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In this episode of the Health Optimization Medicine Podcast, Dr. Scott Sherr sits down with Dr. Bryce Appelbaum to discuss the connection between vision, screen time, brain function, and nervous system regulation. Most people think of vision as eyesight, or how clearly they can see an eye chart. Dr. Appelbaum explains why vision is much broader. It involves how the brain receives information through the eyes, interprets the environment, coordinates movement, and decides how to respond. The conversation explores how prolonged screen use can narrow peripheral awareness, increase visual stress, and keep the nervous system in a more activated state. They also discuss the rise of myopia, the difference between eyesight and functional vision, and how vision performance training may support reading, learning, reaction time, spatial awareness, athletic performance, and recovery after concussion or traumatic brain injury. Join us as we delve into: Screen Time and the Nervous System: How prolonged engagement with close, two-dimensional screens can contribute to visual stress, tunnel vision, fatigue, and sympathetic activation. Central vs. Peripheral Vision: Why stress narrows visual attention and how soft gaze, panoramic viewing, and access to peripheral vision may help the nervous system move out of fight or flight. Eyesight vs. Vision: Why seeing 20/20 does not necessarily mean the eyes and brain are working together efficiently. The Eye-Brain Connection: How the brain gathers, filters, processes, and interprets visual information before directing movement or action. Brain Fog, Fatigue and Reading Difficulty: How inefficient eye coordination and focusing may contribute to headaches, tired eyes, reduced concentration, poor productivity, and avoidance of visually demanding tasks. The Myopia Epidemic: Why nearsightedness is becoming more common and how genetics, limited outdoor time, near work, poor lighting, and screen use may influence its development. Screen Breaks That Work: Why the 20-20-20 rule should be treated as the maximum interval between visual breaks for people who work on screens. The Limits of Vision Biohacks: Why palming may help relaxation, but broad claims that sunning or simple exercises can eliminate the need for glasses are not supported for everyone. This episode is for you if: You spend several hours each day working on a phone, computer, or tablet. You experience headaches, dry eyes, eye strain, blurred vision, brain fog, or fatigue after screen use. You want to understand the difference between eyesight and functional vision. You are concerned about myopia or increasing prescriptions in yourself or your children. You want practical ways to reduce visual stress during the workday. You are interested in vision training for learning, sports, productivity, concussion recovery, or healthy aging. You want to understand how vision may affect nervous system regulation, balance, spatial awareness, and cognitive performance.   You can also find this episode on… YouTube: https://youtu.be/qwtP-0gU5wU   Find more from Health Optimization Medicine and Practice (HOMeHOPe): Website: https://homehope.org/ Instagram: https://www.instagram.com/homehopeorg/ HOMeHOPe Conference 2026: https://homehope.org/homehope-conference-2026 Use PODCAST10 to get 10% OFF your purchase of the Clinical Metabolomics Module at https://homehope.org/products/clinical-metabolomics Find more from Troscriptions: Website: https://troscriptions.com/ Instagram: https://www.instagram.com/troscriptions/ Use POD10 to get 10% OFF your Troscriptions purchase at https://troscriptions.com/collections/our-products   Find more from Dr. Bryce Appelbaum: Website: https://myvisionfirst.com/ ScreenFit™: https://screenfit.com/ Instagram: https://www.instagram.com/drbryceappelbaum/ Get $200 off ScreenFit™ using code SNH at https://screenfit.com/enroll Get 10% off Digital Performance Lenses using code SNH at https://shop.myvisionfirst.com/

In this episode of the Health Optimization Medicine Podcast, Dr. Scott Sherr, Dr. Allen Bookatz, and Jodi Duval explore the glymphatic system and the role sleep plays in clearing metabolic waste from the brain. Getting eight hours of sleep does not necessarily mean getting eight hours of effective brain clearance. The team looks at how the autonomic nervous system, norepinephrine, cerebrospinal fluid and interstitial fluid exchange, aquaporin-4 channels, circadian timing, body temperature, gut barrier integrity, and even anxiety around wearable sleep scores may influence the conditions needed for healthy glymphatic flow. The discussion also introduces a practical HOMeHOPe glymphatic optimization protocol focused on creating the chronobiological, bioenergetic, and environmental conditions that support natural overnight brain clearance. Join us as we delve into: How the Glymphatic System Works: How cerebrospinal fluid moves through perivascular spaces, exchanges with interstitial fluid, and helps remove metabolic waste including beta-amyloid, tau, and cellular metabolites.  Circadian Biology, NAMPT and NAD+: How CLOCK and BMAL1 influence NAMPT and the NAD+ salvage pathway, and why disrupted circadian rhythms can affect cellular maintenance. The Autonomic Nervous System: How elevated sympathetic tone and nighttime norepinephrine can interfere with the conditions required for glymphatic flow. Circadian Biology and Brain Health: Why light timing, cortisol rhythms, and autonomic balance matter for creating the right conditions for overnight clearance. The HOMeHOPe Glymphatic Optimization Protocol: Practical strategies involving morning light, evening light reduction, bedroom temperature, sleeping position, autonomic safety, and gut barrier support. The Role of Sleep Hygiene: Why the environment and signals surrounding sleep may matter just as much as the number of hours spent in bed. The Skeptical Position: The team examines the conventional neurology argument that slow-wave sleep architecture, aging, and aquaporin-4 changes may limit how much glymphatic function can be influenced through lifestyle. Precision vs. Generic Sleep Advice: Why HOMeHOPe emphasizes measurement, metabolomics, circadian markers, and individualized guidance rather than simply telling someone to "get more sleep." This episode is for you if: You get enough hours of sleep but still wake up with brain fog or fatigue. You want to understand how the glymphatic system supports brain health during sleep. You are interested in the relationship between sleep hygiene, circadian biology, and brain clearance. You use a wearable to track sleep and want to understand the potential downside of becoming overly focused on sleep scores. You are interested in practical, non-pharmaceutical approaches to supporting healthy brain function and sleep.   You can also find this episode on… YouTube: https://youtu.be/kLFUm2Ik2s4    Find more from Health Optimization Medicine and Practice (HOMeHOPe): Website: https://homehope.org/ Instagram: https://www.instagram.com/homehopeorg/ HOMeHOPe Conference 2026: https://homehope.org/homehope-conference-2026 Use PODCAST10 to get 10% OFF your purchase of the Clinical Metabolomics Module at https://homehope.org/products/clinical-metabolomics Find more from Troscriptions: Website: https://troscriptions.com/ Instagram: https://www.instagram.com/troscriptions/ Use POD10 to get 10% OFF your Troscriptions purchase at https://troscriptions.com/collections/our-products

In this episode of the Health Optimization Medicine Podcast, Dr. Scott Sherr, Jodi Duval, and Dr. Allen Bookatz explore what happens inside the cell when the body perceives stress or danger. The discussion focuses on Dr. Robert Naviaux's Cell Danger Response and how mitochondria can alter energy production and signaling in response to perceived threats. The team examines why fatigue, brain fog, inflammation, and exercise intolerance can occur even when standard laboratory testing appears normal, and how the different phases of the cellular response are meant to move from defense through repair and recovery. Join us as we delve into: Stress at the Cellular Level: How mitochondria and cells respond when they perceive danger from infection, toxins, injury, environmental exposures, or psychological stress. Why Normal Labs May Not Explain Fatigue: Why standard testing may not capture changes in cellular signaling, mitochondrial output, or a cell's metabolic state. The Three Phases of the Cell Danger Response: How CDR1 involves inflammatory defense, CDR2 involves proliferation and rebuilding, and CDR3 involves differentiation and recovery. Stress, Mitochondria and Energy: Why cells may reduce energy output while continuing to interpret their environment as unsafe. Hormesis and Stress Dosing: Why exercise, temperature exposure, and other acute stressors may be useful when properly dosed, while excessive stress may add to the existing burden. Mitochondrial Nutrient Support: The role discussed for CoQ10, PQQ, magnesium, and NAD+ precursors in supporting the metabolic machinery during the transition through the CDR phases. Parasympathetic Safety Signaling: How extended-exhale breathing, HRV biofeedback, vagal tone work, and other approaches are discussed as ways to reduce chronic sympathetic input. The Limits of the Framework: Why deliberately adding stress to an already overloaded system may be counterproductive when the dose is not appropriate. Disease Management vs. Health Optimization: Why the HOMeHOPe approach looks not only at the trigger but also at the conditions the cell may need to complete its response. This episode is for you if: You experience fatigue, brain fog, or exercise intolerance despite relatively normal standard laboratory results. You want to understand the Cell Danger Response and its proposed role in cellular stress. You are interested in mitochondrial function, cellular energy, inflammation, and purinergic signaling. You want to understand why more exercise, stimulation, or stress is not always the right answer. You are interested in hormesis, autonomic regulation, gut health, circadian biology, and metabolomic testing. You want to understand how Health Optimization Medicine approaches cellular stress and recovery. You can also find this episode on… YouTube: https://youtu.be/0Vx79yABA9k  Find more from Health Optimization Medicine and Practice (HOMeHOPe): Website: https://homehope.org/ Instagram: https://www.instagram.com/homehopeorg/ HOMeHOPe Conference 2026: https://homehope.org/homehope-conference-2026 Use PODCAST10 to get 10% OFF your purchase of the Clinical Metabolomics Module at https://homehope.org/products/clinical-metabolomics Find more from Troscriptions: Website: https://troscriptions.com/ Instagram: https://www.instagram.com/troscriptions/ Use POD10 to get 10% OFF your Troscriptions purchase at https://troscriptions.com/collections/our-products

In this episode of the Health Optimization Medicine Podcast, Dr. Ted Achacoso, Dr. Jup Kuipers, Boomer Anderson, Dr. Allen Bookatz, and Dr. Scott Sherr explore a difficult question: can we influence the biology of an aging brain carrying APOE4 risk? APOE4 is not simply a diagnosis, and a genetic result does not tell us what is happening in someone's brain today. The team looks at how APOE4 may affect lipid transport, microglial behavior, vascular integrity, glucose utilization, mitochondrial function, circadian biology, and epigenetic maintenance. The discussion also lays out a practical three-phase framework: establish the phenotype, reduce ongoing stressors, restore circadian and bioenergetic alignment, and track whether cognitive, functional, metabolic, vascular, and biological age measures actually improve over time. Join us as we delve into: APOE4 Risk vs Diagnosis: What one versus two APOE4 copies may mean, and why genotype is not the same as the current clinical stage. Cellular Energy and Epigenetic Maintenance: Why disrupted energy metabolism can affect the conditions needed for normal transcription and epigenetic maintenance. Circadian Biology, NAMPT and NAD+: How CLOCK and BMAL1 influence NAMPT and the NAD+ salvage pathway, and why disrupted circadian rhythms can affect cellular maintenance. Health Optimization Medicine vs Disease-Centered Prevention: Why the HOMe approach focuses on the cellular environment and the conditions that create and sustain health. The Three-Phase Clinical Framework: How to establish a baseline phenotype, reduce exposomic stressors, restore circadian and bioenergetic alignment, and track outcomes over time. The Skeptical Position: The team considers the argument that APOE4-driven pathology may be too genetically determined for lifestyle and metabolic tuning to meaningfully change the trajectory. What Does a "Reset" Actually Mean?: Why a reset is a claim that needs to be demonstrated through durable improvements in cognition, function, and biomarkers over time. This episode is for you if: You have undergone genetic testing and want to better understand what an APOE4 result does and does not tell you. You are interested in the relationship between APOE4, brain aging, metabolism, vascular health, and mitochondrial function. You want to understand how circadian biology, NAD+ salvage, and epigenetic maintenance may intersect with brain health. You are interested in a measurement-based Health Optimization Medicine approach to genetic risk. You want to understand why phenotype, longitudinal tracking, and objective biomarkers matter when evaluating interventions. You can also find this episode on… YouTube: https://youtu.be/byEspMGRbtI Find more from Health Optimization Medicine and Practice (HOMeHOPe): Website: https://homehope.org/ Instagram: https://www.instagram.com/homehopeorg/ HOMeHOPe Conference 2026: https://homehope.org/homehope-conference-2026 Use PODCAST10 to get 10% OFF your purchase of the Clinical Metabolomics Module at https://homehope.org/products/clinical-metabolomics Find more from Troscriptions: Website: https://troscriptions.com/ Instagram: https://www.instagram.com/troscriptions/ Use POD10 to get 10% OFF your Troscriptions purchase at https://troscriptions.com/collections/our-products

In this episode of the Health Optimization Medicine Podcast, Dr. Ted Achacoso, Dr. Scott Sherr, Dr. Allen Bookatz, and Jodi Duval sit down to discuss what happens when the body's cellular defense systems remain activated after the original threat has passed. Fatigue and brain fog are often treated as problems that require more stimulation, more exercise, or more supplements. But what if low energy is sometimes an adaptive response? The HOMeHOPe faculty explores the Cell Danger Response, how mitochondria and purinergic signaling respond to threats, and why pushing harder can sometimes work against recovery. The discussion also introduces a practical three-phase approach to moving from persistent cellular defense toward greater metabolic and bioenergetic flexibility.  Join us as we delve into: Why Cells Get Stuck in Survival Mode: How infection, toxin exposure, tissue injury, and other stressors can shift cellular priorities toward defense, and what happens when those signals persist after the original crisis. The Cell Danger Response: How mitochondrial function, ATP signaling, inflammation, and purinergic pathways can change during cellular stress. Why More Energy May Not Be the Answer: Why fatigue can sometimes represent an adaptive biological response rather than simply a deficiency that can be corrected with more stimulants or supplements. ATP Has Two Different Messages: How intracellular ATP supports cellular work while extracellular ATP can act as a danger signal through purinergic receptors. The Three Phases of Recovery: How exposomic unburdening, assessment of intracellular and metabolic function, and reinforcement of cellular safety can provide a framework for recovery. Measure, Don't Guess: Why organic acids, acylcarnitines, redox markers, amino acids, micronutrient patterns, and membrane lipids can help identify metabolic constraints and guide targeted interventions. Circadian and Autonomic Regulation: Why morning light, sleep, appropriately graded activity, autonomic regulation, and circadian timing are part of restoring biological capacity. The Limits of the Cell Danger Response Model: Where the evidence is mechanistic or emerging, why the framework should not be used to explain every chronic symptom, and why stronger clinical evidence is still needed. This episode is for you if: You work shifts, overnight schedules, or other situations where acute sleep deprivation is sometimes unavoidable. You want to understand how sleep loss affects brain energy metabolism and cognitive performance. You are interested in the relationship between creatine, phosphocreatine, ATP, and brain function. You want to understand the potential and limitations of using creatine during acute cognitive stress. You are interested in cellular bioenergetics and the Health Optimization Medicine approach to precision health. You can also find this episode on… YouTube: https://youtu.be/0mn-8B6K0bU Find more from Health Optimization Medicine and Practice (HOMeHOPe): Website: https://homehope.org/ Instagram: https://www.instagram.com/homehopeorg/ HOMeHOPe Conference 2026: https://homehope.org/homehope-conference-2026 Use PODCAST10 to get 10% OFF your purchase of the Clinical Metabolomics Module at https://homehope.org/products/clinical-metabolomics Find more from Troscriptions: Website: https://troscriptions.com/ Instagram: https://www.instagram.com/troscriptions/ Use POD10 to get 10% OFF your Troscriptions purchase at https://troscriptions.com/collections/our-products

In this episode of the Health Optimization Medicine Podcast, Boomer Anderson, Dr. Allen Bookatz, Dr. Ted Achacoso, and Dr. Jup Kuipers explore a misunderstood cause of chronic fatigue and leaky gut: the bioenergetic failure of your colonocytes. While many practitioners throw random probiotic strains and anti-inflammatory herbs at gut issues, metabolomic research shows this approach fails to address the root problem. The team explains how a starved microbiome forces gut cells to switch energy systems, leaking oxygen into the colon, destroying strict anaerobes, and allowing endotoxins to flood the bloodstream and drain your cellular vitality. From holobiont metabolomics to targeted mucosal protocols, this discussion reframes gut health through the lens of mitochondrial beta oxidation rather than simply managing inflammation.  Join us as we delve into: The Gut Hypoxia Trap: How starved colonocytes switch to anaerobic glycolysis and leak oxygen into the gut, killing off the strict anaerobes that make butyrate. The Endotoxemia Dilemma: How opportunistic bacteria pry apart tight junctions, allowing lipopolysaccharides (LPS) into the bloodstream and locking your cells into a permanent Cell Danger Response. Why Probiotics Fall Short: Why conventional protocols fail to repair the mucosal shield and how to properly signal Akkermansia muciniphila with complex polyphenols. The 4-Step Clinical Protocol: How to use stool metabolomics, pomegranate ellagitannins, oral tributyrin, and L-glutamine to rebuild the gut barrier from the ground up. Pathogenesis vs Salutogenesis: Why Health Optimization Medicine focuses on restoring root cause physiological health rather than perpetually suppressing symptoms. This episode is for you if: You are dealing with chronic fatigue, brain fog, and unyielding food intolerances despite taking probiotics. You want to understand the true biochemical mechanism behind leaky gut and systemic endotoxemia. You are a practitioner looking to replace guesswork with objective metabolomic testing and precision mucosal protocols. You can also find this episode on… YouTube: https://www.youtube.com/watch?v=_wZH8tJTFWw&feature=youtu.be Find more from Health Optimization Medicine and Practice (HOMeHOPe): Website: https://homehope.org/ Instagram: https://www.instagram.com/homehopeorg/ HOMeHOPe Conference 2026: https://homehope.org/homehope-conference-2026 Use PODCAST10 to get 10% OFF your purchase of the Clinical Metabolomics Module at https://homehope.org/products/clinical-metabolomics Find more from Troscriptions: Website: https://troscriptions.com/ Instagram: https://www.instagram.com/troscriptions/ Use POD10 to get 10% OFF your Troscriptions purchase at https://troscriptions.com/collections/our-products

In this episode of the Health Optimization Medicine Podcast, Dr. Scott Sherr, Dr. Ted Achacoso, Dr. Allen Bookatz, and Dr. Jup Kuipers explore how acute sleep deprivation affects brain energy metabolism and whether creatine monohydrate can help preserve cognitive function when sleep loss is unavoidable. Rather than relying on stimulants like caffeine or modafinil to push through fatigue, the team examines whether directly supporting the brain's phosphocreatine and ATP systems can maintain cellular energy and cognitive performance during acute sleep deprivation. The discussion looks at recent research on single-dose creatine, brain bioenergetics, blood-brain barrier transport, clinical dosing, and the limits of using creatine as an acute rescue tool.  Join us as we delve into: Sleep Deprivation as a Bioenergetic Crisis: Why acute sleep loss is more than simply feeling tired, and how depletion of phosphocreatine and ATP can affect executive function and cognitive performance. The Creatine Rescue Effect: What a 2026 randomized crossover study found when healthy participants received a single dose of creatine after prolonged sleep deprivation. Creatine, ATP & the Brain: How creatine acts through the creatine kinase system to help maintain high-energy phosphates during acute metabolic stress. The Blood-Brain Barrier Under Stress: Why sleep deprivation may change the conditions for creatine transport into the brain and create a window for acute supplementation. The Clinical Protocol: What the episode discusses regarding single-dose creatine monohydrate, timing before an acute cognitive stress period, hydration, magnesium, and other cofactors. Creatine Is Not a Substitute for Sleep: Why acute creatine rescue may help preserve cellular function during unavoidable sleep loss, but cannot replace the restorative functions of deep sleep and REM sleep. Health Optimization vs. Disease Prevention: Why HOMeHOPe approaches acute physiological stress by supporting cellular function before the system reaches a state of failure. This episode is for you if: You work shifts, overnight schedules, or other situations where acute sleep deprivation is sometimes unavoidable. You want to understand how sleep loss affects brain energy metabolism and cognitive performance. You are interested in the relationship between creatine, phosphocreatine, ATP, and brain function. You want to understand the potential and limitations of using creatine during acute cognitive stress. You are interested in cellular bioenergetics and the Health Optimization Medicine approach to precision health. You can also find this episode on… YouTube: https://youtu.be/LvEBMroaLA4 Find more from Health Optimization Medicine and Practice (HOMeHOPe): Website: https://homehope.org/ Instagram: https://www.instagram.com/homehopeorg/ HOMeHOPe Conference 2026: https://homehope.org/homehope-conference-2026 Use PODCAST10 to get 10% OFF your purchase of the Clinical Metabolomics Module at https://homehope.org/products/clinical-metabolomics Find more from Troscriptions: Website: https://troscriptions.com/ Instagram: https://www.instagram.com/troscriptions/ Use POD10 to get 10% OFF your Troscriptions purchase at https://troscriptions.com/collections/our-products

In this episode of the Health Optimization Medicine Podcast, Dr. Scott Sherr, Dr. Ted Achacoso, Dr. Allen Bookatz, and Jodi Duval explore one of the most overlooked causes of declining cellular energy: the structural breakdown of the mitochondrial membrane. While many people invest in premium longevity supplements like NAD+, NMN, and CoQ10 to improve energy production, emerging research suggests these compounds cannot overcome a damaged mitochondrial membrane. The team explains how age-related phosphatidylcholine depletion weakens the mitochondrial lipid bilayer, causing proton leakage, oxidative stress, and reduced ATP production, even when the biochemical machinery appears intact. From membrane lipidomics and clinical metabolomics to phosphatidylcholine replacement and methylation support, this discussion reframes mitochondrial health through the lens of structural integrity rather than simply adding more fuel. Join us as we delve into: The Leaky Mitochondria Problem: Why declining phosphatidylcholine causes proton leaks that reduce ATP production and accelerate mitochondrial aging. Why NAD+, NMN & CoQ10 Sometimes Fail: How expensive mitochondrial supplements cannot restore energy when the mitochondrial membrane itself has become structurally compromised. Pathogenesis vs. Salutogenesis: Why Health Optimization Medicine focuses on building the biology of health instead of simply preventing disease. Clinical Metabolomics & Membrane Lipidomics: How measuring functional biomarkers provides deeper insight into cellular health than conventional blood tests alone. Phosphatidylcholine Replacement Therapy: Why rebuilding mitochondrial membranes with pharmaceutical-grade phosphatidylcholine, methyl donors, and chronobiology may improve bioenergetics. The Prevention Paradigm Shift: Why optimizing membrane integrity may become a foundational strategy for supporting healthy aging and cellular resilience. This episode is for you if: You are taking NAD+, NMN, CoQ10, or other mitochondrial supplements but still struggle with fatigue or poor recovery. You want to understand why mitochondrial membrane health may be more important than simply increasing energy substrates. You are interested in clinical metabolomics, membrane lipidomics, and the future of precision lifestyle medicine. You want to learn how phosphatidylcholine and methylation support contribute to healthy mitochondrial function. You can also find this episode on… YouTube: Find more from Health Optimization Medicine and Practice (HOMeHOPe): Website: https://homehope.org/ Instagram: https://www.instagram.com/homehopeorg/ HOMeHOPe Conference 2026: https://homehope.org/homehope-conference-2026 Use PODCAST10 to get 10% OFF your purchase of the Clinical Metabolomics Module at https://homehope.org/products/clinical-metabolomics Find more from Troscriptions: Website: https://troscriptions.com/ Instagram: https://www.instagram.com/troscriptions/ Use POD10 to get 10% OFF your Troscriptions purchase at https://troscriptions.com/collections/our-products

In this episode of the Health Optimization Medicine Podcast, Dr. Scott Sherr sits down with Dr. Dominic D'Agostino, the premier researcher in ketogenic metabolic therapies. Moving past the mainstream fads of keto ice cream and internet trends, they break down how exogenous ketones actually impact cellular energy, cardiovascular health, and environmental stress. From the liver toxicity associated with certain high-dose ketone esters to the hidden vasodilatory superpowers of L-BHB, this discussion separates the biohacking hype from the physiological reality of ketone supplementation. Join us as we delve into: Fad vs. Science: Why serious researchers use the term Ketone Metabolic Therapy instead of Ketogenic Diet, and why peer-reviewed science is growing exponentially despite Google trends. The Metformin VO2 Max Penalty: Exploring recent data showing metformin can blunt VO2 max adaptations to exercise by 50% and acts as a weak mitochondrial toxin. Mitochondrial Hydraulic Efficiency: How ketones physically tighten electron flow in the mitochondria, reducing superoxide (ROS) production and enhancing endogenous antioxidant capacity. The Danger of 1,3-Butanediol: Why relying on high doses of certain ketone esters and diols can trigger dizziness, liver abnormalities, and dependence, and how to formulate them safely. The L-BHB Advantage: Why the lesser-known L-enantiomer of BHB acts as a potent vasodilator, significantly increasing cardiac output and brain blood flow through adenosine signaling. Performance vs. Recovery: Why exogenous ketones might underwhelm a healthy athlete looking for a power boost, but shine in extreme stress environments like hypoxia, hyperoxia, and recovery. This episode is for you if: You want to know the difference between a nutritional ketogenic diet and simply taking exogenous ketone supplements. You are concerned about the side effects, liver stress, and acidic load of pushing your blood ketone levels too high. You are interested in the synergistic effects of Hyperbaric Oxygen Therapy (HBOT) combined with ketone therapies for traumatic brain injury and mitigating oxygen toxicity. You can also find this episode on… YouTube: https://youtu.be/sU-ZNinqqgg Find more from Dr. Dominic D'Agostino: Website: https://ketonutrition.org/ Metabolic Health Initiative: https://www.metabolicinitiative.com/ Instagram: https://www.instagram.com/dominic.dagostino.kt/ LinkedIn: https://www.linkedin.com/in/dominic-d-agostino-156014b/ Find more from Health Optimization Medicine and Practice (HOMeHOPe): Website: https://homehope.org/ Instagram: https://www.instagram.com/homehopeorg/ HOMeHOPe Conference 2026: https://homehope.org/homehope-conference-2026 Use PODCAST10 to get 10% OFF your purchase of the Clinical Metabolomics Module at https://homehope.org/products/clinical-metabolomics Find more from Troscriptions: Website: https://troscriptions.com/ Instagram: https://www.instagram.com/troscriptions/ Use POD10 to get 10% OFF your Troscriptions purchase at https://troscriptions.com/collections/our-products

In this episode of the Health Optimization Medicine Podcast, Dr. Ted Achacoso, Dr. Scott Sherr, Dr. Allen Bookatz, Jodi Duval, and Dr. Jup Kuipers take a deep dive into the shocking new 21-year pre-diabetes follow-up study (DPPOS) published in the Journal of the American Medical Association on June 15, 2026. Moving past the mainstream longevity hype surrounding Metformin as an anti-aging cure-all, the faculty breaks down why chemically poisoning your enzymes is a profound mismatch for healthy, active individuals. From the bioenergetics of exercise to the clinical application of precision metabolomics, this roundtable shifts the conversation from off-label drug prescriptions to cultivating true cellular safety and mitochondrial hormesis. Join us as we delve into: The Metformin Illusion: The long-term results of the DPPOS study proving Metformin completely failed to outperform a placebo for reducing multimorbidity risk, while intensive lifestyle intervention reduced multiple chronic disease risks by over 20%. Mitochondrial Blockade: How Metformin's inhibition of Complex I of the electron transport chain chemically throttles your cells, cutting cardiovascular fitness gains (VO2 max improvements) in half compared to exercise alone. The mTOR Obstacle: Why daily off-label Metformin use actively blunts muscle hypertrophy and strength gains in response to resistance training by blocking key adaptation pathways. The Rating of Perceived Exertion (RPE) Spike: How chemically throttling your mitochondria drives up lactic acid, leaving active biohackers with nagging, unexplained fatigue during workouts. Pathogenesis vs. Salutogenesis: Why functional and preventive medicine remain trapped in disease-centered thinking, and how Health Optimization Medicine shifts the focus to detecting and correcting cellular imbalances. The 3-Phase Metformin Transition Protocol: A step-by-step clinical sequence using early morning circadian anchors, urinary organic acid testing, targeted orthomolecular cofactors, and pulsed phytoceuticals strictly on rest days. This episode is for you if: You are currently taking Metformin or berberine off-label for anti-aging but feel like your gym gains and recovery have plateaued. You want to understand the exact biochemical mechanisms of how daily chemical inhibitors block the cellular stress signals required for exercise adaptations. You want to learn how to transition off chronic metabolic blockades and restore biological peak quality of life naturally. You can also find this episode on… YouTube: https://youtu.be/v1e132gqY_k Find more from Health Optimization Medicine and Practice (HOMeHOPe): Website: https://homehope.org/ Instagram: https://www.instagram.com/homehopeorg/ HOMeHOPe Conference 2026: https://homehope.org/homehope-conference-2026 Use PODCAST10 to get 10% OFF your purchase of the Clinical Metabolomics Module at https://homehope.org/products/clinical-metabolomics Find more from Troscriptions: Website: https://troscriptions.com/ Instagram: https://www.instagram.com/troscriptions/ Use POD10 to get 10% OFF your Troscriptions purchase at https://troscriptions.com/collections/our-products

In this episode of the Health Optimization Medicine Podcast, Dr. Ted Achacoso, Dr. Scott Sherr, Dr. Allen Bookatz, Dr. Jup Kuipers, and Jodi Duval take a deep dive into the gut-brain-microbiota axis. Moving past the simplistic, pathogenic "pill-for-an-ill" approach of conventional psychiatry and the mainstream hype around over-the-counter probiotics, the faculty breaks down why establishing enteric safety must always precede biochemical optimization. Join us as we delve into: The Tripartite Axis: How the enteric microbiota, gut barrier, and central nervous system communicate at a molecular and metabolomic level to dictate brain state and mood. Epigenetic Signaling: How gut microbes act as active metabolic factories, fermenting dietary fibers into short-chain fatty acids (SCFAs) like butyrate that cross the blood-brain barrier to upregulate BDNF and support synaptic plasticity. The IDO Serotonin Hijack: How gut-driven inflammation activates indolamine 2,3-dioxygenase (IDO), shunting tryptophan down the kynurenine pathway to produce neurotoxic quinolinic acid instead of serotonin and melatonin. The Microglial Fire: How circulating cytokines cross the blood-brain barrier at the circumventricular organs, placing the brain's microglia into an active defense state that triggers cognitive fatigue and brain fog. The 3-Phase Gut-Brain Protocol: Why seeding probiotics into inflamed soil fails, and how to logically sequence clearing overgrowth, rebuilding mucosal integrity with L-glutamine, and seeding validated strains. This episode is for you if: You are running on high-dose over-the-counter probiotics for mood issues but feeling no relief or worsening symptoms. You want to understand the exact cellular and biochemical mechanisms connecting leaky gut to leaky brain and psychiatric distress. You want a practical, clinically sequenced blueprint to restore gut barrier safety before attempting to optimize your neurochemistry. You can also find this episode on… YouTube: https://youtu.be/AX-Mt1crayc  Find more from Health Optimization Medicine and Practice (HOMeHOPe): Website: https://homehope.org/ Instagram: https://www.instagram.com/homehopeorg/ HOMeHOPe Conference 2026: https://homehope.org/homehope-conference-2026 Use PODCAST10 to get 10% OFF your purchase of the Clinical Metabolomics Module at https://homehope.org/products/clinical-metabolomics Find more from Troscriptions: Website: https://troscriptions.com/ Instagram: https://www.instagram.com/troscriptions/ Use POD10 to get 10% OFF your Troscriptions purchase at https://troscriptions.com/collections/our-products

In this episode of the Health Optimization Medicine Podcast, Dr. Allen Bookatz, Dr. Ted Achacoso, and Jodi Duval tackle the widespread trend of supplement fatigue. As biohacking becomes a mindset of treating symptoms with heavy stimulants and endless pills, the faculty breaks down why forcing adaptation on an exhausted system only drives the body deeper into a chronic state of inflammatory defense. From the biophysics of the Cell Danger Response (CDR1) to practical parasympathetic upregulation, this roundtable shifts the focus from treating disease to establishing true autonomic safety. Join us as we delve into: The Cell Danger Response (CDR1): How a sympathetic fight-or-flight state physically stiffens cell membranes and halts aerobic respiration. The Vagal Superhighway: How sympathetic dominance halts gut motility, triggers dysbiosis, and blocks neurotransmitter synthesis. The Autonomic Safety Protocol: The critical importance of chronobiology, early morning sunlight, and circadian anchors. Vagal Upregulation & GABA Support: Utilizing transcutaneous auricular vagus stimulation (taVNS), L-theanine, and Kava to quiet the central alarm and exit CDR1. The Myth of Extreme Hormesis: Why intense stressors like ice baths and strict fasts act as active threats, not adaptation triggers, when your cells are already depleted. This episode is for you if: You are running on a continuous cycle of intense workouts, strict fasts, and multiple wearables, yet feel more exhausted. You want to understand why your cells cannot use nutrients for energy production when they perceive an active attack. You want to learn how to pulse carefully calibrated hermetic stressors only after restoring baseline energy reserves. You can also find this episode on… YouTube: https://youtu.be/uE3LhioxwZQ Find more from Health Optimization Medicine and Practice (HOMeHOPe): Website: https://homehope.org/ Instagram: https://www.instagram.com/homehopeorg/ HOMeHOPe Conference 2026: https://homehope.org/homehope-conference-2026 Use PODCAST10 to get 10% OFF your purchase of the Clinical Metabolomics Module at https://homehope.org/products/clinical-metabolomics Find more from Troscriptions: Website: https://troscriptions.com/ Instagram: https://www.instagram.com/troscriptions/ Use POD10 to get 10% OFF your Troscriptions purchase at https://troscriptions.com/collections/our-products

In this episode of the Health Optimization Medicine Podcast, our faculty, Dr. Scott Sherr, Dr. Ted Achacoso, Boomer Anderson, Dr. Allen Bookatz, and Jodi Duval, tackle the recent trend of therapeutic plasma exchange and "blood washing". Moving past the mainstream marketing of plasmapheresis as a longevity cure-all, the team breaks down why mechanical filtering is only a surface-level fix for microplastic toxicity. From the autonomic anxiety caused by biological lockdown to the clinical application of precision metabolomics, this roundtable shifts the conversation from invasive procedures to measurable, cellular safety signals.   Join us as we delve into: The Protein Corona: How circulating microplastics masquerade as pathogens, triggering localized purinergic signaling and the release of extracellular ATP. The Cell Danger Response (CDR1): Why the body halts oxidative phosphorylation and locks down the cell membrane when invaded, and why blood washing can't touch toxins stuck inside tissue matrices. The Problem with Plasmapheresis: The clinical realities and physiological costs of invasive vascular filtering, including the removal of essential immunoglobulins and clotting factors. The True Detox Protocol: Utilizing organic carbon binders (humic and fulvic acids), phase two liver conjugation (glucuronidation/sulfation), and barrier integrity support to properly excrete microplastics. Pulsed Antioxidant Support: When and why to use targeted NAD, alpha-lipoic acid, NAC, and ubiquinol to transition cells out of a defensive lockdown.   This episode is for you if: You are considering expensive therapies like plasmapheresis to clear environmental toxins. You want to learn how to test your cellular metabolomics for organic acids and brain inflammation. You want to understand how your unique exposome interacts with your cellular safety mechanisms.   You can also find this episode on… YouTube: https://youtu.be/5b4jWqByRAU   Find more from Health Optimization Medicine and Practice (HOMeHOPe): Website: https://homehope.org/ Instagram: https://www.instagram.com/homehopeorg/ HOMeHOPe Conference 2026: https://homehope.org/homehope-conference-2026 Use PODCAST10 to get 10% OFF your purchase of the Clinical Metabolomics Module at https://homehope.org/products/clinical-metabolomics   Find more from Troscriptions: Website: https://troscriptions.com/ Instagram: https://www.instagram.com/troscriptions/ Use POD10 to get 10% OFF your Troscriptions purchase at https://troscriptions.com/collections/our-products

In this episode of the Health Optimization Medicine Podcast, the HOMeHOPe faculty (Dr. Scott Sherr, Dr. Ted Achacoso, Boomer Anderson, and Jodi Duval) tackles one of the most paradoxical trends in modern biohacking: sleep tracking. Moving past the mainstream obsession with daily device scores, the team breaks down the biochemical realities of how tracking your HRV might actually be sabotaging your sleep architecture. From the autonomic anxiety caused by digital wearables to the clinical application of precision chronobiology, this roundtable shifts the conversation from algorithmic scores to measurable, cellular safety signals. Join us as we delve into: The Orthosomnia Epidemic: Why waking up to a red recovery score immediately triggers your prefrontal cortex, activates your HPA axis, and flattens your diurnal cortisol curve. The HRV Paradox: Understanding the actual biological markers of Heart Rate Variability and why an algorithmic score doesn't dictate your physical reality. The Cell Danger Response: How the body is only able to sleep when it feels safe, and why the ultimate "detox" might just be a sleep divorce. Your "Do This on Monday" Protocol: Dr. Ted's clinical sleep anchoring technique, and why prioritizing sleep as the first activity of your day changes your entire circadian rhythm. Precision Cellular Nutrients: The clinical difference between taking generic sedatives and utilizing precision magnesium, glycine, and even strategic carbohydrates (like honey) to optimize GABA and melatonin. This episode is for you if: You are experiencing worsening sleep anxiety and chronic insomnia despite meticulously tracking your data every night. You want to learn how to test your cellular metabolomics for brain inflammation instead of relying on a generic smartwatch algorithm. You want to understand how your unique chronobiology dictates your sympathetic and parasympathetic balance. You can also find this episode on… YouTube: https://youtu.be/n71oG96M1Ek Find more from Health Optimization Medicine and Practice (HOMeHOPe): Website: https://homehope.org/ Instagram: https://www.instagram.com/homehopeorg/ HOMeHOPe Conference 2026: https://homehope.org/homehope-conference-2026 Use PODCAST10 to get 10% OFF your purchase of the Clinical Metabolomics Module at https://homehope.org/products/clinical-metabolomics Find more from Troscriptions: Website: https://troscriptions.com/ Instagram: https://www.instagram.com/troscriptions/ Use POD10 to get 10% OFF your Troscriptions purchase at https://troscriptions.com/collections/our-products

In this special in-person roundtable recorded in Washington, D.C., the HOMeHOPe faculty sit down to decode one of the most important perspective shifts in modern health: the Holobiont. Moving away from the traditional, siloed medical model of "organology" (treating the heart, gut, and brain as isolated systems managed by different specialists), the faculty discusses why true health optimization requires viewing the human body as a complex, interconnected ecosystem of ecosystems. Join us as we delve into: The Holobiont Paradigm: Why you are not just a single organism, but a super-ecosystem made up of human cells and trillions of cooperating microbiota (including in your cornea, ureters, and gut). The Danger of "Organ" Medicine: How specializing solely in individual organs leads to clinical blind spots, and why common prescriptions like statins and PPIs can quietly disrupt cellular energy (CoQ10) and nutrient absorption system-wide. Metabolomics vs. Genetics: Why your DNA only tells you what might happen, while clinical metabolomics tells you exactly what is happening right now. The Cell Danger Response (CDR): How your metabolites act as powerful epigenetic signalers, turning genes on and off to regulate systemic health and recovery. The N-of-1 Future: Why large randomized controlled trials (RCTs) often fail by completely ignoring the gut microbiome, and why personalized, N-of-1 medicine is the only true path forward. This episode is for you if: You are tired of being bounced between specialists for interconnected symptoms like mood disturbances, fatigue, and chronic bloating. You want to understand the limitations of DNA testing and why measuring real-time metabolites is the gold standard for biohacking. You are a clinician looking to shift your practice from illness management to foundational cellular optimization. You can also find this episode on… YouTube: https://youtu.be/ILwab838zVM Find more from Health Optimization Medicine and Practice (HOMeHOPe): Website: https://homehope.org/ Instagram: https://www.instagram.com/homehopeorg/ HOMeHOPe Conference: https://homehope.org/ Use PODCAST10 to get 10% OFF your purchase of the Clinical Metabolomics Module at https://homehope.org/products/clinical-metabolomics Find more from Troscriptions: Website: https://troscriptions.com/ Instagram: https://www.instagram.com/troscriptions/ Use POD10 to get 10% OFF your Troscriptions purchase at https://troscriptions.com/collections/our-products