Taylor (00:01.43)

Hi everyone! Welcome to today's podcast. I have Dr. Jones, our Chief Medical Officer with us today. We're going to be talking about trends that every man should follow, sauna, cold plunging, and fasting. These three are very trendy topics that are on the rise in the wellness space. We wanted to have Dr. Jones on to talk about the medical perspectives of the benefits for these practices. Are they safe? Should you do them? And have his expertise. Dr. Jones, could you give everyone a little introduction to who you are in case they're new here?

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Ryan Jones, MD (00:38.831)

Yes, hey there. How is everyone out there? My name is Dr. Jones. I was one of the founding members with Thrivelab, myself and CEO Joshua Host. We've been in business, I guess, about 2 and a half years here. Myself and our Chief Scientific Officer, Dr. Patel, have kept our ears to the ground on some of the latest and greatest trends in the men's health space. So while you may meet our practitioners more face to face, we're behind the scenes trying to make sure that their practice guidelines and methods are up to date and that we're keeping up with whatever the latest information is in the wellness space. I live in Dallas, I like to golf, I always like to say that whenever I'm on one of these introductions, regardless of what the circumstance is so people feel like they know a little bit about me. I have two kids that are twins. So anyway, that's a little bit about myself. Taylor, actually I haven't had a whole lot of chance to meet you as well. I know we've interacted a little bit via some of our corporate meetings, but can you explain to the audience a little bit about what your role is in our team?

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Taylor (01:36.126)

Yeah, absolutely. Thank you, Dr. Jones. Yeah, it's nice to see you more face to face. But I am the Vice President of Marketing for Thrivelab. This is my first time being on one of the podcasts, so I'm new here as well, but Dr. Jones has been on one other podcast. You should check it out. It was on fatigue and feeling sluggishness, so go look for that one. But yeah, it's really nice to see you face-to-face, Dr. Jones. It's been a while. I'm based in Miami, and I'm a dog mom and I've been with Thrivelab since December of 2022. So I'm relatively new here, but I absolutely  love this team and what we're doing.

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Ryan Jones, MD (02:20.983)

Wonderful. We do appreciate all the work that you're doing here making this a successful endeavor for our patients and for us. All right, so we have a few topics that you brought to our attention here. Some of the latest trends here. What do you have for us?

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Taylor (02:35.666)

Yeah, first I just wanted to dive into the sauna. What are some of the key benefits of incorporating the sauna into a health routine? And if you could also talk about the differences between infrared sauna and a steam sauna, because those two are quite different if you have a perspective on those.

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Ryan Jones, MD (02:54.199)

Right, right. So just to kind of give, I guess, a general overview of what sauna therapy is. So usually this is a dry heat mechanism. I think we've all had some casual knowledge of what a sauna is, seen it on TV shows or sitcoms, or have experienced it ourselves in our local gym. I think they originated kind of in a Turkish culture, made their way up north, their practice a lot in the Scandinavian areas. And that's where a lot of the studies delineating their benefits and what the potential risks are and all that have been performed.

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So it's just a high heat exposure. Usually the humidity factor is a variable one when people are practicing sauna techniques. I think the minimum temperature people tend to like is about 140. I think the ideal set is about 160. I've heard some extremists go up to 180 while riding an aerodyne bike in the middle of it, you know, wearing gloves to protect their hands from burns. I'm not sure that anyone needs to necessarily go that high, but there is a range that tends to hover between somewhere 140 to maybe 160 degrees. And this is in Fahrenheit. Sorry, my conversion to Celsius is a little bit lacking right now. I think it's closer to 80 degrees or so. And so anyway, so it's been long practiced and I think it's always kind of had a soothing, calming and restorative feel for the people who have, who have practiced it over the time, over the centuries. This of course predated some of our current medical knowledge. So now we're trying to find out; why are these people feeling so good after completing these treatments? And what's the key behind it? Do we need to do it? How long do we do it? Things of those nature.

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So kind of give an overview here. I see a few highlights kind of in, we plan to go through. So is it a high heat exposure environment? And this lasts anywhere from, I'd say a minimum timeframe of five minutes, but some people up to a couple hours. There is a variable way to practice that. Let me focus on the benefits by system and then we'll come back to the way individuals practice it because I think it'll help tailor that discussion a little bit more.

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So one reason I hear people commonly use it is for their cardiovascular health. I think a news article comes out every other day about some food or practice and how it benefits longevity and whether or not people's cardiovascular health is improved. So in this one, I feel like the evidence is pretty good. That this is a net benefit to most people. So sitting in the sauna, it sort of mimics a low to moderate intensity cardiovascular exercise. Something like rowing, walking uphill, swimming but not too briskly, nothing too athletic like a sprint or a full jog. And what this does is it trains the cardiovascular system, particularly the heart. I don't wanna go, particularly the heart. So when you exercise, there's an increased, particularly oxygen demand on your tissues. And so your heart's job is to circulate the blood around. It goes to your lungs to get new oxygen. Then it goes around your body, delivers it to the tissues. Tissues use it, and that cycle kind of repeats. So the thing that limits your ability to exercise, for a lot of your better term there, is your heart's ability to pump blood around the body. Your lungs can ingest and distribute oxygen enough for five people. So typically healthy lungs aren't the rate limiting factor. So by sitting in a sauna or by exercising, you kind of get your heart in a mode that gets used to higher demands being placed on it to circulate oxygen throughout the tissues. And in response, you know, it adapts in the way it's muscular, musculature is organized, its rates, its settings, and a couple of other things changing your blood chemistry. So just like walking uphill or light exercise, when you're in the sauna, there's an increased demand on your body, primarily to help regulate your body temperature. Up to 50% of a person's calories throughout the day are spent regulating this function alone. So the way that it works is by raising the temperature around you ambiently. And of course, since our bodies are trying to maintain a certain set, it causes you to increase energy expenditure in the effort to maintain that body temperature. And that puts a stress load on the body, particularly the heart and over time it kind of adapts and it works as a training mechanism to get that a little bit better. I'm so sorry if that's a little bit confusing. Is at least that point relatively clear so far?

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Taylor (07:19.154)

Yeah, I know that's super clear. I guess one of my questions is, say someone does a really intense cardio workout for like an hour or even longer, an hour and a half, and then they go in the sauna, is that putting too much stress on the body?

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Ryan Jones, MD (07:33.723)

So I don't think it's putting too much stress on the body, but I think the benefits there are a little bit mixed. So people using it after cardiovascular exercise, that's okay, but what I actually consider that ironically is as a prolonged cool down phase. So you do the intense part of the exercise via treadmill or whatever is really getting your heart rate up, burpees or something like that. And then there's a prolonged cool down phase that you enter when you're in the sauna, which helps keep your heart rate up, metabolism up during that time. And can provide additional calorie burnings, things like that. But where I typically like the sauna is after weightlifting type exercises, as it improves blood flow to the muscles and can aid in recovery in that way. So while it's beneficial in both, my personal preference is typically that people seek to use sauna after more of a weightlifting exercise, then a cardiovascular exercise. It may be a little bit redundant, although it is beneficial in both cases.

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Taylor (08:33.154)

Gotcha. Now in my experience as a woman, I think that infrared sauna is a little better for me and my body. When I go into a steam sauna, I do feel a lot of fatigue. I do feel great after, but the infrared sauna is the lower temp and the light exposure, and I feel like that's better for my  cortisol and for my stress levels. Would you say that different types of sauna practices are better for men versus women?

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Ryan Jones, MD (09:04.155)

So I think it would depend just a little bit there, again, on the goal. So they're both heating mechanisms. I think the primary difference between those two heating mechanisms, however, is the use of the humidity or the factor that plays in. So heating mechanisms absent humidity, I think, tend to be a little bit less on the cortisol raising side. They are less of a shock to the system because there's two components that have to battle.

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Your body's primary cooling mechanism is via sweat. And when there's competing humidity, it makes that process a little bit more difficult on the body. And so it tends to raise the stress response just a little bit more. So the infrared tends to be a little bit gentler on that. You can still get the benefit of having the improved blood flow throughout the body, particularly the muscles with less of a cortisol response. So I don't know if I'd make a huge difference on the gender based side there, but I would lean it more towards what kind of exercise you've done before.

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But secondarily, and this is kind of always the role in medicine, compliance is key. So is one better than the other in a different circumstance? Usually the answer there is somewhat marginal. But one certainly, like you said, you might be more willing to do one versus the other in that scenario. So the one that's more fitting towards how you feel in the aftermath, I think is typically the one that I would go with in those scenarios.

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Taylor (10:22.43)

Okay, that makes sense. Now, what is the effect of the sauna on hormones? So, as all of our viewers are aware, we are a hormone therapy company, testosterone replacement therapy company, and I'm curious, there's a controversy, does testosterone increase for men using these trending methods, these wellness trends, sauna sessions, does that increase testosterone levels? Does it affect other hormones like the thyroid, other things that we should be aware of or is that just not true?

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Ryan Jones, MD (10:59.451)

So there's a bit of a, so there's three phases, I think, of hormones to talk about, and then we can answer that one nice and neatly. So there's basically your immediate response hormones, which are half hormone, half neurotransmitter, and that's like adrenaline norepinephrine. So, you know, if you suddenly hear a dog bark in the background that you weren't expecting and your heart starts to race, that's those two being released kind of immediately. And that happens within seconds, right? So within seconds of a jump scare, you get a peak in those hormones.

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Lagging somewhat after that is the next phase, which is like your cortisol, okay, which is kind of the classic stress hormone that we all know. Its main job is to kind of shift things into a fight or flight mode, kind of in a semi-sustained method. And then there are your long-term release hormones, which are your sex hormones, typically estrogen, progesterone, testosterone, and to a lesser extent, your thyroid hormone. Those typically have their peaks and shifts over periods of several hours or days. Cortisol within several minutes and of course, adrenaline within seconds. So, the differential effect here will be that the higher intensity of the stress of the sauna that you're using at the time, the more the first two will peak. Your cortisol levels and the initial adrenaline levels, although those probably won't peak so much once you get used to the experience. Your cortisol will kind of continue to rise with each session and taper out.

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But there is a huge difference between long-term cortisol and short-term cortisol. Long-term cortisol is what you don't want. That is a catabolic process, meaning it breaks down parts of the body tissues, it's maladaptive and insulin and sugar regulation. But it works for the short-term, right? Because in the short-term, what you want your body to do is make energy available rapidly, get blood shifted to the right places, keep you on high alert, things like that. And so in a short period of time, I think it's relatively good.

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Sustained, you don't want it, right? And so there's also a secondary effect here with sauna that even though the acute phase of the cortisol might be raised, kind of the long-term mental health benefits of it seem to be stress reducing, so that long phase of cortisol tends to be eliminated, right? So the more people practice it, typically the less net inflammation they'll have. So instead of kind of being high all the time on cortisol, which you don't want, it tends to be a peak, but then quickly drops down, so that the average time you spend at an elevated level is down and that's net positive overall.

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Taylor (13:29.41)

Got it, that makes a lot of sense. Have you actually seen any positive outcomes in patients incorporating sauna sessions? Do you ever recommend that to your patients?

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Ryan Jones, MD (13:38.095)

So absolutely, but what typically happens is it is something they have tried or are curious about more than an outright recommendation to start, honing back in onto stress mediating activities. Essentially anything that you truly enjoy that is not dangerous is a stress mediating activity and you should engage in it. So if you're a person who likes to play golf, you find that stress relieving, please by all means go play golf. If you enjoy a cycle, if you enjoy knitting, all those things that kind of put your mind at rest are good ideas. So for patients who are looking for other outlets for stress relief, if this is something that makes them inherently uncomfortable, then you will be kind of chasing your tail there, right? If you're in there the whole time and what you literally feel is that you're miserable, you're not enjoying this experience, your mind is too easily distracted, you want to get out and do other things, then it's probably not for you. But if you have tried it once or twice and it is something that kind of syncs up with something that you typically enjoy, you feel better after, then I think it is the right activity for you. You should do it per studies at least two times a week, ideally four or five times a week for at least 30 minutes a day. That's my recommendation for those who do practice it, that is generally a healthier group than those who do not. And so based on that means I do, however, if it is something you just frankly don't like, you've tried it 10 times, I wouldn't want you to push past it and engage in that activity. We would between us discuss other alternatives for ways that we might mediate their stress or try to get the same benefits.

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Taylor (15:06.498)

Got it. Now, another one of these trends is cold plunging. Practitioners of intense cold plunging methods have been preached upon by health gurus and holistic practitioners like Wim Hof. What are your thoughts on cold plunging? Is this legit or is it more just of a trend?

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Ryan Jones, MD (15:25.083)

So, well, it definitely is trending, right? This is one of the newer aspects of health and wellness that we're hearing about these days. And you mentioned, I guess, kind of the king of that arena, Mr. Hoff there, who of course advocates it pretty wildly. So it can be a little bit counterintuitive, right? We just spent the last few minutes saying how hot you should be and then now it's how cold you should be, which one is kind of net benefit. So there's kind of two ways to think about this one.

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For me, not to jump ahead, we have another topic I guess we're gonna cover which is fasting. The current on a one to 10 scale, I would say, if we're gonna practice any one of these things, I think fasting has the highest level of evidence, right? That is a good practice for most people, particularly depending on what your goals are. Sauna would be a very close second to that. Cold plunging is still kind of finding its way, all right? There's a lot of positive information out there, but it's an expensive practice when for some people it's kind of hard to organize and schedule around. So people want to know, hey, am I really missing out? Are there other ways to kind of get this? So for cold plunging, just to give a little bit of the background, the benefits that have been shown to be related to cold plunging have primarily been related to people who practice cold exercise, more so than just an acute plunge. So swimmers who swim in the ocean during, not in the Caribbean areas, kind of North Atlantic, things like that, in their local lakes or rivers. That has been where most of the study has come from. Obviously, they're exercising concurrently, and so people were trying to decipher, well, is the cold what's providing the benefit here, or is the exercise what's providing the benefit here, and how do we delineate between those? And so cold plunging has been, in recent, I guess, years, found its way into the forefront of our consciousness in that regard. And so what I would say is, just in short, there are a couple of pathways to potential benefits there that I would like to see the most rigorous studies done on, but that the preliminary data looks pretty good for currently. Okay, so it impacts a couple of things.

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So one is muscle recovery. I'll start there. So it depends on the kind of exercise that you've done. I like cold plunge in scenarios where you are not trying to gain mass for the most part. In situations where you're trying to gain mass, that kind of acute inflammation, muscle tears, disruptions, micro cuts, things like that in the actual muscle tissues, you actually want the inflammation in the initial phase because that allows the repair mechanisms to have more growth, right? If you cut those a little bit short, then the muscle response tends to be a little bit blunted from that. So if you're already kind of at the fitness level that you desire, I think cold plunges are great.

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Particularly if you're looking to gain mass or even endurance tissue to a higher degree than you currently have, what I typically recommend is that you stick more with the sauna route because it can inhibit that growth a little bit. However, for an acute issue, right? So if you're gonna exercise regularly, should you give you a cold bath every day? I don't think so. If you've done a particularly hard exercise or you've competed in something that is hard on the body, my favorite example here is if you finally run that marathon that you've been looking to do. I think getting in a cold plunge for the next several days there is beneficial, right? Because now you're shifting away from worrying about whether or not you're protecting as much muscle tissue as you can to reducing the amount of inflammation and joint damage that you may have from other causes. So it's very good at reducing inflammation in that regard, getting immune boost, and we'll talk about that a little bit here, after something that can be damaging to the body, but there's just a little bit of a trade-off. When it comes to cold plunge, at least that's what it seems, if you're going through a building phase versus a maintenance phase, right? But in every case, if it's been a particularly hard effort that day and you're looking to kind of get, you're trying to mitigate the effects that can potentially be damaging from exercise, particularly along with like a marathon race, then I think that's the best time to use it.

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Taylor (19:43.938)

Got it. That makes a lot of sense. So could you elaborate a little bit more on the immune function and how that actually works, how going into a cold plunge or going into a cold bath, cold shower benefits your immune system? Because you think about what they say when you're feeling sick. Go into a hot shower and you'll feel better. Is that not true? Is that just a wives' tale? Or would you prefer if you're not feeling well or you’re under the weather to go into a cold bath instead.

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Ryan Jones, MD (20:17.371)

So I think if you're acutely ill, meaning you're infected with something, I would avoid cold plunges altogether or the sauna. That one I would just stick with the rest and let your body kind of fluctuate between whether or not it's going for fever or not in that regard. Where the immune boost comes from is not inviting an acute infection. The immune boost comes in kind of the immune system's other responsibility, which is tissue maintenance and repair and clean out.

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That's more of where the immune benefit comes from. So what the studies have shown is when people have cold water immersion, swimming in the ocean, ice baths, whatnot, there's a jump in one cell line called the monocytes. And what monocytes do in general is help clean out what I wanna say is like debris, cellular debris. It helps to get rid of, you know, cells that are damaged, that are signaling that they're too injured to repair, things of that nature. So to kind of make a parallel, there was a controversy, well, it used to be kind of the general understanding that people who run a lot, as they get older, they'll have bad knees, right? You're using your joints a lot, you're putting a lot of stress on them as you get older, you're gonna develop arthritis. But some physical therapists did a bunch of pretty rigorous studies and found out actually the opposite is true. That people who do a good amount of moderate running throughout their lives typically have less arthritis. And the theory here is that the small amount of damage that gets done whenever you engage in those activities triggers a very similar immune response to the cold immersion. It triggers clean out of the debris so that things kind of get nice and shiny and polished. So if you own a home or an apartment or a car, it's not best just to run it and leave it alone. Every now and then you want to trigger something to go in there and do maintenance, change the oil, make sure the lights working, get the fluid levels up various degrees. So it's something similar to that. So when you emerge in cold water, and to some extent, sauna therapy as well, heat and cold shock proteins, both are part of a family of just stress response proteins that help trigger this cascade that allows your body, or at least triggers it, to release more of those cells that are capable of clearing out debris material. And so I think that's more of the boost in immunity that they're getting. Those cells are also responsible though for, in some, to some degree, they kind of what was called chop up and present proteins, which means whenever there's something foreign in your body, bacterial or viral, what it does is, you know, you chop up the bacteria, you take a piece of it and you take it to the other cells and they say, is this part of me or is this something else? And if it's something else, it triggers response to get rid of it and it's part of you, it's supposed to ignore it and let it pass. So an increase in those cells is theoretically allowing for more detection of foreign proteins and that includes abnormal cancer proteins or misfolded proteins. So there's some theoretical benefit there that needs to be proven in rigorous studies that it may help cellular immunity work towards clearing out old, again, debris tissue, tissue that is not functioning to its optimal level at the cellular level.

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Taylor (23:35.086)

That's incredible. It'd be great to see these studies built out more over the coming years and see what is actually factual and what we can depend on with the benefits.

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Ryan Jones, MD (23:45.043)

Right, right. I just had to make a brief, have you tried cold plunge therapy? I have not myself yet.

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Taylor (23:50.446)

Yes, I have and it's miserable. I feel like my body just needs like to be comforted and like feeling good, but going into the cold plunge, I'm just in there like I need to get out immediately.

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Ryan Jones, MD (24:02.603)

Right, but you know, that's the thing that I think of all the effects that they feel might be the strongest one is that kind of putting your body and really in this case your mind through something that is somewhat rigorous tends to overall have a net mental health benefit kind of across the board, decreased rates of anxiety, depression and a few other things. Whether this be just that you're, you've started a new exercise program that makes you sweat, gets you out of breath, cold plunge, sauna, anything that is mentally taxing and challenging that you can make some measurable progress on or achieve or overcome, seems to have like a resetting level for many people to where some of the other things that was causing them day-to-day stress tends to have less of that impact and overall improves their mental health. Again, it seems to improve their cortisol levels over time.

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So regardless of even if it has a specific physiological benefit, which I believe in the net it probably does, it seems to have a pretty clear and distinct mental health benefit for most people, just in that it's engaging in something challenging that kind of resets some of the perspective that you have neuro homogeneously and psychologically.

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Taylor (25:20.83)

Yeah, I think there's a lot of power in knowing like you can do hard things and you can make it out okay. I mean it's only a few short minutes. I really should be tougher on myself.

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Ryan Jones, MD (25:29.511)

Right, right. But it's good. But once you get out of it, it's kind of, it's the reverse of the, of the late exercise theory. So, um, some people say that it's better to work out in the morning because then what you get is a whole day of feeling great about yourself, because you've already done your workout. Whereas if you put it towards the evening, and this is just personal preference, but for some people, when they put it towards the evening, they have a whole day of anxiety thinking about how they still need to work out and all the other things they have to do. So I think just the sense of accomplishment, accomplishments are that you get after doing it, having put your mind and your body through something, getting on the side, at least to a high. There's an endorphins that are released clearly after something like that, particularly sauna and cold plunge, intense cardiovascular exercise in general that is net good for people. So even if this isn't your particular jam, I'd say, I mean, find something that's challenging and work to get it done. You'll feel better in the after.

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Taylor (26:20.018)

Yeah, I think even just starting with a cold shower in the morning for a few minutes before I take my hot shower is an easy way to incorporate it. I do know that a lot of people are like, oh, I don't have access to a cold plunge or I can't afford to buy a cold plunge, I don't have space in my house for something that large. Same with the sauna, if you don't have a building that has it or you don't have access to that. There are other affordable ways to get access to these practices at home. And you can incorporate them, you just have to find you know what you're accessible to at home and make a twist of it.

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Ryan Jones, MD (26:58.895)

No, I agree. I agree. You know, you don't have to spend a million bucks to get all the benefits of these different opportunities here. I think a cold shower is a great introductory way. Any amount that's lower than core body temperature will trigger this response at least in some degree. I think technically the definition starts at around 60 degrees, particularly, well, if you live up north, your tap water comes out well below that. In the summer months in Texas, you know, that might be a little bit of a challenge. But anything below 60 degrees, I recommend keeping it above 40. For most people, I don't think you need to get into literally freezing water if you can avoid, if you can help it. But somewhere between 40 and 60 degrees, you can kind of make your way down over time if that's your preference, if you're finding that you're enjoying that experience.

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Taylor (27:43.918)

Exactly. To go back to mental benefits of these practices, another mentally taxing practice for some people is the concept of fasting. And that's one of the topics I wanted to dive into today with you. The benefits of it physiologically, mentally, how would you say fasting should be incorporated into your life? Let's go from a male's perspective and then also from a woman's perspective.

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Ryan Jones, MD (28:12.587)

All right, all right. So there's a, it's a bit of a, it's a bit of a confusing named hormone that's involved here. And that hormone is human growth hormone. And so when I talk about fasting, I think the popular conception about human growth hormone is that it makes me bigger and stronger. Okay. And that is in some periods and sometimes true, but it can be confusing based on its effect here.

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So fasting, it heavily depends on your goals here as well. Growth and maintenance are a little bit different. So for guys who are looking to add muscle tissue to their body, I think intermittent fasting may not be the best part, particularly in the up phase, because what you're trying to do there is pack on the pounds and you really need calories to do so, particularly protein calories, and the longer you do that throughout the day, assuming that you have some physiological stress, meaning you've lifted typically the better gains you'll have.

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Fasting causes an increase in HGH, in human growth hormone, the naturally derived kind. But this counter, this is meant to counter insulin. So what insulin does in this concept is it helps get energy into the muscle tissue, right? Glucose and insulin kind of work together, go in there and gives the muscle the physical tissue and some glucose reserves that it needs. When you fast, you're HGH goes up, but it blocks the effect of insulin. So there's actually less carbohydrates and all that going into your muscular tissue. This helps with insulin sensitivity over time. So if you have an issue where you're borderline diabetic or frankly diabetic, by all means, I would practice this. But for otherwise healthy males who are looking to gain muscle mass, I think intermittent fasting may not be the best. In this scenario, they tend to eat several small meals throughout the day that are high in protein. Just long story short in that regard.

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For people who are looking to lose weight though, I think this is an excellent strategy for two reasons. Number one, two of them are psychological. One is you get to experience hunger and know what true hunger is. And I think that's important, particularly in the West, because we tend to eat on schedules and not when we're hungry. So when you do intermittent fasting, you get a little bit more acclimated to the natural triggers of when you should eat rather than eating out of habit or out of time. Which is where people tend to kind of take in a little bit more than they should. The second psychological thing I like for intermittent fasting is that because it's set on a time, it's easy to note when you're compliant and when you're not, right, for patients. So other people tend to think, you know, hey, I'm not eating nearly as much as I have, but they tend to kind of graze throughout the day. You know, they have a bite of a donut here, a couple gummy bears here, a little bit extra here, and that adds up throughout the day.

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So by holding it at least to a certain time, it kind of limits the time that they have to pay attention to what they're actually eating and counterintuitively it improves compliance. Because they know you just can't eat anything at this point, right? And then towards the end of the day, I need to watch exactly what I eat and that'll help me kind of in my dietary goals. So in that way, I think it's good. So, and so in that regard, the net effect for most people of intermittent fasting, I would say for guys, is typically, it depends on how you're utilizing here, but I would avoid it, exercise regularly, a lot of protein to boost your testosterone on one side. If you are kind of an endurance athlete, I think intermittent fasting is probably your best bet for some period of time, because of the way it interacts with cortisol, HGH and a few other things, you typically get your highest total testosterone levels over time via that method, right? So it's two different strategies for guys there. Again, a growth phase for a human body versus a maintenance or losing phase are typically where those divides occur for me. So again, less so for those trying to gain mass, those trying to lose or maintain, I think intermittent fasting is great and can net keep their T levels in that ideal level.

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Taylor (32:24.226)

That makes a lot of sense. With women, there is controversy about if fasting is beneficial to them. And I'm curious, what would be the ideal fasting range for women that you would recommend? You know, a lot of people forget that you do fast when you sleep. So if you add that into your fasting schedule, it's really not that big of, that daunting of a task to just wait to eat until 10 or 12, but what would you recommedisnd is the best time frame for women without disrupting their other hormones?

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Ryan Jones, MD (32:59.036)

Um, so it's, it's the best, the best answer, for people who get to experience true hunger is when you first get your early, your real hunger signals. But on a, on a time basis, I'd recommend most people wait till at least noon, if not 2 PM, uh, in general is when I would recommend, particularly for women, noon or 2 PM is when I would recommend starting, uh, to eat. So the fast should basically start no later than 8 p.m. the night before, and go to noon or 2 p.m. the next day, kind of long answer short.

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Taylor (33:33.078)

Gotcha. And for those that are not willing to, or did not wanna do a full fasting cycle, what other restraints around eating and eating times would you recommend? You know, I personally stop eating at 8 p.m. I sometimes eat around 10 in the morning, but I make sure that I stop eating at least two hours before I go to sleep. And of course, no sugary foods or anything like that. Do you have no desserts? Do you have any other recommendations?

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Ryan Jones, MD (34:04.939)

Yeah, in general, there's kind of three things that I typically follow. And again, weight loss and weight gain are a little bit different. Weight gain and by weight gain, I mean muscle mass, not adipose tissue here. I like the, my macronutrients, my fats, carbs, and protein divided into thirds for the calories and spacing that out in small portions throughout the day, making sure to have, you know, intense exercise at least once throughout that day. For maintenance and loss, what I typically recommend is; don't, if you can at all help it, don't eat and then sit down. I think the first hour after a person eats, I don't think you need to get on a treadmill and get yourself running 12 miles an hour and then throw up. But I think if you can maintain time on your feet at the very least after you eat, typically tends to be my favorite way to minimize the impact of calories that are taken in if weight loss is your goal. So whenever you eat, I try to time it around when I can do at least some activity. My preferred activity as of current is rowing, but bicycling was it before. So I would eat and then within maybe 10 or 15 minutes get into an exercise mode and do something light and kind of keep it going. Because what that does is has your body kind of utilize the excess part of that calories. It gives a little bit of muscle tissue injury, let your body take the protein and use it towards growth, maintenance and repair there. And of course, if there's excess adipose tissue, it's used kind of in a steady state carb fashion. No matter what though, the timing matters some. It can help some. But the truth is the total net calories that a person takes in a day will always be king when it comes to weight loss. So for better or worse, if you have not started heading in the direction that you want to, particularly downwards on the scale, somewhere or another, there are more calories being taken in than you need and it's best to try to find where those are.

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Taylor (36:07.57)

Yeah, exactly. The timing matters to an extent, but really what your calorie intake is and the quality of the food that you're eating is definitely the most important. Well, that is all I had today to discuss with you. Thank you so much for your time and knowledge and insights. It's great to have the medical perspective on all of these topics that I think a lot of social media lacks in that department, discussing the medical perspectives, what's real and what isn't, and also how our hormones are affected by all of these things. So thank you so much for taking the time and sharing this with us. Did you have anything else to add?

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Ryan Jones, MD (36:48.679)

Let me see, there's one or maybe was there one or two things I wanted to make just to be cautious. Particularly for the cold plunges. There is two categories of persons that I recommend avoid those kind of outright. Those are people with known vascular disease. So if you've recently had a heart attack or you have circulatory issues in your legs. You know peripheral vascular artery disease. Those people typically recommend avoiding a cold plunge altogether. And for those with severe autoimmune disease, lupus, psoriasis, rheumatoid arthritis, that is a group that I would recommend stay away from that. The ones who have had some cardiovascular trouble, I think can tolerate the sauna. The rise in heart rate can be a little bit more gentle, right? The exercise tolerance there can build a little bit more gradually. So for those looking to get a cardiovascular benefit in that regard, I think the sauna is definitely better. Just the initial impact of getting into the cold plunge tends to be a little bit blunt on the cardiovascular system. So if you have issues with circulation there, it's hard to kind of taper it up gradually and make it safe. So I typically recommend that those populations avoid that part altogether. That's the last thing I want to throw in just for safety. You know, at first do no harm. So I want to make sure that the patients know.

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Taylor (38:00.406)

No, thank you. And also with fasting, is there anyone who should steer clear of the fasting method due to medical exclusions?

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Ryan Jones, MD (38:08.443)

To be honest, it's medically not really, it's pretty safe across the board. The time that people spend without calories, that the one, maybe the most consistent thing across all species that is shown to improve lifespan is calorie restriction. So the less time that you're in calorie surplus, typically the longer on average per species things tend to live. So that's what I would say, I think it's pretty good for everyone. I don't think there's anyone, unless your doctor has specifically placed you on a regimen. Otherwise, I can't think of anything where you absolutely need to eat consistently in that way, except for maybe brittle diabetics. They, of course, need to maintain their blood sugars to a certain level, so our diabetics should be careful and cognizant of what their blood sugar is. But outside of known sugar dysregulation, I don't think there's any real restrictions on that. And it seems like it may be particularly beneficial for those who have some history of neurodegenerative disease. If the facet can get pronounced enough to lead to ketosis, it seems to have an effect on some neurodegenerative diseases like Parkinson's, maybe to a milder extent, different forms of dementia. When sugar's not around, your brain kind of preferentially uses those ketones. And there's been mixed reports about whether or not that can improve focus and concentration, things like that. But in the limit, it seems to improve longevity for one, and perhaps reduce your risk of neurodegenerative disease.

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Taylor (39:36.874)

Thank you. Awesome. Well, from this podcast, I'm going to start cold showering in the morning and putting myself through that. And I'm also going to be a little more serious about my fasting. And then maybe I'm also going to try the steam sauna a little more than the infrared. I think all these things I can incorporate into my life. And I think all of our community can too.

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Thank you so much, Dr. Jones. And again, we are a hormone replacement therapy and testosterone replacement therapy company. We are focused on hormone balance, personalized treatment plans to help men and women nationwide. We are also insurance-based and we have also recently launched nutrition coaching and life coaching to support you with all of your holistic needs going beyond prescriptions and going into what you need from every level to live a healthy and balanced life. So please take our self-assessment if you haven't already to find out what your potential symptoms are and book an appointment with one of our providers and we will get you matched and discuss how we can get you in balance.

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Ryan Jones, MD (40:42.151)

All right, no worries. I think you summed it up beautifully there.

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Taylor (40:44.958)

Awesome. Thank you so much. Have a great day, Dr. Jones.

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Ryan Jones, MD (40:48.475)

Thank you, you as well, Taylor.

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