Episodes

EPISODE DESCRIPTION Strength is how much force you can make. Power is how fast you make it, and it fades roughly twice as fast with age. In part four of the training series, Dr. Altamash Raja and Dr. Darsh Shah explain why most of that loss isn't about muscle size, how to train power with moderate loads moved fast, and why you stop a set while the reps are still fast. They close with how to get back to sprinting without a hamstring strain. TOPICS COVERED Strength, power, speed, and rate of forc...

EPISODE DESCRIPTION Is zone 2 really the secret to longevity? In part three of the training series, Dr. Altamash Raja and Dr. Darsh Shah dig into the cardio evidence: why the biggest drop in mortality comes from going from nothing to something, how much benefit sits beyond 150 minutes a week, and what the J-curve and athlete AFib data actually show. They question the zone 2 and Norwegian 4x4 hype, test wearable VO2 max estimates, and share a single-run rule for avoiding running injuries. TOPICS...

EPISODE DESCRIPTION How many hard sets does muscle actually need, and does the weight on the bar matter? In part two of the training series, Dr. Altamash Raja and Dr. Darsh Shah work through the 2026 ACSM position stand: strength and size as two goals with two prescriptions, why effort matters more than load for growth, and how little it takes to maintain what you've built. They audit their own programs live, then make the case for building a training floor around your real constraints before ad...

Is your training week built on evidence, or on habit? In part one of a five-part series, Dr. Altamash Raja and Dr. Darsh Shah unpack the American College of Sports Medicine's 2026 resistance training position stand: what didn't consistently matter (training to failure, machines versus free weights, complex periodization) and what did, depending on the goal. They lay out four training qualities, three questions to ask before writing a program, and a realistic week for people who already train, pl...

EPISODE DESCRIPTION Should doctors be worried about AI, or should administrators? Family physician Dr. Sam Robinson left a 2,200-patient insurance panel with a 13-week waitlist to build Altaura Health, a direct primary care longevity practice outside Sacramento. He joins Drs. Raja and Shah on the four pillars he actually measures, the routine panel that caught a diagnosis nobody was looking for, and why the physicians automating their administration, not their judgment, will define the next era of private practice. TOPICS COVERED Why family medicine is the natural home for preventive care, and the four conditions longevity medicine is really aiming at Four pillars measured, not marketed: visceral fat by DEXA, VO2 max, muscle mass and strength, and extensive biomarker panels Leaving insurance: 2,200 patients down to 300, 13-week waits to same-week access, pricing, super bills, and working around HMO coverage Will AI replace doctors: the pilot analogy, Mark Cuban's argument, and why the…

EPISODE DESCRIPTION Acid reflux isn't a problem of too much acid. Gastroenterologist Dr. Badal Shah joins Drs. Raja and Shah to break down what's actually failing (the lower esophageal sphincter), how patients end up on PPIs for decades, and how to wean off without rebound. They cover the long-term risks of acid suppression, fiber as the most underrated GI intervention, SIBO vs. leaky gut, what probiotics can and can't do, and why fecal transplants cure recurrent C. diff more than 95% of the time. TOPICS COVERED From scopes to lifestyle: why a procedure-trained GI left the reactive model for post-acute care and lifestyle-first practice Reflux pathophysiology: transient LES relaxations, not excess acid; stress, sleep, obesity, and immobility as drivers PPIs: who truly needs them, rebound reflux, weaning protocols, and long-term risks (C. diff, pneumonia, fractures) Fiber and FODMAPs: the 30–35 g/day target, soluble vs. insoluble, and elimination diets done right Microbiome without the …

EPISODE DESCRIPTION If antidepressants haven't worked, is that the end of the road? Dr. Patrick "Rocky" Sullivan returns to break down transcranial magnetic stimulation — what it actually does to the brain, how it differs from ECT, and where it fits alongside ketamine and Spravato. He covers accelerated theta burst protocols, why insurance decides your session count, the gap between response and remission, and what clinics are overselling. Treatment-resistant, he argues, doesn't mean untreatable. TOPICS COVERED What TMS is doing at the level of the brain, and how it differs from ECT Why depression is likely several conditions sharing one label Standard vs. accelerated protocols — theta burst, SAINT, and the 36-session insurance ceiling Choosing between TMS, ketamine, Spravato, and ECT for a specific patient Neuromodulation for chronic pain — CRPS, fibromyalgia, and the pain-mood overlap Field critique: what clinics oversell, and what patients should ask before starting RESOURCES & LIN…

Dr. Darsh Shah and Dr. Altamash Raja catch up on hybrid athlete training, peptides, AI, red light therapy, health tech, and the balance between optimization and resilience. From HYROX prep and the rise of competitions like the Lifetime Games to recent peptide committee votes, CMS reimbursement cuts, and AI tools like Claude and ChatGPT, the conversation explores how new trends are changing fitness, medicine, and daily decision-making for both patients and doctors. They also reflect on building ...

Dr. Darsh Shah and Dr. Altamash Raja sit down with Dr. Marissa McCarthy, a board-certified physical medicine and rehabilitation physician, brain injury specialist, and residency program director for the University of South Florida PM&R program. Dr. McCarthy practices at the USF Concussion Center and the Performance Lab in Tampa, where she works with athletes, military veterans, and patients recovering from traumatic brain injury. This conversation goes far beyond the basics of concussion care. ...

Dr. Darsh Shah and Dr. Altamash Raja sit down with Dorian Greenow, founder of Keto-Mojo, for a wide-ranging conversation on ketosis, metabolic flexibility, chronic disease, and what it means to make health measurable. Dorian shares how his own experience with weight gain, depression, and discovering nutritional ketosis shaped the creation of Keto-Mojo. From the history of ketogenic diets to the difference between nutritional and therapeutic ketosis, the conversation explores food addiction, ket...

Dr. Darsh Shah and Dr. Altamash Raja sit down with Brian Devorkin, a third-year medical student at Case Western and host of BackedBriScience, for a wide-ranging conversation on fulfillment, longevity, chronic illness, and the harder questions behind choosing medicine. Brian shares how chronic fatigue and Lyme disease shaped his understanding of health, agency, and what it means to “get your life back.” From his gap year working with longevity researcher David Sinclair to the realities of medica...

In this episode, Dr. Darsh Shah and Dr. Altamash Raja explore the emerging concept of metabolic osteoarthritis and the growing evidence linking joint degeneration to obesity, insulin resistance, inflammation, and metabolic syndrome. They break down novel research on GLP-1 medications and metformin, discuss how excess adipose tissue may contribute to joint damage, and explain why treating metabolic health could become an important part of osteoarthritis care in the future. TOPICS COVERED • Is osteoarthritis a metabolic disease? • The concept of metabolic osteoarthritis (MetS-OA) • How obesity, insulin resistance, and inflammation affect joint health • GLP-1 medications, weight loss, and osteoarthritis outcomes • Metformin and the future of disease-modifying treatments • Why strength training and muscle preservation matter for joint longevity RESOURCES & LINKS MENTIONED • STEP 9 Trial – Semaglutide and Osteoarthritis (https://www.nejm.org/doi/full/10.1056/NEJMoa2403664) • Effect of Metf…

Casey Stevens is a trauma-informed therapist, speaker, and guide focused on nervous system healing, consciousness, emotional resilience, and the relationship between trauma, identity, and human potential. In this conversation, we explore high performance, vulnerability, trauma, nervous system regulation, parenting, purpose, and the hidden emotional costs of achievement. Casey shares her perspective on mysticism, somatic healing, post-traumatic growth, value systems, and why true peace comes from...

Dr. Tanuja Sharma is a board-certified family and integrative medicine physician and the Medical Director of Integrative Medicine and Arts at Tampa General Hospital. She completed her integrative medicine fellowship through the Andrew Weil Center at the University of Arizona and is leading one of the most ambitious hospital wellness overhauls in the country — from redesigning the patient menu with a Michelin-rated chef to running evidence-based mindfulness, acupuncture, and music therapy program...

Dr. Altamash Raja and Dr. Darsh Shah sit down with Amy Morin, LCSW, to discuss how to turn pressure into strength, build resilience through small wins, and navigate burnout in today’s work culture. Morin gives us simple tools and a practical approach to manage anxiety, dread, and difficult situations. We talk about significance of self-awareness, focusing on what you can control, and how using actionable strategies like a “motivation buddy,” clearer communication, and adapting to others can help...

Darsh and Altamash unpack the first major ACC/AHA lipid update since 2018, now reframed as a dyslipidemia guideline expanding beyond LDL to include triglycerides, ApoB, and lipoprotein(a). They highlight earlier prevention, the new PREVENT risk calculator, return of numeric LDL and non-HDL targets, routine Lp(a) screening, stepwise therapy beyond statins, and greater use of CAC imaging. Using a “trucks and cargo” analogy, they clarify lipid markers, review therapies from statins to PCSK9 inhibit...

We welcome back sleep expert Jade Wu to discuss practical sleep strategies for high performers, especially around travel, naps, and sleep technology. Dr. Wu suggests we may be over-relying on technology for our sleep, making the case for simplicity when it comes to sleep scores, managing jet lag, and even mattresses. Jade Wu, PhD, DBSM, is a board-certified behavioral sleep medicine psychologist, founder of Thrive Sleep Clinic, and author of Hello Sleep: The Science and Art of Overcoming Insomn...

Behavioral sleep psychologist Dr. Jade Wu returns for round three to explain why sleep is the ultimate performance enhancer — not a cost to be paid. She breaks down sleep's role in physical repair, cognitive function, and emotional regulation, and shares why both neglecting sleep and over-optimizing it backfire. Practical strategies for high performers: daytime light exposure, strength training, sensory-based wind-downs, and treating sleep like a friend — not an engineering problem. Jade Wu, Ph...

Dr. Lauren Spivack is a board-certified OB-GYN, Menopause Society Certified Practitioner, and fellowship-trained minimally invasive gynecologic surgeon. She treats patients in South Jersey and through the evidence-based telehealth platform Alloy (https://www.myalloy.com/). In this episode, we break down the Women's Health Initiative, the FDA's 2025 removal of the black box warning from estrogen products, the newly named musculoskeletal syndrome of menopause, testosterone in women, and why the fo...

In this episode, Dr. Altamash Raja and Dr. Darsh Shah break down the newly released 2025–2030 U.S. Dietary Guidelines, explore new research on exercise variety and longevity, and discuss how rapid advances in artificial intelligence are reshaping healthcare, clinical workflows, and the future of medicine. From nutrition policy controversies to BMJ research insights and real-world AI tools saving physicians time, this conversation examines how policy, science, and technology intersect with every...

Today, Dr. Priya Jaisinghani joins us to cut through the headlines. We move beyond the "cheating" narrative and explore the biology of obesity as a chronic disease. We discuss the phenomenon of "Food Noise"—the constant mental static about eating—and why silencing it is a matter of brain chemistry, not willpower. We get into the weeds of patient selection, explaining why BMI is a broken metric (especially for South Asian populations) and why being "skinny" doesn't mean you’re metabolically heal...

In Part 1, we established that psychiatry often treats a metabolic crisis as a simple chemical imbalance. Today, Dr. Matt Bernstein returns to give us the solution. This episode is a masterclass on the ketogenic diet—not for weight loss, but as a critical medical intervention for serious mental illness. We explain why a "starving brain" (insulin resistance) leads to psychiatric symptoms and how ketones serve as a clean-burning alternative fuel that bypasses broken glucose pathways. We break do...

In this episode of Medicine Redefined, Dr. Altamash Raja and Dr. Darsh Shah sit down with psychiatrist Matt Bernstein, MD to question why mental health outcomes continue to worsen despite more medications and access to care. Matt introduces metabolic psychiatry, a framework that looks beyond symptoms and diagnoses to the underlying biology of the brain — including metabolism, insulin resistance, and energy function. He explains why treating neurotransmitters alone often falls short, and how lif...

Darsh and Altamash break down why health outcomes are shaped by small, repeated choices (not occasional slip-ups). Using weight gain around the holidays as an example, they discuss how consistency and habit adherence matter more than intensity or “reset” culture. They explore how simplifying habits makes them easier to stick with, and why prioritizing maintenance during high-risk periods can prevent long-term health decline. A practical conversation on building health that actually lasts. On ...