An Ounce of Prevention, MD

Dermatologist with interest in preventative health and clinical translation of longevity science. Not intended to be medical advice.

[An Ounce of Prevention, MD @AnPrevention]

@JohnGoldman You’re Benjamin Buttoning!

[An Ounce of Prevention, MD @AnPrevention]

@CharlesMBrenner bruh

[Amy Faith Ho, MD MPH @amyfaithho]

Hey @DrOz,

When you started practicing medicine in 1993, the RVU reimbursement rate was $31.60. @CMSgov is proposing that in 2027, it is $33.40.

Adjusted for inflation (+132%),
that’s a 54% cut…

No wonder you quit practicing medicine. The financials don’t make sense.

Can you tell @CMSGov…oh, wait a minute…

🤔🤨😒

[An Ounce of Prevention, MD @AnPrevention]

@inaki_delaparra @JohnGoldman Just “preordered “ - looking forward to trialing. Thanks for the rec!

[An Ounce of Prevention, MD @AnPrevention]

@Alan_Couzens Multiple labs values over the past two years, my HOMA-IR (a measure of insulin resistance) has been strongly and inversely correlated with how much movement I did the prior 48 hours. It’s ranged from significant insulin resistance (3.9) to normal/good insulin resistance (1.1)

[An Ounce of Prevention, MD @AnPrevention]

@JasonFitz1 This was a nice listen on my long run yesterday. Thank you for the great content!

[An Ounce of Prevention, MD @AnPrevention]

Super interesting- thanks for sharing! Does it surprise you that anaerobic capacity went down even though they were doing one higher intensity session per week? Does this suggest perhaps two higher intensity training sessions per week would be better, especially if in a block leading up to a race?

[An Ounce of Prevention, MD @AnPrevention]

@davidasinclair @JoinLifespan Nice paper! Will be interested to see if the Descovy story plays out. Hoping someone does an analysis on it like Bannister did for metformin.

[An Ounce of Prevention, MD @AnPrevention]

@BradStanfieldMD @Tellit007 Curious to learn the dose you take?

[An Ounce of Prevention, MD @AnPrevention]

@DocPriyamMD Frontal fibrosing alopecia

[An Ounce of Prevention, MD @AnPrevention]

@JohnGoldman The heat is brutal. Just bought a misting vest and an omius cooling headband myself for summer running - we’ll see if either becomes a part of the routine for me

[An Ounce of Prevention, MD @AnPrevention]

@DrDeepMD The recent characterization of Maria Morera’s gut health at 117 was a fascinating supportive anecdote in this direction.

[An Ounce of Prevention, MD @AnPrevention]

@Brady_H Can I wear expensive jogging clothing?

[An Ounce of Prevention, MD @AnPrevention]

@runliftrunlift Similar viewpoint here - I think dew point sometimes can be more meaningful too than temperature

[An Ounce of Prevention, MD @AnPrevention]

@DrDeepMD @TakeWeightOffMD The absolute risk of depression is an increase of 237 per 100,000 patient years.

Many, many men and women use it successfully to treat their alopecia without issue.

Please do not dismiss something that deeply impacts many patients.

[An Ounce of Prevention, MD @AnPrevention]

On point as always Alan - this echoes my personal thoughts in this topic. I’m not persuaded that running economy/skill has a longevity benefit.

I have wondered if beyond aerobic fitness, having the muscle power/stamina & mental fortitude to progressively propel forward on an inclined treadmill adds a layer of explanatory power to the “VO2max-longevity” dataset.

[An Ounce of Prevention, MD @AnPrevention]

My subjective take is there is quite a bit of individual variation in exercise induced glucose excursions including described in the article posted. Also some evidence that GLPs increase fat metabolism/reduce RER, reducing reliance on glucose excursions. I agree with your comment and wouldn’t personally intervene for exercise glucose excursions, but I think the individual variation is interesting. For me personally 0.5-1.0 mg tirzepatide weekly would blunt a glucose excursion from ~160 to ~130 at higher intensities. I suspect this phenomenon of exercise induced glucose excursions also explains some of the borderline A1c’s we see in endurance athletes.

[An Ounce of Prevention, MD @AnPrevention]

@CoffeeBlackMD Agree with you - similar leaning in favor. Aware of a 30 y/o F with normal A1c, normal FBG, but insulin in mid 20s with some excess adiposity and “low energy”. The fasting insulin helped make the case for a GLP

[An Ounce of Prevention, MD @AnPrevention]

@MichaelAlbertMD Nice write up - I personally do similar on a PCSK9i and zetia.