Joshua Host: 

Hey guys, so excited to spend some time with you today. This is Joshua Host.  I'm here with my partners and our chief science officer, chief clinical officer, Dr. Dr. Nayan Patel and our chief director of clinical excellence, Dr. Bimisa Augustin. And so excited to spend some time just talking about the origin of ThriveLab and our purpose and mission and what we're so passionate about here today as far as in this conversation. So I guess I'll just talk kind of briefly about just the origin of how I came here and then I'd love to open it up and so I can share the incredible folks on the team and they can share their story as well. So, 10 years ago I was hit by a car while I strapped into a road bike that left me with a traumatic brain injury and after seeing specialists and then put me on drug treatment plans my side effects were increasing and my symptoms weren't going away. I ended up reading a paper by Harvard Medical School in the off-label treatment of traumatic brain injuries with bioidentical hormone replacement therapy. And within 30 days of starting treatment, my brain turned on. And I was elated because I was really afraid at the time. A lot of people were counting on me and I felt like I had a new lease on life. And at the same time as well too, I was obsessed and wanted to understand who else was dealing with it. I started going to different conferences and learning from specialists and discovered that we're in the beginning of an hormone imbalance epidemic. Along that journey, I've had the fortune of meeting some truly exceptional clinicians, thought leaders, and folks that are changing hormone health and how it's accessed for patients. Because right now, we have over 84 million folks in the US alone that are suffering from a hormone imbalance, and only 12% will find treatment. The mass majority are going to be misdiagnosed or rejected for care. And so, I have the incredible fortune of introducing, we'll start with Dr. Patel. The next person to the right of me on this screen. So, Dr. Patel, if you wanna kick off and talk about your journey with ThriveLab.

Dr. Nayan Patel:

Absolutely, Josh. Thanks for including me on your journey as well. And what Josh just explained, I was probably one of the pharmacists behind the scenes trying to make all the medications for the doctors that are trying to help these patients out all the time. And my journey as an HRT specialist started way back even before I went to pharmacist school. I'm a pharmacist by trade. And I started pharmacist school in 1992. And my first gig was actually at a compounding pharmacy. So it's like, oh my God, even before I graduated, I was already involved with making medications and learning about compounding and not just compounding any medications, compounding with hormone replacement therapy. So I've been in this industry for probably close to 30 years now, doing just basically just helping make medications, compounding. But over the years, what I have seen is something that nobody else can see. I have analyzed prescriptions for well over a couple thousand doctors all over the United States and how they prescribe medications and how the outcomes are measured. And so when Thrive was launching their pad, I was very excited to learn that they had the same mission as I did, which was, can we get outcomes? Can we help patients achieve the best outcomes for themselves? And, and I have protocols and say, you know what, this will be a perfect way to mirror my protocols, their approach and get the outcomes we want. So when, Joshua, when you came by and asked the questions, Hey, I would love for you to at least consider joining us and just checking things out. And I was so pleased to at least, I wanted to at least give it a shot. And so when we went to El Salvador together and on a small two day retreat, that's when the aha moment came. I said, Oh my gosh. Yes, I can do this thing. I mean, this is something that is in my wheelhouse and I would love to see results in the patient's first hand because I've seen the results as a back end from the doctor's point of view but I have now also the results as a first hand. So this was my opportunity to join the company and see the results in first hands and I'm so happy to be here today to just tell you that in this last one year or so that we have been able to help patients on six phones I believe or maybe more than six phones I think but it's incredible to see when the results are there how fast we can progress. So, Josh, if you can, I would love to see if Dr. Bimisa can go next.

Joshua Host:

Yeah, thank you so much, Dr. Patel, for your background. It's been such an honor to be on this journey with you and with Dr. B and with the rest of our team. You know, and I remember when I first talked to Dr. B and I was so blown away. And Dr. B was the very first clinician that had joined. And when I met her, she was so electric, a combat medic. And her amount of gusto, for patient care and being a service for others. You know, her desire and passion around impact was just so magnetic. And, you know, now being together for over two years and watching the outcomes that Dr. Patel has had, or Dr. Augustin has had with, we say Dr. B! Ha ha. That Dr. B. has had with her patients has just been, it's been like constant and just watch in as far as the patient testimony. And so, you know, we'd love to pass the mic, Dr. B, to you, just for your experience and journey with ThriveLab.

Dr. Bimisa Augustin:

Thank you. So I first want to say thank you Josh for being such a fearless leader and I thank God every day that I got a chance to meet you on January 8th, 2021. Oh my god.

Joshua Host:

I love that.

Dr. Bimisa Augustin:

And I really appreciate the fact that I have such good colleagues Dr. Patel you have been a wealth of knowledge and I just, I mean I will follow you guys to the end of earth, okay! So I absolutely love it. My journey actually began, yes as a combat medic. Six deployments under my belt. I just had so many comorbidities on top of PTSD. Okay, I didn't get a traumatic brain injury, but I had other issues, a really bad left leg surgery three times and I don't believe in taking pain meds. I've actually had three surgeries on my left leg. So I wanted to change some things. I was like, why am I 28 years old dealing with migraines every day, dealing with hypertension, you know, on antihypertensives and being diagnosed with PTSD and major depressive disorder. And I was like, I'm not psychotic. I mean, it happens, but I'm not. You know, I am human, you know, and I did enjoy my time in the military, but I didn't want all these meds thrown at me. So I felt like I needed another way. So I wanted to step outside the realm of conventional medicine and God opened the door for me big time because I met Josh and I met Jordan and I was able to be a human. You know, I was able to, that was the first time I actually cried. Like I was like oh my gosh I get to tell my story and I get to meet other humans just like me. You know, so I wanted to make a difference, not just put a band-aid on what someone is telling me and say okay come back in six months and then I'll change your meds if I have to. I get to interact every single day even when I'm in my clinic with different patients. They email me they tell me how great their feeling, they do different. So I took that into my civilian life you know and I do spread the word, you know, about ThriveLab and the joys and the things that BHRT has done for me, and also to the veterans. I live in a community where there's over 120,000 veterans, okay,  and active duty alone and then you know they have spouses. So I'm seeing it every single day, you know, how male and female they're just not feeling well, they're not doing well, they're not aging gracefully. And I can say honestly at the age of almost 44 years old, I feel great. I'm off all anti-hypertensives. I'm only on nutraceuticals, but I love them. Go through ThriveLab, you know, cause the longevity blend has done wonders. I'm back out to being the adrenaline junkie that I was, you know, when I was in my twenties. I've lost 40 pounds since then! Ah! So, I asked Josh and the team not to remove my professional head shot from when I first started, because patients actually see this and they're like, oh my gosh, that cannot be you.

Joshua Host:

Wow.

Dr. Nayan Patel:

Wow.

Dr. Bimisa Augustin:

I feel like I'm aging backwards. And BHRT has been such a blessing. The depressive mood is gone. But yes, I'm still human. I still get aggravated. I still get upset. I still cry, but I'm able to get over it. And I just, I can't say enough about ThriveLab. It has done so much for me. And that's even outside of any other period menopausal issues that I was having. But all in all, it's just mentally, physically, emotionally, even spiritually ThriveLab has been such a blessing to my life. And I just want to say thank you to both of you guys, you know, and to the whole team, you know, for being on my side and by me.

Joshua Host:

That is so beautiful. And you know, and I remember just how magnetic your story was and how, you know, it's interesting because I think that I was patient zero and then you were patient one you know, and clinician one patient one. And also, you know, you're, you're the doctor for Pia for my wife as well too. And so, it's been beautiful to see as far as our team has grown. And I think one of the things I've noticed is we have obviously a very mission driven team and it's folks that are so focused on purpose and living a life of service. And we're all looking for how to turn one ounce of effort into 10 pounds of cure. And what we realize is by uniting around this mission of making hormone health accessible and affordable nationwide, we've been able to multiply our efforts to change patients' lives. And what's crazy is now seeing three to seven five star reviews come in a day, and it has nothing to do with the validation at all. I think what it is though it's watching the benchmark of changing patients' lives come to fruition. Because I've been shoulder to shoulder with both of you guys, and I know your hearts, and I know how important it is to you as far as the effort and energy you're putting out to ensure that it's magnified. And so, you know, with having something that we're at this impasse with hormone imbalance, you know, it's interesting because I remember even like a few years ago and talking with folks about hormone health, you know, most folks were completely unaware and the healthcare community as a whole, you know, both, you know, both of you and talking to clinicians around the country realize that. And Dr. Patel, as an author, as really one of the clinical leaders in the space for over 20 years serving over 250,000 patients in hormone health, you've seen as far as just the gap in understanding from the healthcare side and what that's translating. And I'm curious, maybe if you can talk about, where do you think the gaps are? Like why are so many patients being misdiagnosed?

Dr. Nayan Patel:

It starts from education. So the provider is not provided, has given the proper education on dealing with this hormone health is the primary concern. I'm always going from conferences to conferences every single year. And trying to learn from there is going to help the providers gain the knowledge to help the patients that are actually seeking this help. And I'm sad to say that the conferences that they're putting out there right now are very minimal and the education level is not there. And so if the providers are not trained, the patients are not going to get the care. So the patients are looking outside now to see who else is out there who is specializing in this industry that can help us. And so I'm so glad that ThriveLab, even though we may not have a proper background of complete medical history or medical team, but what we are, we are specializing in one area, that is literally, people are not being, they're just being abandoned, which is the hormone health. And it starts from not just the sex hormones that we're talking about, but we also talking about the thyroid and the insulins and the cortisol, the stress management. And when we're talking about stress management, nobody wants to deal with it because it's so hard, it's so difficult. And so making those protocols that are in a bite-size, so everybody can follow through and make sure they can achieve success for themselves is what we want to pry upon.

Joshua Host:

It's beautiful.

Dr. Nayan Patel:

And so I'm on this journey with all of you guys to make sure that we put protocols in place that the patients can actually see themselves doing it. Because if you put a protocol that is so far fetched, the patients do not want to do it. Then guess what? We just lost the customer. We lost a patient on this

journey. So we want to put simple ideas, simple treatment plans that can help patients take the first step. And when you know to become a great leader you have to start. You don't have to be a great leader to be born with, you have to start someplace and we want to give them the step by step measures to start and achieve success for themselves. So that's what I see as what we can do and what we should be doing.

Joshua Host: 

Yeah, I love that. Thank you so much for sharing that. And it seems like one thing that you had mentioned as well too is just this kind of provider-patient partnership and making sure there's awareness and education on the provider side, and then making sure that the patients are able to access providers, the right provider and this need for specialization. Dr. B, you've been so instrumental in the 90 Days to Thrive mentorship program with providers. How do you feel that this emotional engagement piece of ThriveLab of spending so much time with patients on the front end, you know, translates into patient success in, you know, finding their, that correct level or optimal level of hormone health?

Dr. Bimisa Augustin:

From a lot of the reviews, you can see that a lot of patients are like, oh my goodness, I actually felt heard. You know, someone is going to sit there, interact with them and not just read from some script or some, you know, I call it like a chain effect. Like, okay, you are this patient, that means you're every patient, so I'm going to treat you with this, this, and this. You know, it's not that way. So we talk to them on a mental level as well. So if they need to vent about something they can and then they can tell us okay, this is actually taking effect probably because of this, they're feeling upset. They can cry to us. They can just open up and feel like we're not those providers that are just gonna look at them-

Joshua Host:

Wow.

Dr. Bimisa Augustin: like okay well, you know, well try this, you know, because I don't know what to tell you about this, you know. We're not just treating one thing. We're actually taking care of the patient as a whole. They come in a lot of patients come in not feeling good, I mean just they're feeling horrible and they've been feeling this way for so long and-

Joshua Host:

Yeah, they forgot what normal even feels like.

Dr. Bimisa Augustin:

Yes and a lot of people are told that you know hormone therapy is so taboo you know oh my gosh it's gonna cause cancer you're gonna die and they are

so afraid, they ask a list of questions and I usually tell them when they're on the call if there's a question that you have I need for you to stop me you know get me off of my soapbox. Ask that question because I don’t want you to forget it. And then what we're gonna do is we're gonna talk about it and then I'll get back on my soapbox. You know and they're like oh my gosh and usually by the time that 45 minutes to an hour ends every one of their questions has been answered and they have never been able to sit down and have a provider do that with them. I mean and then after that it's like hey I want you to come to my daughter's wedding or I want you to come to my restaurant or you know something because now they feel like they have a relationship with their provider and it's not just oh you know, provider patient, I actually have someone I can talk to. I actually have a friend, you know,

Joshua Host:

Yeah.

Dr. Bimisa Augustin:

And it's, it's also great that we're doing this on a virtual platform because even they will ask me, where are you at? And I'm like, Texas. Oh my gosh. Well, I'm like in Tennessee, you know, or something. And it's great. They're like, we didn't realize that providers like this actually existed. You know, and then the fact that they can talk to the pharm D and they're, I mean, they're just blown away. So it’s definitely making big changes in their lives. We still have some growing and changing to do, but I think right now the platform that we are in and that we are working is like doing amazing things for patients all over the United States. 

Joshua Host:

Yeah, I mean, it's interesting. I think for most of us, I've seen, you know, going to the clinic setting in the past, many an hour waiting to see the doctor, the nurse comes in, takes a moment with you, you know, take your vitals, doctor comes in for five to 10 minutes, and then makes a diagnosis from prescription, right? And you're like, well, are you sure you even heard me? Like, we didn't even talk. Like, we didn't spend any time together. Do I trust this plan now? And, you know, it's just the even, idea to be able to spend 45 minutes to an hour with a specialist, as Dr. Patel was saying in this area, that's what our providers are credentialed around. That's what they're trained around, the senior clinical team. This is their last two decades of experience. And to have that three times the national clinic average to spend with a provider, this is what we're seeing as far as in patient testimonials. They’re saying, this is the first time I've ever felt listened to. This is the first time I've ever felt connected or cared about by my provider. You know, one thing I had a question on Dr. Patel, I've always been so moved, you know, by your, how you describe the pyramid, right? Because, you know, it starts at top with the sex hormones and, you know, I think if you could, this has been so powerful as you explained it for me in my life, my own health journey, you know, I don't know if maybe you can share it as far as with listeners of what this pyramid is and how this translates into their health.

Dr. Nayan Patel:

Absolutely. So to me, the whole pyramid describes all your problems. All your problems are coming from hormonal problems, right? Or all most of your endocrine problems. But all the problems start from, and I divide them into four phases. The base of the pyramid, which is the big chunk of the problem, comes from cortisol, or just your adrenal glands or your stress management, which you and I know. Nobody wants to deal with stress manangement because they think it's out of their control. How can they control what's going to happen to them at work? How can they control what's going to happen to them at their house or financing or road closures or bad weather or whatever, right? Or pandemic or, you know, there's so much different stressors out there that they think they don't have, they don't have control over that. But that's the biggest chunk of the concerns are right there. Right above the cortisol, is the next big chunk, is insulin which is your diet. Your diet reflects how your body responds to it or reacts to it. Reacting is bad, we know, responding is positive, but based on your eating habits or your nutrition plan it's going to affect your hormones and it's also going to affect how you feel. And above that one, which is a smaller section, is your thyroid gland. The thyroid affects, even though it affects every cell in your body, it is there but it’s not as big as your diet and your stress management. And then comes the hormones, the sex hormones, and that's the tip of the pyramid. But the sex hormones is what we have in our tool bag to treat with all the problems. If you have so many problems and you only have small tool chests to deal with all your problems, that's not going to work. So when Dr. B said that we spent 45 minutes to an hour sometime to listen to every single thing, it's because why? Because we want them to use the hormones to gain control of the body, to deal with the stressors, to deal with the diet, to deal with-

Joshua Host:

Yeah.

Dr. Nayan Patel:

every single thing that comes to you so that the hormones become more effective. And it's not just giving you, anybody can prescribe medications, but what it is, is giving the medication with the right knowledge and the right support, which ThriveLab does, is the fuel to go from, for where you're today to successful person.

Joshua Host:

Yeah, I love that. Thank you so much for sharing that. I know it's been really impactful in my life and every time I hear it again, it adds some additional depth as far as for me. So it's great to hear. One of the things that we've identified, women are disproportionately disadvantaged when it comes to access to hormone health because of the complexity and also because of the perceived liability. You know, Dr. B, I was wondering maybe if you could just share your thoughts as far as on why it's so important as far as that, for our focus on women's health and making sure that women have access to high outcome, affordable care. And so, I think that's a good point.

Dr. Bimisa Augustin:

Well, women are kind of like superheroes. Okay, so we do, we tend to manage a lot of things in our lives at once. Our stress levels are, I would say, a lot higher because we react, you know, a lot differently than what males will to certain situations.

Joshua Host:

Yeah.

Dr. Bimisa Augustin:

I mean, we can carry 15 different things in both hands at one time and then try to take care of everything all at once.

Joshua Host:

Yeah.

Dr. Bimisa Augustin:

Well, if they're not feeling well, you know, the fatigue starts to set in. They can't move on with their everyday life. They can't function. Their relationships fail even with their children because they don't want to talk or they're just having these depressive episodes. It is so important for women to be seen and heard especially when it comes to their hormones because there's a lot of balance that is absolutely needed for us to carry on a day-to-day life. Josh, you know I'm a crazy multitasker. And I love doing it. I'm not stressed about it at all. You know, it keeps my life wholesome. You know, dealing with the six kids and, you know, dealing with the husband and dealing with that, the ailing parents and, you know, and then my patients. I love doing it. I absolutely love doing it. But I can say from a personal experience, not feeling well and not realizing until Katie Joe came into my life and was like, Dr. B, this is what's going on, that my hormones were totally imbalanced. I mean, and I was like, I never thought about it. But I myself, even as a clinician, I went to my primary care at the VA hospital and still was not heard. I was like, I'm not seeking pain management. I'm not seeking, you know,

Joshua Host: 

Antidepressants, SSRIs.

Dr. Bimisa Augustin:

I'm not depressed.

Joshua Host:

Yeah.

Dr. Bimisa Augustin:

Yeah. So, you know, it was just, it took just that shift, you know, and that help from Katie Jo, when she did the home visit with me, to see on the, I was on the inside. I wasn't on the outside anymore looking at, I was on the inside. And I’m like, wow.

Joshua Host:

Yeah.

Dr. Bimisa Augustin:

Wow. It blows my mind that I can be both a clinician and a patient and realize that oh my gosh these changes are happening in my life and I'm a woman. 

Joshua Host:

Yeah, you've been such a powerful testimony, I know, to other patients that I've talked to, and also other clinicians that have joined just your journey. It's interesting just watching the women around me, how they take care of everybody-

Dr. Bimisa Augustin:

Yes.

Joshua Host:

-and have the least amount of time for their own self-care. And so I think for us, it's been such an honor to have that focus on that we can drive outcomes, compress time to outcomes as well too. So then we can fit it in that window. And that was one of the things I was so taken by in my time with you, Dr. Patel, is that for the last two decades, you've really specialized on the men's health side. But as you said, that's a little bit more simplistic. There's not as many levers there. You know what I mean? So it's like, you took that on and you're like, nailed it. You know what I mean, like there's there's certainly things to stay on top of, you know, but, you know our men's health side, our patients are seeing such phenomenal outcomes, you know, and on the women's health side because of the complexity, you know, you've also made sure to keep that as a central focus. I'm curious, like, why was that important for you, you know, to have that focus point on women's hormone health?

Dr. Nayan Patel:

Well, women's hormones, because we all know women don't like to complain, right? But when they're complaining, when they do complain, it's really, they're really gone on the far end side, right? And so when women complain, that means they're in really, really bad shape that they're not been heard yet. And when you put them on for the first time we're on camera seeing or in the office, the 45 minutes is a very short amount of time for just to discuss what happened yesterday. Forget the last 10 years or what was going to on in the last 10 years.

Joshua Host:

Yeah.

Dr. Bimisa Augustin:

Yeah.

Dr. Nayan Patel:

I focused on women more so than men because the complexity was intriguing. But more importantly, I thought I was able to help them better because when women talk and they tell you what's wrong with you, they can literally pinpoint down exactly how they feel.

Joshua Host:

They're much more descriptive, much more articulate about their issues. Yeah.

Dr. Nayan Patel:

Guys, a little bit muted. More general session. And so, for women's health, it's been, I've been very blessed that I was fortunate to learn that women's health came naturally to me, because I was, I shouldn't say I'm a very good listener, but I was a better listener, and I heard the pain, and I was able to help-

Joshua Host:

Yeah.

Dr. Nayan Patel:

-resolve some of the issues with simple solutions, and after that came the next step, right? Now what? Now hormones are good. What else can I do? I want to lose weight. I want to do this. I want to do that. I want to go hiking again. I want to do every single thing. And then came the pyramid scheme. I said, oh my God, I can help with the hormones. Can I help with the stress? Can I help with the nutrition? Can I help with every single thing? And if everything is functioning fine, can I do something else for you to gain your life back? And so, thanks for asking. But yeah, that's my passion.

Joshua Host:

It’s been a bit of a Trojan- you know, it's interesting you say that- because I feel like hormone health is a bit of a Trojan horse in our ultimate mission, you know, which is to help our patients give their gifts at the highest level, you know, right? Like, and we see it as like being here for service, you know, like what do we do, you know, to help our patients live the fullest life? So then that way they can go and bring the most value into the world, you know, but if you're suffering, and you’re in pain, you know, it's kind of laughable to talk about self actualization or kind of laughable to talk about giving your gifts at the highest level, right? Because the emotional pain points of- the pain of intimacy of not being intimate with your partner-you know, whether it's on the male side of low libido or erectile dysfunction or on the women's side of low libido or pain during intercourse. You know, these are things that are creating so much emotional turmoil or on brain fog and lack of energy or insomnia, sleep disturbances, and they're just robbing patients of their quality of life. And so it's so beautiful because with our program, since we focus so much on this emotional engagement piece, it allows us to be able to measure twice and cut once to validate and personalize the patient's plan. And it also allows us to build a very deep bond, right? And this provider/patient partnership, and we see this as something that then, you know, we anticipate will last for the next 15 to 20 years with the patient and see them through all sorts of different lives of life seasons. Hormones are very different. It's not a set and forget it. What we're ultimately looking to do is find the patient's hormonal bioidentity, you know, so they can be optimized into the future. One of the questions I had though for to kind of bring up and talk about is, you know, we had identified, that 76% of our female patients had listed weight loss as their number one goal, right, which is a huge number as far as of interest and a pain point. Dr. Patel, you know, you work deeply on rolling out semaglutide as far as for our patients. Can you talk a little bit about semaglutide, what it is, the kind of studies behind what it's doing for patients, from a weight loss standpoint.

Dr. Nayan Patel: 

Absolutely. I mean, it's something that we have known for decades that the average weight of a person in America is climbing and it hasn't decreased for at least the last 30, 40 years now. And everything stems from, we talked about the second bucket, which is an insulin, it's the biggest bucket that we have. And without the proper diet, we are seeing a very steep rise of what we call insulin resistance in America. And semaglutide is a peptide. It's a peptide that has been approved by FDA for the reasons to help reduce insulin load. And when we do that part, when the insulin starts leveling off, so does the weight. And so using the semaglutide as a peptide to level up insulin to help reduce the weight is one of the reasons why we think that adding that as a supplement or adding that as a treatment program for our patients is going to help have better outcomes of the hormones. Because again, they cannot do semaglutide by themselves because they have to have the mind first and the hormones get them in a proper state of mind for them to make the right choices about nutrition. So having the hormones taking care of it and then adding solutions like semaglutide for the insulin resistance to help reduce that insulin load down to help them feel better. It's like an add-on. If there was some other peptides that can help do the same thing with the cortisol, you better believe we'll be launching that program next as well-

Joshua Host:

Yeah.

Dr. Nayan Patel:

because that's the bottom, though that's a big behemoth that we have to move eventually anyways. But so having programs like these is to help our patients gain control of the body. At the end of the day, patients are in control of the body. And what we are doing is giving the mind back, helping with the nutrition and the insulin. If they need some vitamins, we are also thinking of bringing a whole customized packs for these patients to help better tailor made their vitamin needs. For all those things. Eventually, the patient becomes the control of their own destiny. And we are just here to support them.

Joshua Host:

Yeah, I love that. It's so powerful. And you know, Dr. B, you're working with, you know, male and female patients on a daily basis, you know, who are, you know, trying to deal with whether it's male patients, they're thoracic fat or for female patients, you know, kind of their trunk fat. How does this weight loss program with semaglutide support, you know, help you support your patients? Like, how is this, you know, how is this being included?

Dr. Bimisa Augustin:

So I do let them know about the semaglutide peptide, but I tell them that this is just a small piece in a journey. It's going to require some more work, but it will, it does help, it does. Basically, like Dr. Patel said, getting control, helping them get control, so that way they can continue to go to the gym or take those walks, and they see the results. So that way, its not going to lead into or it will reduce hypertension, triglyceride levels. I mean, all of the above. So I do let them know about this. And it is very important. I mean, for the ones that feel like they can't get this, their BMI down, no matter what they do, no matter what they do, this is actually help. It's not a quick fix or a pill for an ill is what I call it.

Joshua Host:

Mm-hmm.

Dr. Bimisa Augustin:

So this is something that you are going to have to continue, you know, or add in with your journey of hormone optimization and weight loss.

Joshua Host:

Yeah, and it's amazing as far as what studies have shown. There was one study with 1,306 patients taking semaglutide, and they were showing weight loss of approximately 6% of weight loss by week 12, and 12% weight loss by week 28. And so once a patient then gets to 28, because I think for anybody where weight loss is a focus, losing 12% of body weight’s pretty exceptional as an outcome. But what do patients do to keep it off? You know, because we've all heard about diets where, you know, there's some sort of intervention, we lose the weight for a temporary period of time, but then, you know, if a patient gets started with you on semaglutide or on our weight loss plan as a part of the overall, you know, BHRT management, how do they keep the weight off?

Dr. Nayan Patel:

So that's where, once the weight's gone and in order for you to make sure that you don't fall on the same trap again off of eating those wrong foods, you have to have proper hormone balance. And that's what it's like we stop with the hormones, we get them to the weight loss and with an end of the hormones again, because without the hormones, they don't have the mental clarity. They have foggy thinking. They’re mood aren’t correct. They're not sleeping better. They're overall, all these pieces comes into play for making sure that they're making good choices for themselves-

Joshua Host:

Wow.

Dr. Nayan Patel:

-because we all want to make the right choice. We all do, right? We all say that eating junk food is bad, but you know what? If the bag of chips is thrown in front of me, you know, let me take a couple of swabs at it, right? And having the self-control is so important. And to gain the control, you have to be hormonally optimized. That's what the hormones comes into. It's like angel of life and angel of death. Too much is not right, and too little you can't function. So you've got to have the right amount properly monitored by a team that is dedicated to have the whole life spent just on hormones to make sure the patients are happy, because doctors don't have time to listen to patients. We do.

Joshua Host:

Yeah. That's beautiful.

Dr. Bimisa Augustin:

Yeah.We are accountability partners. Actually, I will tell my patients, we are your accountability partners. We take a team approach, you know, so because you're going to have to control every aspect of your life. We all have stress, good, bad, ugly, pretty, you know, but you have to learn how to control it. So keep your cortisol down. You know, I know cravings come, but you don't have to snack on this high saturated fat food, you know, make a different choice. Take a walk.

Joshua Host:

Yeah, I love that. You know, this is beautiful as far as this focus that, you know, Dr. B, that you have and our providers have as far as lifestyle, you know, and making sure that it's a complete plan. You know, one of the things that I heard Dr. Patel say, and also you include as well, too, in this focus on weight loss is that without having your hormones balanced, the weight loss is somewhat of, you know, of the fatalistic approach, right? Because you're unfortunately always going to have this problem of putting back on these fatty deposits, like unless you can optimize for your hormones as well too. And it reminds me of this director of a weight loss clinic who was working with us to implement a hormone health plan for their patients. Because what they were saying is, we're setting patients up as far as what these weight loss plans, but they're not losing weight. Or they lose weight and then they put it right back on. And it was exactly that. It's because of the hormone imbalance, right? And so as it seems as a weight loss intervention, you know, semaglutide, as an example, if we can help a patient lose 12% of their body weight, you know, over a 28-week period, you know, but then at the same time now, balance their hormones. And then that, it sounds like what you're saying, Dr. Patel, like that's a recipe for long-term sustainable success.

Dr. Nayan Patel:

Yes, exactly. I mean, we want to continue having success, but in my 25 year career as a pharmacist, I have seen all the weight loss, fads have come and gone. This is the first time we are actually making a difference because now we have a peptide that can actually help with the insulin more than anything else. Every drug that we had in the past was either we lose your appetite or we lose your fat muscles of your fat cells faster and then you gave right back. This is the first time it's actually is affecting your insulin load, which gives me a hope that this is gonna be long lasting, provided the patient is gonna make the right choices afterwards.

Joshua Host:

So Dr. Patel, tell us, I mean, so why does it matter that semaglutide helps with managing your insulin load? Like how does that translate into weight loss?

Dr. Nayan Patel:

So insulin, as the insulin level rises, so do your sugar cravings and the carb cravings and when the insulin level is high, it also brings a lot of metabolic stress on your body. Metabolic stress means a lot of attrition of fat cells, right, and then that's where the BMI starts getting higher and higher for us. So in the whole cascade of all these different reactions happening, the first thing is insulin. We need to make sure that insulin level starts dropping slowly. If they can just start dropping slowly, everything else, it's like a domino effect. It will start falling one by one after another. Right? But if we can't be attacking all the other metabolic disorders, we have to attack the insulin load first. If we can reduce that out, everything else, that's why it's not a, it's a slow ramp up process, right? You slowly increase the medications of semaglutide until the patients are tolerable and then you keep the maintenance dose. And at the maintenance dose is when this starts to seep by month three, see the weight loss that's happening. It's not the first week. So it takes a while to see the weight loss. It's because of all the other stressors that are affecting the insulin load, that one has to relax first. So that's what the whole process is. But once the load is down and the insulin load is down and everything else is OK, the patient can still make bad choices and the insulin levels can rise again. And so having to make sure the hormones are in proper control of your mind so you can make the right choices is to make sure that you have your hormones balanced at all times while before, during and after semaglutide.

Joshua Host:

Yeah, that makes sense. And thank you so much for breaking it down. I think it helps to better understand why insulin load is important and how that plays into the effect of gaining or losing weight. I'm curious from both your guys' perspective, if a patient is on semaglutide and they're on Thrive Optum, what are the recommendations around eating windows and also caloric restriction? Like are there any kind of guideposts that you know you're recommending as far as for patients that embark on this journey?

Dr. Bimisa Augustin:

I usually tell my patients, yes, intermittent fasting is good for some. It's not good for all. Portion sizes should, I mean, I guess, be measured for a normal body. Your body has to learn how to utilize the fat that you intake for energy. So if you're excessively eating, especially high saturated fats, your body's not going to know what to do with it. Insulin's going to rise. Stay there. You're going to get the metabolic, the visceral fat, it's going to stay. So look at portion sizes. It's not necessarily about, it somewhat is about what you eat, but I would say about the amount of what you're eating. Because not all diets work for everyone. 

Dr. Nayan Patel:

Yeah I do agree with Dr. Bimisa on that one that, yes, as much as people have talked about intermittent fastings, and I completely agree with intermittent fasting as well, that we should have some window of when we should eat and when we should not eat. You should not be eating three hours before you go to sleep anyways.

Joshua Host:

Yeah.

Dr. Nayan Patel:

You should not be eating as soon as you wake up the first thing in the morning. You know, you got to give somebody a chance to recuperate-

Dr. Bimisa Augustin:

Exactly.

Dr. Nayan Patel:

-if you just, if you just do three hours before you sleep and maybe it's like three hours after you wake up, that goes. 12-15 hours of window that you're not eating anyways. So that's, to me, that's a little bit of fasting to begin with but-

Dr. Bimisa Augustin:

Exactly.

Dr. Nayan Patel:

-the key is the portion size right. When can you see a dessert coming down the food line and say you know what no thank you I'm going to pass on that today. You know that commitment is required and it comes from you. It doesn't come from any doctors or anybody. It comes from the patient themselves that they have to make the choice right there and I'm not going to be there to tell the patient Oh, you cannot eat this today. I'm sorry. They make the choice themselves.

Joshua Host:

Yeah, it's interesting. Nothing tastes as good as discipline, right? Like, because, you know, I love a good dessert just like anybody else, but, you know, it's interesting, going through different seasons, you know, like right now, me and my wife are in a season of not having desserts, like after dinner. And, and it's going through those, there's something about obviously feeling good in your body, right? And you know, like you have this momentary release of endorphins, you know, from having but then right after you feel bad again. You know what I mean? You're like, ah, I did it again. It got me again, like two

minutes and then I'm gonna feel bad for the next two days! And you know, the taste of discipline feels so good. And you know, it's interesting as well too, like intermittent fasting. You know, I'm a huge fan of intermittent fasting. I eat at 10 and five. But I've noticed as far as my wife, for example, you know, she's read a lot about this and she can feel as well too, spiking her cortisol levels for intermittent fasting. Whereas sometimes I'll be on a nomad diet of just one meal a day, that doesn't work for her. I mean, her cortisol levels are just like, off this year, body's just stressed. So it does seem like that with what you guys are saying that each body is different. It also seems when you're talking about portion sizes, I think we all can feel that when we exercise we need to eat some more, you know, slightly more. And when we don't, we should eat less. You know what I mean? And so, you know, I was talking to somebody yesterday and he was like, you know, I got injured. I wasn't moving for a couple of weeks. I go, but let me guess you were still eating to maintain the same level of portions. Yep. Okay. And that's why you put on 20 pounds, right? And it's so important, I think, to reflect on the amount of exercise that we're having compared to our portion sizes as well too, you know, to ensure that, you know, we can maintain that. that proper level. And it also is amazing too, like I think Dr. B you talked about just measuring portion sizes. And for some folks this is just something that they're not willing to do. But if you want real results and you want them fast, measuring your macros and micros like that ultimately is gonna translate to success for you, right?

Dr. Bimisa Augustin:

Yeah.

Joshua Host:

Cause then you know what you're putting in your body is calories, protein, carbs, and you're gonna have a much better idea as far as, you know, what, how you're going to put on or lose weight. You know, we're, I know we're coming up close here. I wanted to talk a little bit about something else that's really important. And, you know, Dr. Patel is the author of The Glutathione Revolution. And also, you know, with patents as far as and glutarol for Glutathione, you know, you've educated all of our, you know, clinicians and a lot of folks now with your book on the benefits of glutathione. I wonder if maybe you could just give us a high level. What are the benefits? Why is it important that someone is on a glutarol or glutathione? What are the benefits that they could see and are there any downsides? 

Dr. Nayan Patel:

Absolutely. So this is my favorite subject, of course. And the reason is because every human cell, every living cell in your body has glutathione in there. And as we age, the level starts dropping slowly. And it's not because we're producing very less amounts. We are producing less granted, but our needs are still the same. So the needs and our production has a change in there, as the year goes by the change becomes wider and wider and so we have less of glutathione in our body and our needs have far surpassed what our body can produce. When that imbalance happens is when we have onset of diseases, metabolic diseases, we have onset of our body getting full of toxicities and heavy metals and chemicals and metabolites and the liver gets taxed all the time. And so optimizing glutathione levels in your body has always been my dream and if I can do that effectively I'll be able to keep a body clean from inside the whole time. Is that what we want? And so it's again, Josh, thanks for reminding me but I was doing the research 14-15 years ago on glutathione and when we discovered the way to deliver glutathione to human bodies for the first time, it took me 12 years just to do research to figure out how much to give, how to give, when to give, how long can I keep giving glutathione, can I do it forever and things like that. And so I did 20 years of research before I launched the book and the products to support that. And just to make sure that I was doing things correctly. But the reason why I'm so passionate about glutathione today is because that's the only chance that's the only product that's produced by the humans that gives a fighting chance to survive through anything. Right? If the levels are good, you can keep the liver clean. A clean liver means a clean body. It can literally fight infections because it can improve your immune systems immediately. And we have known in the last three years during this great pandemic that people that were immunocompromised were the most susceptible to diseases. And having the immune system in check at all times, a body self-sufficient, it produces enough glutathione. Replace those back to normal, we don't have to do anything else. So that's why I'm so passionate about this at this point. We are just in the cusp of the research at this point. We've already done two clinical trials, we are funding more clinical trials this year and I think it's going to be in the next five years. Just watch out, we should be having a lot of studies coming out to support what we're trying to do is to have optimum health for all our patients.

Joshua Host:

Yeah, I love that. And thank you so much for that background. And you know, I'm constantly learning from you as we all are as far as on this, this area on glutathione and, and the benefits. And, you know, one of the ways that you broke it down for me, that made it easy to understand as you said, well, imagine your body, like a pool and your liver and kidneys are like, are like the filters, right? They're at the ends of the pool. They have these little white caps that you pull up. And then if you pull up that white cap, there's all going to be all sorts of junk in there, right? You know, because we have all these environmental toxins, like all this stuff that we're eating that's just polluting our body. Our body doesn't know what to do with it, right? And so the liver and kidneys are just chock full of it, right? And as you explained it, like glutathione, like over a 30 day period of time, like what it does is it goes in and cleans out that pump. You know, so it's like, now, you know, now your body can actually process, you know, correctly without having this junk that's bogging it down.

Dr. Nayan Patel:

Absolutely. And it's not the junk in the colon, because people think that detoxing means just empty the colon out and you'll be fine. The junk is actually in the kidneys. Oh, sorry, not in the kidneys. Well, kidneys too a little bit, but it's in the liver cause liver is, it holds all the toxic metabolites, toxic chemicals, everything inside that one. That is what needs to be cleaned out, every day.

Joshua Host:

Yeah, that's beautiful. And I've seen that in my life, you know, just as you've introduced me to glutathione, and I have so much love and respect for you. And also just in my life of being there for me, like whenever I'm experiencing something, it's like a care package on the way. I got you, Josh, it’s all settled with glutathione. It'll show up the next day and there it is. And, you know, within a few days I'm fully restored. So it's definitely been a miracle as far as in my life and something that, you know, I passionately shared with others around me. You know, I think just in closing, I just want to tell you guys how much I love and respect you and what an honor it is to be on this journey with you, to be working with folks that are so passionate about impact and being here for service of others. You know, and I think this mission of making hormone health accessible and affordable nationwide is so critically important with this absolute avalanche of hormone imbalances that we're seeing from patients across the age spectrum, you know, because of environmental toxins, chronic stress, diet, the way we live our lives. I think for any listeners listening now, like if you're in pain, you're experiencing symptoms, we offer a free self-assessment, you know, for you to check out and see the probability of imbalance. We offer some free consultations as well too. You can also have a 45-minute consultation with a specialist in this space for only $45. It's critical for us that you find the support that you need so you can live life to the fullest. Thank you so much guys for taking the time here today and for being on this journey with me. I appreciate you.

Dr. Nayan Patel:

Thank you very much for having us as well.

Joshua Host:

Beautiful. Alright guys, thank you so much.

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