always individualized to the, to the person who's sitting in front of me. But you know, for the people who are gonna supplement, you know, quality does matter. You know, if you go down to your local drug store and just buy it with off the shelf, you really sometimes don't know what you're getting. You don't know how well it's gonna be absorbed. You don't know what other things might be in it, you know, if you don't wanna have, you know, drug, drug or drug supplement interactions. So you have to know, you know, from a high quality source why you're taking something and you know, for how long is this to you know, fill you back up to baseline or is this something you're gonna be taking for the rest of your life.

Brian (37m 24s):

Yeah, and I know you talked about, you know, boosting nitric oxide, you mentioned dark leafy greens, you know, did you also mentioned, what was it be be Oh yeah, be, yeah be like bee juice or beets in general,

Michael (37m 37s):

The juice is a little bit more complicated because there's probably a lot of sugar in some of the, you know, over the counter preparations And so if you have issues insulin resistance, you're probably gonna wanna avoid those type of processes. But, but it's a little bit complicated with some of the, the oral nitrates because it really comes down to do you have healthy oral bacteria, you know, one thing you wanna avoid is using the really astringent mouth washes. The washes basically nuke and kill all the good bacteria in your saliva that break down those nitrates. And then a lot of people also get stuck on the proton pump inhibitors, you know, the medicines, you know the purple pills and stuff like that, that block acid in your stomach. Well you need acid in your stomach to break down proteins, you need acid in your stomach to be able to make enzymes to make these reactions happen.

Michael (38m 19s):

So if you're pounding, you know, the acid levels down, you're probably gonna have low nitric oxide levels.

Brian (38m 25s):

Okay, that makes sense. And yeah. Got it. Is there anything else that we missed?

Michael (38m 33s):

I'd say what, you know, what testing you should consider, consider, I mean I can kinda bang 'em out real quick, but like I said earlier, if you go to a conventional cardiologist with symptoms, you know they're gonna do a 12 lead dkg and they're probably gonna do a stress test on you and if stress is abnormal you're going to the cath lab. But that's kind of late to the game. And for people who want to be more proactive and not reactive, you have to look at the endothelial function. There's different tasks that can look at that non-invasively, you know, one test is called the max pulse, you know, basically looks at are your arteries elastic like an accordion or they stiff like a big lead pipe. You have a device in that's called the endo. It basically simulates exercise and tells you how much can your arteries dilate when you stress it with exercise, the ideally your should triple, they're quadruple in size with exercise if you're under like 1.68, so your arteries only dilate six 8%, you have endothelial dysfunction and you're set up to develop plaque in your arteries.

Michael (39m 25s):

If you don't fix that. Then the next thing is looking at inflammation. There's blood markers that can do it of course, but we can look for inflammation in the artery on the side of your neck, there's a artery there called the carotid artery. You can have a task called the carotid entomo medial thickness test. It's a C I M T for short. And that will measure the flow. So it'll assess if there's any blockages in your arteries, but also measure the thickness of the entomo. The entomo layer should be normally pretty thin, you know, the thicker it is, the more inflammation is in the artery, the more likely able B particles than things that are carrying cholesterol through your blood vessels. They're taking detours and now they're getting stuck in the artery causing this inflammatory response. And then there's a test called this CT coronary calcium scan.

Michael (40m 6s):

Usually it's about a hundred dollars or so by W it's kinda like a mammogram for the heart. You know, cancer screening generally has it, right? You know, you're looking for things very early. You know, a calcium score is kind of looking at, you know, plaque in your arteries before you have your first symptom. Calcium's supposed to be in your bones, it's not supposed to be in your artery walls. So if calcium in your artery walls, you've had some break-ins and you have an issue, then you need to work with somebody who's kind of, you know, knowledgeable about this and they can do the advanced blood work and figure out, okay, what's causing the plaque in you? And then teach you how to kind of mitigate that risk.

Brian (40m 39s):

Yeah, and I mean, you know, I love what you're doing because I, I wish there were more, more health professionals that sort of get on the preventative side of things. Was that something that you thought to yourself like as you were in in the hospitals, you're like, like almost like a missing link out there for, you know, missing piece of the puzzle for people in their health is, you know, like you said, almost waiting till it's too late and not getting and being preventative and so like, you know, someone like yourself who has the experience of the of, of being in the hospital but now bringing that experience out to preventative health.

Michael (41m 13s):

Yeah, I mean it actually started when I was finishing up my cardiovascular training, you know, cardiovascular training's three years after doing three years of internal medicine after doing four years of in you know, medical school. So it's 10 years of training to be sitting where I'm at right now, plus all the 20 years of experience being a physician. So the, the third year of fellowship I was actually thinking I was gonna go be an interventional cardiologist, which means I would be in the hospital, you know, a lot more of the time, especially in the middle of the night fixing people with acute heart attacks and while it's very rewarding to save people at the end, I kinda call it like humpty dumpty medicine, like you're just picking people up, you know, and trying to get them back together. I was like, why don't we just prevent them from falling off the wall in the first place. And back to the four-legged stool, you know I got a little bit of nutrition training in my, you know, medical school and a little bit in my cardiovascular training but not a lot.

Michael (42m 2s):

And so I basically kind of stumbled upon the the paleo world and then realized that like, oh if you change up, you know, certain things and had people be glutened free, then maybe their migraines and the arthrosis improve and then one thing led to another and you know, you just are kind of just getting more curious and I think that's really where my benefit was, was like I just got curious about like if we really looked earlier we could prevent all this and while it's great that we can stop it when it happens, you know, in the middle of the night, you know, it's kind of like a never-ending process, you know? So I was like, I'm gonna have to step out of the hospital, be able to focus on this more and that's what I've been doing for the past three or four years.

Brian (42m 36s):

Yeah, that's great. And I wanted to touch on another topic that just came to me regarding nutrition. Like the myth around saturated fat and how that could be an issue for people and then also sodium. Maybe touch on both of those and and talk about, cuz I would say imagine, imagine most people are dehydrated and lack and hemp not enough sodium. And most people think that, you know, having a, having an egg yolk is bad or something like this cuz it's the saturated fat. But maybe explain that a little bit.

Michael (43m 4s):

Sure. The So I'll take sodium one first. Yeah. And you know there are people who are sodium sensitive you it's gonna raise their blood pressure, they're gonna have more edema or swelling and their extremities. So if you have, you know, bad kidneys, you have a, you know, a bad pump heart, you know you got systolic or diastolic heart failure, then you may need to be a little bit more restrictive in your sodium intake. But maybe not as tight as some of the guidelines say, but sodium will actually damage the endothelial glyco. So if you damage it like okay Alex, you start down that pathway of lower nitric oxide arteries gets stiffer, plaque starts form. So you do have to be a little bit careful. You know, you can't a lib soil all day long with no, you know, side effects.

Michael (43m 46s):

So you just have to, you know, test, don't guess or look at your arteries If your arteries are pretty healthy with it, you know, whatever sodium intake you're doing is okay. But one trick is when you look at your blood work, you know, when you see a, on a chemistry panel, your sodium level, that's not how much dietary sodium you're getting. That's just what's, you know, the electrolyte is in your blood and if your sodium levels are high on your blood test, it basically means you are dehydrated If your sodium levels are low on your blood test, it's not that you're not low on sodium, it's that you're, you know, basically over hydrated or flu fluid overloaded and it's diluting the sodium. So that's kind of the sodium side of things. And then to your other question, saturated fat, that's a great question and it is a little bit complicated, but you know, saturated fat for most people is not a major issue.

Michael (44m 30s):

Now you can sort of know, know if you have a problem by looking at some blood work and you can look at APOE genotype, your APOE genotype, you get one copy from your mom, one from your dad, the three and the three is the normal genotype. Those people tend not to have as much issue with saturated fat people have an APOE four gene, they tend to have a little bit more issues with the saturated fat. And in my office I also do a lot of advanced lipid testing. You know, Boston Heart Lab is one company I utilize, they have a, a panel called the the fatty acid balance panel. It'll actually give you how well that person's absorbing the saturated fat that they're currently getting in their diet. So I work with a lot of people who are on keto diets or carnivore diets, they come to with lipids that are sky high and if they see the traditional cardiologist or the primary care doctor, you know, the first answer is here's your statin, you know, your lipids are horrible.

Michael (45m 18s):

Where I do a little bit more deep dive and say like, well genetically you're not really, you know, predisposed to tolerating this type of diet so maybe you cut back on the saturated fat and if you wanna stay on this higher fat diet, you're probably gonna have to do more mono sat fat, you know, olive oil, academia nodes, you know, something like that. Or poly insat fat, ideally through cold water seafood. So just cut the saturated fat and you know, isy calorically change it to a different fat type and then often the lipoproteins will start to trend in the right direction. In that instance then.

Brian (45m 50s):

So it sounds like you, you use a lot with genetic testing

Michael (45m 55s):

At least, you know, puts you in terms of the right mindset. Like is this likely to, you know, be tolerated long term? You know, it's back to the kind of the conversation we had before. Like there's no perfect diet for everybody. So you know, the keto diet, you know, if you have a really bad seizure disorder, neurologist says you gotta be keto for life and that's reasonable because the benefits outweigh any risk. But if you're just doing keto cuz it's cool, you sometimes need to know what would your baseline look like before you did that diet. Because I've seen a lot of people mess themselves up with these type of diets. You know, it's not evolutionary beneficially being ketosis all the time. You evolutionary wouldn't have decided to do that. You know where we're at, you know we got four seasons, so it's a wintertime, there's not a lot of food growing where I'm at right now.

Michael (46m 38s):

So you would tend to have been more ketotic in the wintertime. You would've eaten protein and fats cuz carbohydrates don't grow in low light cycles. And then the spring and summer when the berries and the rest of the food starts coming in, you would eat more carbohydrates and you would not have been in ketosis. So that's how you gotta think about is not only do we eat time restriction during the day, but do you would eat more seasonally? It was only past couple, you know, decades that you got blueberries from Chile, you know, in January in Chicago. Like you just didn't have access to that stuff.

Brian (47m 6s):

Yeah, very true. And yeah, I mean, I've done the genetic testing and then there you can, you can sort of plug it in. I, I think I used 23 and me, and then I, I think Rhonda Patrick has a on her side where you can plug in and get sort of an interpretation of that. And I think I, I believe I was sort of a slow metabolizer of saturated fats. So that is something I've actually cut back a little bit on as well. And then I've also done like some hair mineral testing as well as far as for heavy metals and, you know, to look at, you know, minerals in general and see if there's any, you know, dehydration or if you're low in magnesium and things like that. Yeah, I had a, I had an individual on my podcast lane, oh God. Oh, Barton Scott. And upgraded formulas, I dunno if you've heard of them, but they do hair mineral testing and I, I found it fairly beneficial to learn that stuff

Michael (47m 52s):

For sure.

Brian (47m 54s):

So getting to the end, let's, we've touched on a lot of great things. What would you say, this is a question I asked most my all, mostly all my guests. If you were gonna give one tip to an individual who was looking to maybe get their body back to what it once was in their, let's just say in their fifties and sixties, what one tip would you give that individual?

Michael (48m 15s):

It's actually pretty easy and it's free. Never miss the sunrise for the rest of your days. It all starts with circadian biology. If you see that morning sun, naked eyes to the skies, you know, that's what my friend Carrie Bennett on Instagram talks about, naked eyes to the skies. That light entering your eyes in the morning time tells your brain what time of day it is. That sets off the cascade of how to make optimal hormones, optimal neurotransmitters. It sets you up for getting proper sleep at night. It helps, you know, with leptin sensitivity. So leptin is the master hormone that determines your body composition. So if you want to have optimal body composition, you need more morning sun.

Brian (48m 53s):

Love that. I like that also, because I do that every morning and even if the sun's not out, it's still beneficial.

Michael (49m 1s):

Correct. I mean, the, the sun changes and it's intensity and color throughout the day. So in the morning there's no UV light, so you're not gonna get a burn when you go outside in morning. That's mostly to help set your circadian rhythm. After, depending on your environment, 30 minutes to 60 minutes, U v A comes out, that wavelength of light, when it hits your skin, nitric oxide gets released. That helps keep your blood pressure normal. And then depending where you're at, you know, we're out of vitamin D winter in St. Louis right now. There's about a two month period in St. Louis. It doesn't matter how much, you know, skinny, exposed outside the wavelengths of light from UVB don't make it through the atmosphere. So you're not making vitamin D on your skin those months out of the year.

Michael (49m 42s):

But otherwise, even on a gray, cloudy day, you're still getting light information in your brain that tells your body what time of day it

Brian (49m 49s):

Is. Yeah. Well, this was great. Where's the best place for people to find you, Dr. Kleiman?

Michael (49m 56s):

Well, thank you for the opportunity to, to chat with your audience. It's always a pleasure talking with somebody who's kind of like a biohacker help optimizer, but if people are interested in, you know, the things that I talk about, you know, every Monday night on Instagram, 6:00 PM I do a IG live, you know, usually the first a month it's an ask me anything. And it really is, ask me anything about cardiovascular health, longevity, biohacking, and I'll answer your questions. And then the other, you know, Monday is typically it's a cardiovascular topic. Tonight I'm actually talking about how to optimize your own labs, but sometimes it's a, a red light topic or, you know, why do you, you wear these particular types of blue blocking glasses, so people are interested in that. I'm on Instagram, the name is just Dr. Twyman, d r t W Y M A n, and also my website, it's dr twyman.com.

Brian (50m 39s):

That's great that you do a, so every Monday night you do like a q and a

Michael (50m 42s):

For the most part. Yep. Yeah,

Brian (50m 44s):

The power of social media.

Michael (50m 46s):

Yeah, it's amazing. I mean, I actually call it the Matrix because, you know, I don't like this much blue light technology messing up people's sleep cycles. But I use the matrix unplug people to help them understand that there's a different way to look at your cardiovascular health. How do you optimize your mitochondria? So get on there, help them unplug, go see their sunrises.

Brian (51m 5s):

Awesome. Well, thank you again for coming on and dropping all this knowledge on us and I, I really appreciate

Michael (51m 11s):

It. You're very welcome.

Brian (51m 14s):

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 notes@briangrin.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. Michael Twyman

He focus on the prevention and early detection of heart disease. Utilizing the best of conventional medicine, integrative/functional medicine, quantum medicine, and biohacking he works to get to the root cause of your cardiovascular issues.


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