I'm a cardiologist. After 40, stop guessing about your health. These numbers tell you whether you're building a long, vibrant life — or quietly declining without knowing it.
I run these on myself. I run them on every patient I care about. Most are cheap bloodwork. All are available now. And together, they paint a picture no standard annual physical will ever give you. Print this. Bring it to your next appointment. Your 60-year-old self will thank you.
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𝗙𝗮𝘀𝘁𝗶𝗻𝗴 𝗜𝗻𝘀𝘂𝗹𝗶𝗻
Target: below 5 μIU/mL. Ideal: 3-4.
This is the 10-year warning bell your standard panel completely misses. Your glucose and A1c can look "normal" for a decade while your pancreas is working overtime to keep them there. Fasting insulin catches insulin resistance 5-10 years before your A1c moves. By the time A1c rises, the damage is already extensive.
𝗛𝗢𝗠𝗔-𝗜𝗥
Target: below 1.0.
Calculated from fasting insulin and fasting glucose. The single best measure of insulin sensitivity. Above 1.0 and your metabolism is already under strain. Above 2.5 and you're insulin resistant — even if every other number looks fine.
𝗛𝗯𝗔𝟭𝗰
Target: below 5.4%.
Not below 5.7% — that's the threshold where medicine calls you "prediabetic." By then you've been metabolically compromised for years. Optimal is below 5.4%. Blood sugar mastery is longevity mastery.
𝗧𝗿𝗶𝗴𝗹𝘆𝗰𝗲𝗿𝗶𝗱𝗲 : 𝗛𝗗𝗟 𝗥𝗮𝘁𝗶𝗼
Target: below 2. Ideal: below 1.
Your metabolic health crystal ball. This ratio predicts insulin resistance, cardiovascular risk, and metabolic syndrome better than any single lipid number alone. A ratio above 3.5 is a red flag regardless of what your total cholesterol says.
𝗔𝗽𝗼𝗕
Target: below 80 mg/dL for moderate risk. Below 60 for high risk.
I've written about this extensively. ApoB counts every atherogenic particle hitting your artery walls. A 2024 analysis found 54% of patients had dangerous levels that standard LDL testing completely missed. If you only know your LDL, you're driving with one eye closed.
𝗟𝗽(𝗮)
Test once in your lifetime.
100% genetic. 1 in 5 Americans are elevated. Triples heart attack risk independently of everything else on this list. Diet and exercise cannot lower it. The 2026 ACC/AHA guidelines now recommend everyone be tested. Most never have been.
𝗵𝘀-𝗖𝗥𝗣
Target: below 1.0 mg/L.
You can have perfect cholesterol and inflamed arteries silently preparing to rupture. hs-CRP measures the fire behind the plaque. The JUPITER trial proved that finding and treating inflammation saves lives — even when lipids look fine. If this number is elevated, your mouth, your gut, your metabolic health, and your visceral fat are the first places to investigate.
𝗩𝗶𝘁𝗮𝗺𝗶𝗻 𝗗
Target: 50-80 ng/mL.
Not the bare minimum of 30 your doctor accepts. Suboptimal vitamin D is linked to higher inflammation, weaker immunity, increased cardiovascular events, worse mood, and poorer outcomes across nearly every disease I treat. Supplement D3 with K2 — without K2, calcium deposits in your arteries instead of your bones.
𝗧𝗲𝘀𝘁𝗼𝘀𝘁𝗲𝗿𝗼𝗻𝗲 (𝗧𝗼𝘁𝗮𝗹 + 𝗙𝗿𝗲𝗲)
Men: optimal range 600-1000+ ng/dL total.
Declining testosterone is an independent predictor of cardiovascular death in men. It's tied to insulin resistance, arterial stiffness, visceral fat accumulation, and systemic inflammation. DHEA-S drops 10-20% every decade after 30. Tracking these isn't about vanity — it's evaluating your body's systemic resilience.
𝗕𝗹𝗼𝗼𝗱 𝗣𝗿𝗲𝘀𝘀𝘂𝗿𝗲
Target: below 120/80. Aim closer to 110/70.
Every point above optimal is cumulative arterial damage. Buy a home cuff. Measure morning and evening, seated quietly for five minutes, arm at heart level. White-coat readings in the office miss what's really happening. The smartest $40 investment in cardiac self-care.
𝗩𝗢𝟮 𝗠𝗮𝘅
Men over 40: above 40 mL/kg/min. Women over 40: above 35.
Cardiorespiratory fitness is the single strongest predictor of all-cause mortality — stronger than smoking, diabetes, or heart disease as individual risk factors. A landmark study in JAMA found that extreme fitness was associated with the lowest mortality with no upper limit of benefit. You can estimate VO2 max with a timed mile, a rower test, or a wearable. Get faster every year.
𝗡𝘂𝗺𝗯𝗲𝗿 𝗼𝗳 𝗠𝗲𝗱𝗶𝗰𝗮𝘁𝗶𝗼𝗻𝘀
Target: as few as possible.
Every medication you're on should be earning its place. I just wrote about five commonly prescribed drugs that do more harm than good with long-term use. Bring your full medication list to every appointment. Ask: "Do I still need this?" Deprescribing is one of the most powerful and underused tools in medicine.
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Thirteen numbers. Most available through cheap bloodwork and simple tests. Get them once or twice a year. Here's what I want you to understand: these numbers don't just tell you where you are. They tell you where you're heading. A fasting insulin of 8 today becomes diabetes in five years. An ApoB of 120 today becomes a heart attack in ten. An hs-CRP of 3 today means your arteries are inflamed right now — regardless of how healthy you feel. The standard annual physical checks a fraction of these. It was designed to find disease that's already there. This panel finds the disease that's coming — years before it arrives.
What gets measured gets improved. Optimize with the foundation I write about every week on this platform:
Zone 2 cardio plus resistance training 3-4 times per week. High-protein whole-food nutrition. Sleep 7-9 hours — non-negotiable. Morning sunlight. Stress management. And the targeted supplements I've covered in detail — creatine, magnesium, CoQ10, D3+K2, glycine, omega-3, psyllium husk.
The breakthroughs coming in the next decade — gene editing for cholesterol, cellular reprogramming, senolytics that clear senescent "zombie" cells driving inflammation and aging, GLP-1 drugs rewriting metabolic medicine — will be most powerful for people who've already built the metabolic foundation to receive them.
The future of medicine is personalized. But it starts with knowing your numbers today. Print this list. Book the bloodwork. Own the data. Prevention isn't passive. It's the most aggressive thing you can do for the decades ahead.
Druckenmiller was asked what separates great investors from everyone else.
His answer had nothing to do with intelligence.
First: extreme passion. You cannot compete against people who love this business if you don't love it. They will outwork you, outthink you and outcompete you.
Second: competitiveness. They have to be sore losers. They have to want to win badly enough that losing is genuinely painful.
Then he got to the part most people get wrong.
"I haven't even gotten to IQ yet. Anything over 125 or 130 doesn't help you. It's largely superfluous."
Beyond a baseline, intelligence stops mattering. The edge is elsewhere.
Third: ego that gets checked at the door. You can have one but you cannot let it anchor you to a position. The market does not care what you think you know. When things happen that you didn't anticipate and they always will, you have to be able to change your mind without inventing reasons to stay.
Fourth, and the one most people never master: think against the crowd.
"If you're in the crowd, those positions are already owned by everyone. It's not easy to fight your emotions and go against the crowd, but that is a big piece of it."
Passion. Competitiveness. Humility. Independent thinking.
Just those four things, done consistently for decades.
My June public newsletter is now available:
https://t.co/q9AWNzBSmY
The issue focuses on defining and planning for the more multipolar and volatile world we have moved into.
I sat down with @JanvanEck3 to discuss on private credit, gold, bitcoin, India, and the rise of ETFs.
Jan manages $200 billion in assets and he did not hold back on explaining where he sees opportunity in the market for investors.
YouTube: https://t.co/8eCH5hGuIW
Spotify: https://t.co/JOaAnTftUn
Apple: https://t.co/pMB9RgeZVW
TIMESTAMPS:
0:00 - Intro
1:14 - Private credit market & where the opportunity is
4:26 - ETF industry growth & what most people miss
6:09 - VanEck's history & gold as a core asset class
9:42 - AI, commodities & the infrastructure buildout
12:34 - Bitcoin vs. gold — why BTC hasn't kept up
22:22 - VanEck's big bet on India
28:49 - Navigating today's macro environment
34:06 - U.S. government debt & the Social Security crisis
38:12 - Balancing economic data & sentiment
44:31 - Corporate AI adoption & the token cost problem
49:28 - When will AI make investment decisions?
56:33 - Jan's father's legacy & what guides VanEck today
INSTEAD OF WATCHING AN HOUR OF NETFLIX TONIGHT.
This 60-minute Cambridge lecture by Demis Hassabis will teach you more about the future of AI than most people will learn in the next 5 years.
Bookmark it and give it an hour, no matter what.
This guy demonstrates the ‘Tyson Push-Up.’ One of Mike Tyson’s key exercises was the hip hinge push-up, something he reportedly did up to 500 times a day to build strength and mobility in his hips.
We just published "Hash-based signatures for Bitcoin," a new analysis of post-quantum schemes by @kudinov_mikhail and myself at @blksresearch.
This paper serves as a gentle intro to hash-based schemes and explores how to optimize them specifically for application in Bitcoin. 🧵
@profplum99 made this free for all to read. It's the most important thing most of us will read all year.
Just take 5 minutes and read it now:
https://t.co/tTfx7jAJ2T
THE $7.4 TRILLION DETONATOR: AMERICA’S HIDDEN LIQUIDITY BOMB ABOUT TO OBLITERATE EVERY MARKET ASSUMPTION
The most dangerous number in financial history is hiding in plain sight.
$7.4 trillion parked in money market funds. Not in stocks. Not in real estate. Not in gold. Not in Bitcoin. In idle Treasury bills earning 5%+, waiting for a single Federal Reserve decision to unleash the largest capital reallocation event in human civilization.
This isn’t cautious investing. This is a civilizational coiled spring with a central bank trigger.
THE DETONATION PHYSICS
When the Fed cuts 150-200 basis points, MMF income collapses by $100-140 billion annually. That lost yield must hunt returns somewhere.
Each 1% MMF reallocation releases $74 billion.
10% rotation unleashes $740 billion … exceeding most nations’ GDP.
20% exodus deploys $1.48 trillion into risk assets.
The flows don’t trickle. They cascade through institutional pipes like a breaking dam.
THE HISTORICAL PATTERN NOBODY REMEMBERS
1998: $1.3T MMF → Fed cuts → Tech bubble ignites
2003: $2.1T MMF → Fed cuts → Housing mania begins
2009: $3.8T MMF → Fed cuts → Everything rallies 300%+
2025: $7.4T MMF → Fed signaling cuts → Unknown territory
Double the 2009 powder keg. But now Bitcoin exists as 24/7 institutional-grade scarcity with ETF rails.
THE FOUR HORSEMEN TRIGGERS
3-month T-Bill drops below 4.0% from 4.8%
Fed confirms sequential cuts beyond one-and-done
High-yield spreads compress below 350bps
Crypto ETF inflows sustain above $2B weekly
All four converging = detonation sequence.
THE BITCOIN MATHEMATICS
MMF pile: $7.4 trillion at 5% yields
Bitcoin supply: 21 million fixed, 96% mined
BlackRock IBIT: $100B AUM in under 10 months
If 5% rotates ($370B): Bitcoin $280-350K
If 10% rotates ($740B): Bitcoin $550-700K
If 15%+ with sovereign buying: Bitcoin $1M+
Not speculation. Thermodynamics. Finite supply meets infinite liquidity in mathematical collision.
THE MECHANISM
MMFs flow through institutional architecture:
Prime brokerages rebalancing
Pension allocation triggers hitting
Corporate treasury deployments
Sovereign wealth hunting uncorrelated returns
ETFs absorbing without selling pressure
Every pipe terminates at scarcity. Only one asset is provably finite, instantly settlable, globally accessible 24/7: Bitcoin.
THE FED’S CHOICE
Keep rates high: Recession, debt spiral
Cut aggressively: $7.4T liquidity tsunami
Bond markets price 150-200bps cuts through 2026. The choice is made. The spring releases.
THE COUNTDOWN
When 3-month yields crater from 5% to 3%, capital doesn’t deliberate. It hunts yield with systemic urgency.
Gold supply: uncertain
Real estate: illiquid
Stocks: expensive
Bonds: debasing
Bitcoin: mathematically provable 21M cap with instant global settlement.
The largest dry powder pile in history aims at civilization’s scarcest asset.
The trigger is Fed policy in motion.
The timing is bond-market priced.
The outcome is thermodynamic inevitability.
When the spring releases, price discovery enters unknown physics.
Choose accordingly.
The Oct 11 Crypto Crash — What Really Happened
TL;DR:
Roughly $60–90M of $USDe was dumped on Binance, along with $wBETH and $BNSOL, exploiting a pricing flaw that valued collateral using Binance’s own order-book data instead of external oracles.
That localized depeg triggered $500M–$1B in forced liquidations, cascaded into $19B+ globally, and earned the attackers about $192M via $1.1B in BTC/ETH shorts opened on Hyperliquid hours earlier, but minutes before Trump tariff announcement.
It wasn’t a USDe failure!! It was Binance’s design flaw, timed with macro panic (Trump’s tariffs) for cover.
What looked like chaos was actually a coordinated exploitation of Binance’s internal pricing system, amplified by a macro shock and systemic leverage.
1️⃣ The Setup
Binance’s Unified Account let traders use assets like USDe, wBETH, and BNSOL as collateral.
Instead of oracle or redemption prices, Binance valued these using its own spot market - a major vulnerability.
On Oct 6, Binance announced a fix to move to oracle-based pricing, but rollout wasn’t until Oct 14, leaving an 8-day window.
2️⃣ The Exploit
During that window, sophisticated actors manipulated Binance’s order books, dumping ~$60–90M of USDe, driving it to $0.65 on Binance only (still ~$1 elsewhere).
Because the Unified Account marked collateral to internal prices, this instantly wiped margin value and triggered $500M–$1B in forced liquidations.
Then, Trump’s 100% China tariff headline hit, magnifying panic and liquidity stress.
3️⃣ The Profit Engine
The same day, fresh wallets on Hyperliquid opened $1.1B in BTC/ETH shorts, funded by $110M USDC from Arbitrum-linked sources.
As the Binance cascade unfolded, BTC and ETH cratered, those shorts netted $192M in profit before closing out at the bottom.
Timing, precision, and funding paths all suggest coordination.
4️⃣ The Contagion
Binance liquidations dumped BTC/ETH/ALTs into thin books.
Other exchanges mirrored the collapse through cross-market bots.
Market makers hedged across venues were forced to unwind everywhere.
Result: $19B+ global liquidations, with many alts down 50–70% intraday, all triggered by <$100M of manipulated collateral.
5️⃣ Who’s at fault?
Binance: design flaw + delay in oracle rollout = root cause.
Exploiters: executed and timed the manipulation, profited via external shorts.
Ethena (USDe): not at fault - protocol stayed 1:1 collateralized, redemptions normal, peg held everywhere else.
6️⃣ Aftermath
Binance admitted “platform-related issues,” promised compensation for affected margin/futures/loan users, and rolled out minimum price floors + oracle integration.
USDe remained operational, and the incident is now a case study in how exchange-side pricing errors can trigger system-wide liquidations.
Bottom line:
A ~$90M dump on Binance and a $1.1B leveraged short elsewhere sparked a $19B bloodbath.
Not a stablecoin failure, but a masterclass in exploiting flawed collateral valuation during peak macro stress.
@TheOnlyEZ I'll let you listen to what they said in their own words👇, beginning at 2:40 for a few minutes. For example: “You folks are delving into our world...That's what *WE* do...That's what *BANKS* do...You're putting us at risk.”
https://t.co/rhvkeJGN6Z
Last week, I had the chance to catch up with one of my favorite thinkers and writers, @jsmian. If you aren't familiar with his work, I highly recommend it.
Here's the link to our conversation:
https://t.co/pfd3SMktHz
Here is the current full suite of 2x leveraged single stock ETFs from GraniteShares
$NVDL - 2x Long Nvidia
$PTIR - 2x Long Palantir
$INTW - 2x Long Intel
$AMDL - 2x Long AMD
$TSLR - 2x Long Tesla
$CONL - 2x Long Coinbase
$FBL - 2x Long Meta Platforms
$AAPB - 2x Long Apple
$AMZZ - 2x Long Amazon
$BABX - 2x Long Alibaba
$CRWL - 2x Long CrowdStrike
$DLLL - 2x Long Dell
$TSMU - 2x Long Taiwan Semi
$IONL - 2x Long IONQ
$UBRL - 2 Long Uber
$LCDL - 2x Long Lucid
$MRAL - 2x Long MARA
$MSFL - 2x Microsoft
$MSTP - 2x Long MSTR
$MULL - 2x Long Micron
$MVLL - 2x Long Marvell
$NOWL - 2x Long ServiceNow
$PDDL - 2x Long Pinduoduo
$QCML - 2x Long Qualcomm
$RDTL - 2x Long Reddit
$RVNL - 2x Long Rivian
$SMCL - 2x Long Super Micro
$UBRL - 2x Long Uber
$VRTL - 2x Long VRT
$BULX - 2x Long WeBull
$ETRL - 2x Long EToro
$SMCL - 2x Long SuperMicro
$TSL - 1.25x Long Tesla
$QCML - 2x Long Qualcom
$AVGU - 2x Long Broadcom
$NVD - 2x Short Nvidia
$TSDD - 2x Short Tesla
$CONI - 2x Short Coinbase
$MSDD - 2x Short Strategy
MacroVoices @ErikSTownsend & @PatrickCeresna welcome, @LukeGromen. They’ll discuss, gold to bitcoin to stocks. And of course no Luke Gromen interview would be complete without an update on Luke’s outlook for the U.S. Dollar. https://t.co/tzpvIWLbAx
Interview: Talking "Peace Black Swans" & Fiscal Red Bull Redirection on Palisades Gold Radio
I am pleased to rejoin Tom Bodravics on Palisades Gold Radio to explain and evaluate the Trump 2.0 Playbook.
https://t.co/rPznleNQXv