Men Need Health Too w/ Dr. Josh Dobstaff

This episode brings you a fascinating conversation with Dr. Josh Dobstaff, founder of Progress Medical, who beautifully merges the worlds of traditional and functional medicine in his unique practice. Tune in as we explore his holistic approach that aims at hormone optimization, medical weight loss, and performance optimization. We also take a sip of Discretion whiskey from Tarnished Truth Distilling Company — a delightful treat for the whiskey aficionados among our listeners.

Our discussion with Dr. Dobstaff delves into the intriguing sphere of aesthetic treatments, hormone therapy, and how to combat medical weight loss. We unmask the various symptoms of hormone imbalances and discover the myriad methods of hormone replacement available. For those who find regular visits for hormone replacement therapy challenging, Dr. Dobstaff offers insights into alternative therapies such as IV hydration and B-vitamins. We leave no stone unturned as we tackle the importance of gut health and its impact on overall wellness.

Finally, we present an in-depth analysis of Dr. Dobstaff's innovative approach to medicine, which includes customized IV hydration and infusion therapy. We also delve into the importance of diet in reaching health goals. The episode concludes with a thought-provoking discussion about the current state of men's role in the functional, holistic field, and possible reasons behind the discrepancy. This episode is packed with a wealth of information that is sure to inspire you to rethink traditional medicine and explore the potential of a more personalized and holistic approach to health and wellness. Catch this enlightening conversation and embark on a journey towards improved health.

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Transcript

Speaker 1: 0:31

Welcome back to the whiskey with some podcast. It is your constant co-host, chris Ian Tyler. You all. This week we bring on our special guest.

Speaker 2: 0:41

This is Dr Josh Dobb staff with progress medical.

Speaker 3: 0:45

Thanks so much for coming on today.

Speaker 2: 0:47

Yeah, thanks, guys. Thanks for having me of course.

Speaker 1: 0:50

Tyler's always like out in the world meeting new people, yeah, and he's like, oh, this guy will be perfect.

Speaker 2: 0:57

I'm here for it, yeah, no, it sounded like a perfect opportunity to sit down and chat, so I'm excited.

Speaker 1: 1:02

Definitely. So before we go into the deep dive, we are drinking on Some whiskey. Tyler brought back from Virginia a couple weeks ago. It's the discretion whiskey. Where's this? Aren't tarnished truth distilling company? That's correct.

Speaker 3: 1:21

Yeah, their Discretion is kind of like their flagship. What's get the half coming out of there Interesting?

Speaker 1: 1:26

Yeah, yeah, it's Super classic mash bill 70% corn, 18% wheat, 12% malted barley should have like a classic dry oak Vanilla, some tobacco leaf and green apple notes on the nose and then taste. You should get your Typical like weeded mash bill butterscotch honey, some caramel in there.

Speaker 3: 1:50

Yeah, let's give it a shot. Cheers, cheers.

Speaker 2: 1:54

It's pretty smooth to me, yeah.

Speaker 3: 1:56

Virginia Beach, virginia Beach.

Speaker 1: 1:59

Very interesting.

Speaker 3: 2:00

So my wife, jennifer, actually really liked this discretion and she's not really a whiskey drinker, so that said a lot. Yeah, I really like the other one that we had a couple weeks ago, which is the tarnished true three-year High-rise. Yeah, that one's my one of my favorites, but I like the spiciness with a rye a little bit more, but. But this one's a really good one and evidently for people who don't like whiskey.

Speaker 1: 2:27

Yes, she's a little particular.

Speaker 3: 2:30

Oh yeah, that's the nice way of saying it.

Speaker 1: 2:34

If I'm spending money on something I Expect to be pretty killer, but it's very true but, doc, tell us a little bit about yourself, yeah.

Speaker 2: 2:43

Yeah, so yeah, my name is dr Dapsas, so I started progress medical here in Wilmington. So this kind of was sort of a culmination of a kind of many years of putting together some ideas of what I would want my own Kind of practice to look like. I'm in practice for almost 15 years All across the state. I've done quite a few different things. Largely a big portion of my career was in hospitals, so you know that's where some of my foundation was. My background is internal medicine, which is more of a traditional route right. But you know, as I was going along and you know, in different hospitals and I've I'm a medical director and a few different Clinics across the state, really I kind of got a blend of different things and some different ideas and brought all those together to bring it back to Wilmington to see what my own practice would really look like and and really what that is to me is a blend of sort of a traditional medical practice. You know, in Bringing in some things that we would call maybe more functional concepts Maybe you all heard of Functional medicine, have you really okay?

Speaker 3: 3:52

Yeah, we brought on a doctor, doctor Hillary Rutledge, who has a functional medical practice. Yes, great good.

Speaker 2: 3:58

So you've got a good kind of background and I think I actually absolutely love the functional piece because it's a little bit of a deeper dive right. I mean it's kind of internal medicine is great. I mean that really looks at all aspects of the body and and very good detail and and everything. It's just. You know, I keep saying traditional when I talk about internal medicine and that's a good way to describe it, because that's the typical doctor that you think of when you go to them.

Speaker 3: 4:23

Right.

Speaker 2: 4:23

I'm not really interested in necessarily being that typical doctor, but I'm not a full-fledged functional doc either. But I feel like why not blend them both together? Yeah, I mean that kind of makes the most sense, because I think there are some areas where internal medicine is maybe lacking, or the family medicine route, you know, those right short visits where you maybe feel like you're not getting that deep dive and Maybe not getting the attention. So, like you know, when we look at functional things we can go into a sort of a different direction which I thought was really great, and wanted to bring that together, blend them, to blend them together and then you know see what we could come up with. So, as a brief kind of Overview, what I do is there is some, you know, sort of what I would, I guess I would call primary care which blends those concepts together. I felt like that was a good foundational piece. But then really have gotten a lot of good experience and knowledge on hormone optimization, which I think is an underutilized thing, especially on the traditional side. Medical weight loss is Kind of a big thing right now and so those two go very well together. But we do kind of do them either separately or together, depending what the patient needs. And then I've been very much into, you know. You know I've always kind of been an athlete throughout my life and I love the idea of sort of not only optimizing hormones but performance and so bringing in some more like IV, hydrational things, replenishment, you know, kind of getting into those custom things where we can really make people feel good as soon as they're leaving the office. Got me, got me really excited. So, Started kind of putting together all these little concepts and that's kind of how progress medical came to be.

Speaker 3: 6:06

So when you were in the hospitals, what were you doing in the hospitals?

Speaker 2: 6:09

So initially I was. It's called a hospitalist, so it's kind of like a hospitalist is kind of like your primary care physician while you're in the hospital you can think about it Okay. So I'm the guy that would go and admit you from the emergency room, get you upstairs, see you every day round on you, you know, call a specialist if we needed to, and then, whenever you were discharged, you go back and see your regular doctor. Oh, okay, so there was, you know, that was fine, you know, but COVID changed that Kind of saw a lot of different things. I was working in a hospital in the mountains at the time and it was a very, very small hospital and then we had to sort of turn into a you know, I see you based hospital with limited resources and ability to transfer really sick patients out. So right, that was a that was interesting experience and you know all providers and doctors, especially hospitalist doctors, I think, really Kind of got philosophical maybe and questioned you know what the right approach was for them in terms of their career and for me. I was already thinking about what might be different and then this sort of you know COVID kind of just expedited that sort of Transition for me.

Speaker 3: 7:18

Yeah, where did the first kind of inkling of you know I might want to look into more of this like functional realm of medicine, before you started kind of combining them both together?

Speaker 2: 7:29

Really, when I got into hormones optimization because when I started learning more and more about that and you know like we're talking about when I talk about hormone replacement, I'm talking about testosterone, estrogen, thyroid hormone, things like that and you know, it really kind of opened my eyes about. You know how a lot of the symptoms for men and women who are kind of hitting their mid 30s to you know beyond, you know how much of it could a keyword is, could be a, you know, related to, you know, lack of hormones. And so you know, when you think about cardiovascular risks and cancer risks and and you know All these things, why are we so tired when we hit 35 and 40? And you know, is it, you know, is it just a menopausal thing for women? But the answer is really no. I mean, you know women need testosterone too. That's a big sort of misconception, and so you know, part of the reason why they may not be feeling good is because their testosterone is not optimized. In fact, by the time they're 40, their testosterone levels have dropped by at least 50% Compared to when they were 30s, in their 30s, and so that's sort of a key consideration and something that we talk a lot about when we're talking about hormones, and so it really opened my eyes because you know there's different ways to test for these. You know Hormones and then it kind of gets you down this path where it really is more of that functional. Right process and and and. Then you can do a much deeper dive when you're doing those things and Looking into those things, and it's just kind of expanded really from there right.

Speaker 3: 9:04

So with your practice, is it more of like that family general practice or is it honestly?

Speaker 2: 9:10

No, I wouldn't say that. I mean I do some kind of foundational primary care Concepts. I I have much more of like a concierge type of primary care which is more of like a you. You pay a sort of a subscription fee to have, you know, access to me and my team, and we try to make it a 24 seven thing. So if you've got an issue at 11 o'clock. You know you kind of can call us and we're either getting you in the next day or saying you know, maybe we need to do something else, right? Away that kind of thing. So I do think all of these sort of functional concepts really boil down to good primary care. And then as people you know start naming, you know they need some sort of, you know, recovery type things. You know we have all sorts of things and even aesthetics I mean. So we've kind of branched out into different things to see. So but that is a, you know, kind of a common question I get is like what is your actual practice as a right cares of the other things? And it's I really kind of consider it a Good conglomerate of all those things. Foundational primary care. We can branch off into other areas if we need to okay, nice.

Speaker 1: 10:14

So like Looking at your website, his office is so much more casual. Feeling like it's not a sterile is like walking into like a traditional hospital or normal doctor's office. It definitely has that concierge feeling where you feel at home. You don't feel like that was. That was really kind of the idea, yeah.

Speaker 2: 10:36

I mean it was. The hope is that it wasn't gonna. You weren't gonna walk in and it was gonna. You know Smell doctory and look very, you know, I don't know too sterile like you said yeah, and you know we try to figure out a way to make it much more comfortable appearing. So credit to my wife, lisa, for that. She did all the design aspects of it and you know, still, we're still making tweaks and, you know, trying to make it. So everybody, you know you walk in and you don't feel like you're walking into a doctor's office. You know you're still gonna get good care.

Speaker 1: 11:03

Right, yeah, yeah. That's the random things I pull up and look at. I'm like that actually gives me like the Like one. Guys hate going to the doctor in general. Yeah, sure You've noticed that, yeah but making it so it feels like, oh well, you know, I'm still at home, or it's something a little bit More casual.

Speaker 3: 11:21

Yeah.

Speaker 1: 11:21

I feel like it. I'd be way more comfortable showing up to a doctor's appointment like that You're not gonna feel rushed.

Speaker 2: 11:28

You know it's not like. You know there's other. I mean we have people. I mean we have a relatively smaller waiting room, I guess, compared to other you know doctor's offices. But you know you're not gonna feel like we're just ushering you in, ushering you out, kind of that's not, that was never the goal. So, like when I really kind of thought through what I wanted this to be like, didn't want to be like that if we're talking about anything traditional which again has some value it wasn't gonna be that quick. You know, you got 15 minutes and maybe feel like you got nothing accomplished, kind of visit. So we're trying to do something a little different.

Speaker 1: 12:01

Interesting my random thought process. It says that you have in mode therapy.

Speaker 2: 12:07

Yes, yep, in mode. So that's more on the aesthetic side of things. So, and the reason we got into a little bit of aesthetics is because we were getting really good Results with the hormones and weight loss. So as you do that, then you know things are a little bit Maybe saggy or thinner and things like that. So we've got some good options for sort of like whether it's face or body Things that can tighten up the skin and wrinkles and even some fat, so like in mode is a well-known company that provides some of these machines and I don't know you guys may not have heard of it there's something called Morpheus, morpheus 8, and so in this aesthetic world, if you look it up, it's actually a very popular thing to use, a technique to use for what we're talking about. So usually what that is, it actually does Microneedling into the skin and when it's in the skin it emits a radio frequency sort of sort of like heat which damages the underlying area on just underneath the skin, including the collagen. So it almost like induced damage in a controlled fashion that, as it heals, sort of tones up and tightens the skin, reducing fine lines and wrinkles, and you can even target fat areas as well. So you can do that on the face, you can even do that on the body, goes very deep into the tissue and, you know, can coagulate fat. So we actually get really good results. It goes very well with our you know, weight loss option, like I said or even somebody that wants to just try general body contouring. So that's, the Morpheus is probably one of the more popular products we have. We also have like a laser hair removal Option, and so I think you guys have heard of cool sculpting, yeah. Yeah so it's actually the opposite. So cool sculpting uses cooling to kind of freeze fat and then it leads to sort of a I guess like an inflammatory response that shrinks. Theoretically, this uses heat and then it meets a radio frequency under the skin to heat that area. Okay again does sort of a similar thing, causing a reduction in fat underneath the skin.

Speaker 3: 14:04

So so is that what the medical weight loss is?

Speaker 2: 14:08

So no, not really. That's sort of a, an adjunct or a supplement to the medical. Okay so the weight loss is usually more of a medication based thing. So trying you know, really achieve good weight loss results and so Maybe you guys have heard of like ozempic and Wigovic or sort of the popular injection type medication, now the, the generic names called somegalotide, and that's typically what I end up prescribing and we get really good results with that. So that's. There's other options, but really most people come in looking for that and so it's a once a week injection, usually talking about on average 15% weight loss, which is really good. And there's always new things coming out, new injections, a lot of things. You know that we're keeping an eye out for, whether pills or other Injections, and so we just found people really get great results. It, like I said earlier, it goes Hand in hand with hormone optimization, because I like to tell people, you know I can't really it's hard to optimize your weight If I haven't optimized your hormones too, because a lot of the reasons why you may be having sort of that stubborn weight gain or really difficulty losing weight as we age which you know, if you're 30s, you know, late 30s, 40s, you know then everybody's really experienced that right then you know Part of that could be a hormone based thing. So I try, and you know, when I'm doing a weight loss evaluation which is an extensive sort of lab panel, usually includes hormones to the least say, you know this may be contributing, and then we can have a conversation about, you know, really developing a customized, tailored treatment plan for you that really, you know, dials into what your body's needs are.

Speaker 3: 15:41

I've heard a lot about the like ozampic and stuff too, and my question I've always had and it's probably different for you, the most other people, I would assume is when I think of, like, what the media is telling you about ozampic. It sounds like you walk into like a medical professional place and they're like we're gonna give you this shot, you're gonna magically lose this weight, right, but they're not telling you to do any of the other things that are involved with it.

Speaker 2: 16:02

Yeah good, I'm glad you said that, because and that's really an important thing like I don't want anybody coming in thinking they're just gonna get this and even though you, technically, if you just did it, I'm hesitant even to say that you can lose weight, because you will right the Point and the goal is to have a long lasting effect. We don't lose the weight and then gain it back, which is actually been shown. If you just just do the injections, then go off the injections, you are likely to gain it right back. So what the program is designed to do while you're on the injections, you you combine that with. You know the ride died and exercise programs which build those healthier lifestyle habits while Maintaining and reaching that weight that you really want. And then, as you know, as we hit that goal weight, then we start trying to figure out can we get you off this medication? Some people talk about being on it for life. I don't really personally agree with that. I think it can take longer. For some it can be a relatively shorter process, it just depends. But I mean it's customized and you know. So once we get to that maintenance phase, or even trying to wean off, then we have it structured in the right way. So you know, because those reports that you know even say you know you may be losing. When you're losing weight you may actually be losing more muscle than fat which. I haven't looked into, I haven't verified, but anytime you're losing weight quickly, you're going to lose. It's not always going to be just fat, I mean anybody who loses weight. It's never going to be, you know sure.

Speaker 1: 17:33

I'm not fat.

Speaker 2: 17:33

It would be lovely if it was, but it's not the case, and so we got to be really careful With, you know, monitoring those things and making sure we're Maintaining muscle through a structured exercise program in order to make sure that that kind of thing isn't happening right. So yeah, I mean it's not without you know side effects and risks nothing that I do is no, no physician does anything without Without risks, so we have to keep that in mind. That's why we Do it under the supervision of myself and make sure that you know it's as safe as as possible, right, but there are there. It's not for everybody. There are things that rule people out from taking it, and so that's an important consideration as well.

Speaker 3: 18:15

Yeah, so something that I know you've met, sarah, old from upper.

Speaker 2: 18:19

Yeah, yeah, she's great.

Speaker 3: 18:21

Yeah, something that we've talked about in the past is there's a lack of men and the like functional, holistic type of Field. So, like anytime you look for functional medicine, it's almost all women. Yeah, my question to you and I'm not sure if you even thought about this much, but why do you think that is like? Why do you think men are more hesitant to take that more like holistic, from like looking at their Porma therapy down to like what they're eating approach?

Speaker 2: 18:49

That's a great question. I guess I don't have a good answer. I think it boils down and I'm not saying men are less open, but it does boil down to openness about the alternative options. There's plenty of female Internists that really maybe aren't interested or don't have good education about hormone, hormones and what they can, what they can do, how we can supplement and help each other. I mean so, but I agree, I mean in the functional world you know some of the groups I'm involved in here in Wilmington. I mean it seems like we're dealing with more probably female base. I don't have a good answer for that. I wish you know there was more and I really, like I said, I think it boils down to, you know, us being more open about what People need and I really think. Covid changed. You know, that perspective and that dynamic and like that. That thought about what are we putting in our bodies and what is this treatment really? And maybe we don't really want to just take a pill or whatever it is, which is not what internal medicine is it's fully about. But at the same time, people started asking more questions, right, I mean, when there was whether it was controversial and whether it was valid or not. You know that's a whole separate conversation, but the point is People were asking different questions and I think this is the emerging Aspect. This is the emerging field that Internists need to take note and and and be aware of, and and be a little bit more open about, and so hopefully it's for any male or female MD or DO that you know, is Seeing people ask more and more questions about Some of these alternative therapies to be like, not only like, no, no, no, no, don't do that as like. Maybe you know we keep getting these same in questions. We started have to ask ourselves Maybe there's some validity here and a lot of these treatments are very well studied, so it's not like we're just kind of doing these fringe treatments.

Speaker 3: 20:39

Right right.

Speaker 2: 20:39

Yeah, that's a really important consideration.

Speaker 1: 20:43

I was interested, like you say, in fringe treatment and it makes me laugh because, like for years, I feel like people looked at and like this these are fringe doctors, they're like the treatments are prescribing or just like on the edge, like no one really talks about it. But I would say in the past, like five to ten years, people there's been more research has been Proof to show that like these are things that are helping people and actually doing good work.

Speaker 2: 21:08

Absolutely yeah. I mean, if you look at hormones, I mean hormone replacement has been studied since I mean like the first hormone pellet Procedure was done in like the 1930s.

Speaker 1: 21:18

Oh I mean.

Speaker 2: 21:19

So it's. There's Hundreds of studies, you know kind of validating the benefits of hormone optimization. Again, you know nothing, it's not for everybody, nothing truly is. But there are. It's way more, you know, like hormone deficiency and you know who is a good candidate for hormone optimization. It's way more prevalent than people really realize, and even myself you know, even just a few years ago, when I first got involved in it and started learning more and more about it. I mean it's fascinating, and so it's really not French, it's not something that is just us kind of. You know, going rogue and I'm dark alley doing Validated process really.

Speaker 3: 22:01

Yeah, I think you touched on something really important too is just Taking that time to find out who that person is, because exactly what you say like it's not for everyone, what? What a lot of traditional type of medicine you'll see is, hey, this one thing is for everyone you come in here, you have this one symptom. We're gonna treat that one symptom the way we treat everyone else with that one symptom. Yeah, so I think you touch on something really important there, that it really is the individual themselves. I was even doing like research on like diets for individuals and so just wherever your ancestors were from, like hundreds of years ago, makes a difference on what you can and can't tolerate.

Speaker 2: 22:37

Sure, so like even down to that point.

Speaker 3: 22:39

So just yeah, making sure you find the right person. It's willing to take that deep dive and it's you know.

Speaker 2: 22:43

I mean, speaking of openness of doctors, it's really open to some patients too. I mean everybody has their own, brings their own perspective and needs and goals into the mix, and there's plenty that do want to pill, but there's a lot that don't, and you know. So when, when I do start evaluating a patient that wants to come in and see me as their primary care physician, my first question of them is you know, or the first approach is really trying to dial in where their philosophy is, because I think as providers we need to be a little bit more malleable, not to say this is how it has to be. You tell me where you fit into this. You know traditional, this functional, and then we're gonna wrap it around and, you know, kind of package this up into something that you can actually see some value in and it kind of motivates them to Go further. And you know, really you know, then we can kind of work together to develop treatment plans that they're gonna really get behind you know right.

Speaker 3: 23:34

Yeah, and just like anything in the world, if you're working together on something, you're more, probably more willing to stick with it, I would assume, right.

Speaker 2: 23:40

Yeah, I mean that's been my kind of observation as we've gone through this, really so.

Speaker 1: 23:46

I think it's just interesting, because it's so hard Nowadays, like you said, define a doctor who doesn't treat you like oh hey, you're here, check, check, check, hop out the door and they're not getting that good Like getting to know you treatment, and I think that's part of the reason why people aren't as open about what their issues are. They're like okay, well, this is my current issue, that's what I'm here for, because you only got ten minutes to see me.

Speaker 2: 24:11

Yeah, and if you, I mean, imagine if you had to Do a podcast in ten minutes. I mean, how would I feel for you? You know, you kind of ushering me in, ushering me out and me feeling like I have all these stuff to say. Yeah, but I can't, I can't say all this in ten minutes. It's the same thing with somebody who's got. You know, maybe they do have a list of symptoms, maybe they have something they really are struggling with, whether it's mental, you know, emotional, physical, whatever it is, and it's like ten minutes doesn't cut it and you know, it's not like doctors are bad. They didn't go into this field for that. Yeah, I mean, there's a lot of factors. Again, that's a broader discussion, but there's a lot of factors involved in why those. Maybe it's not ten minutes, maybe it's 20, whatever it is, but it's still fast and you know whether it's insurance or you know, and you know just the volume of patients, and so I got to be careful. I feel like, with you know, I almost am capping the number of patients that I'll see on a concierge primary care basis because, my first Observation is going to be can I deliver and not become that? right, yeah like, how can I kind of keep it with that same vision in mind? And then what is it going to take to reach more and more people, whether it's more staff, you know, or whatever it is. You know, how can we do that? So it's going to be sort of an incremental process for me to to get to that point, but obviously we want to help as many people as we can, absolutely.

Speaker 1: 25:39

I like that. So we're going back a little bit. You mentioned hormone therapy. So, as a person who doesn't know much about anything, when I think of hormone therapy I'm like, so you're doing like testosterone, trt Yep, that's one of one aspect of it, yeah, okay. So my question to you is like For an, a per a normal person, what are the other options? I know you mentioned a few, and what is that like? What do those things actually affect? Besides like your tiredness?

Speaker 2: 26:10

Yes, well, I mean. So when we're talking about, we're talking about hormone replacement, I mean, typically the big ones we're talking about is testosterone, astrogen for for women, progesterone for women. Thyroid is a hormone. There's a lot of different ways to, you know, replace that as well, but we're talking about just like we'll start with testosterone, for example. So what happens is we kind of do a questionnaire and go through a process to identify. You know, could this be, could all this be, signs of, you know, low testosterone? So, and it's not just a libido thing- oh, that's a big thing, no some people do come in and they talk about that, but quite honestly, they're coming in because I'm tired, I'm gaining weight. I got mental fogginess, like I just don't feel like things are clear anymore. I'm more moody, I feel like I'm getting more depressed you know, and these are all things that are just happening more and more as we age. I mean, maybe there's other reasons for that, of course there is, but how we respond to those stresses of life and everything really depend on how optimized we are physically right, and so that these are all things. So there's probably about 20 different lists of symptoms, you know you'll see hair loss, joint pains, things like that poor sleep quality, like there's. There's just a list that goes on and on, because there's really nothing in our bodies that Testosterone for men and estrogen and progesterone for women doesn't touch Right receptors for these hormones everywhere. And there's a really big component to that. And so you start to ask your question like why do people get heart attacks? You know, I mean, and there's studies that show, I mean testosterone, you know, at certain levels, is shown to reduce your risk of heart attacks and strokes, alzheimer's disease, all these things that just everybody can do consider sort of this natural part of aging. You know it's not all Hormones, is not all testosterone, but there is a component of that that has been clearly associated with it. That is an important consideration. So I think part of your question is then how do we replace those hormones? I'm not sure, yeah, what you're asking, but I mean. So there's a number of different ways that we do that. I mean there's creams. They just kind of put on your body and it absorbs in. There's something called pellets, which is a small in office, minor surgical procedure. I wouldn't even call it a surgical procedure, it's just a 25 minute thing procedure where the pellets go, are inserted underneath the skin and they absorb Into your system over time. So you only have to do a pellet procedure Typically, on average will say, four times a year, as opposed to doing a cream every day. And you know, some people talk about variable absorption and how it affects your levels. That's a whole different story. But those are the main things I do, and the reason I do those too is because they are called what there? What's called bio identical hormones. So now there's two different types of hormones, and I'm just gonna keep diving. So there's bio identical and they're synthetic. So synthetic is Fake but it's made you know kind of chemically and it's not the exact structure as the testosterone that's in our bodies. Bio identical means it's identical and chemical structure to what's in our bodies. So I Encourage that there are none of them are without potential for side effects. I mean, if you think about your hormone level getting too high, like high testosterone, no acne, and you know it goes the other way and things like that, what we're not shooting for, that of course we kind of keep it conservative and go up. But what you know, when we do the bio identicals it really sort of is a cleaner process and then, so you know, the side effects with synthetics are a little bit different. So that we've seen. So there's plenty of people that do synthetics and that's typically an injection into the muscle. You know, once or twice a week some people do request that and you know I'm happy to Do it as long as they understand that. You know it isn't synthetic and it's a different side effect profile to it. And you know kind of doing a lot of education about what the difference is between the two benefits and risk of each one and you know really just kind of making sure they feel like they're making a good, informed decision really so the synthetics is at what like the Average person like me would think of like a typical steroid that people take to like get ripped type of thing.

Speaker 3: 30:37

Right, yeah, like an orange-warchen egg or type of you know, it's not even that it's still testosterone.

Speaker 2: 30:41

It's like we call like sippian a that's it's all these different terms that are, you know, sort of like in, in a way, all that you just kind of inject in your skin. It's still testosterone.

Speaker 1: 30:51

It's just structured.

Speaker 2: 30:52

You know the basis testosterone. There's some added kind of components to it that are a little bit different. Your body could sort of recognize that a little bit differently and we see you know kind of different side effects as a result of that. So it's still testosterone, but you know, again, I, I just always encourage the bioidenticals, you know, but again, it's really up to the patient. So, and then you know, for talking about estrogen, that's also. You know we can do that as a pellet. There's a cream for that as well. You know there's other formulations for that, and so it's very common for for for women.

Speaker 3: 31:24

So is that harder to? Because I know women need testosterone, just on a much lower level. Then men, is that a in the grand scheme, not trying to trip you, but like in the grand scheme of things. Like, is that harder to like dose a woman with testosterone than a man because you have to like be more careful with the way that it's balanced, or anything like that.

Speaker 2: 31:42

Or Not necessarily, it's just much lower doses. Okay so like you know, I mean for a pellet, for example. I mean we're talking about, like each pellet for a male is either 100 or 200 milligrams, and sometimes I'm putting in you know, 12 pellets it could be. A woman may need one you know, it's just less dosing and we're targeting different testosterone levels for a woman than a man. So, clearly want that way, way down. But you know, still, I've had plenty of women that I mean. Their testosterone levels are like undetectable you know, and that's not how it's supposed to be, but it's just, it happens and they don't understand and nobody tells them that. You know, testosterone is just as important. In fact, by our concentration standpoint, testosterone is the most abundant hormone in a woman's body, more than estrogen or progesterone. So yeah that's just really an educational piece. So it's just fun to talk about, and then everybody's like, oh, okay, and then we, you know, go down that road and if they are interested and it is appropriate for them, then they really do see a difference. And yeah and usually their husbands are happy to write, I'm sure.

Speaker 1: 32:53

So transitioning, because I'm just going through all the stuff that you guys offer, I mean, and I think it's fun because to me I'm learning so much about stuff like I would have never thought about, so, like I didn't know pellets were a thing, like, like I said, for me as an normal person, the only thing I ever. When people are like, oh hey, he got testosterone, it was just like he walked in had to get shots in his butt.

Speaker 2: 33:18

But, this.

Speaker 1: 33:19

I'm like this seems more, like I said, concierge, better, easier for people to maintain. Like a pellet seems way easier. But also like the creams. I have heard of creams, though.

Speaker 2: 33:30

Yeah. Yeah, I mean I have no idea how they worked, but they're yeah. I mean there's people that don't want to do the pellets. Guys are hard actually to get them. They don't like guys are harder with the needles that way harder than women. So I have some guys who just won't come back, really because of the needle standpoint, and it's just kind of funny, but at the same time it's, don't worry, you know it's a painless thing. I mean, I numb up the area and you're not going to feel anything. It could be a little sore the next day and everything. But you know, by all means, we certainly try to make it as comfortable as possible little ice and Tylenol and usually it's a very well tolerated procedure.

Speaker 1: 34:05

Yeah, so, because me and Tyler do this podcast quite regularly, there are some days where we imbibe a little too much.

Speaker 2: 34:14

Yeah, I know if you need to get the infusion. We shouldn't actually bring with some in here or some time, and keep it going Pretty cool.

Speaker 1: 34:22

But you guys do IV.

Speaker 2: 34:25

Yeah.

Speaker 1: 34:26

So is it just like just called IV fluids, or is it like IV?

Speaker 2: 34:29

hydration? Yeah, we can. You know however you want to call it, but it's a IV fluid type thing, which is a different. You know there's a few different I call them recipes which is a combination of different things depending on what you're trying to achieve. You know, if you're hungover, there's something for that and that usually involves something that kind of controls some nausea. Really, you just need to be hydrated, but there's some like B vitamins and that something for nausea. We can even give you a light, you know, anti inflammatory or pain medication for that, which is it's not a narcotic or anything, it's just a. It's called tortolls, like.

Speaker 1: 35:03

I've heard of that.

Speaker 2: 35:05

Yeah, just like Ibuprofen. So. But then you know, a popular one for us is called performance and recovery, which is good for, like, a lot of athletes. So it's got different aminos, some B vitamins, some vitamin C high dose vitamin C is a very popular thing these days, so and then a mineral blend kind of combine all those together. But you can. It's IV hydration is really fun because you can kind of dial in specifically to a patient. You can. I mean we can go kind of we have our standard blends, recipes, but I mean, if somebody's coming in looking for a certain thing, I'm not going to do a whole micronutrient panel and we can really dive into what we're missing, and then we can just I can create a customized one for you if you, if you really need to. So it's kind of like sky's the limit and as long as it's done in a structured, you know, safe way of course there's a lot of things to consider when we're kind of creating custom infusions, but it's very doable and it's it's fun because and people are walking out almost immediately being like, oh man, I feel a lot better. You know, it's not just a hangover thing, but there's other. You know possibilities there and the cool thing. So I don't know if it's probably yeah, it should be on the website, but something called NAD. So now we're starting talking about getting into sort of an that's more like an anti aging space, which is really where I want the practice to go. You know, sooner than later, and NAD is a cofactor in our body that really drives cellular processes and those levels decline as we get older. So you do an infusion of it and sort of obviously the idea to replenish those which would enhance those cellular processes and helps with what we call mitochondrial function, which is important for your energy. You know cell and turnover and you know how they sort of. You know cells always die and everything in that whole process keeps carrying on. But it enhances that and optimizes that so that you can, you know, kind of help from an aging standpoint. Pretty interesting stuff.

Speaker 3: 36:58

Yeah, I know, joe Rogan is a big proponent of NAD. He talks about it a lot on his podcast.

Speaker 2: 37:03

Yeah, it's an interesting infusion. It's it. It's kind of it's got, it's one that has that you have to control how fast it goes in because it kind of gives you a little weird flushed feeling. It's it's very interesting. It's not in a bad way, but so you just control how quickly it goes in, so sometimes it takes a little bit longer to to get that one. That's a fully infused, so it could be up to a couple hours. Some people are even longer. But I mean it just depends on how it makes you feel it's a pretty interesting it doesn't last. It's like, you know it's once the infusion is done, then you're good, but it's a pretty, it's pretty wild, and so, like I said, high dose vitamin C is a popular thing as well, and we've got a lot of different other add ons that we can do, depending on what you're looking for from like inflammation, or you know, just general vitamin replacements like B vitamins and magnesium and things like that, and even some, you know, infusion, then injections, again tailored more towards, you know, weight control and fat metabolism and optimization. So B12 is a very common one and we have a combination of a few things that focus on that as well. So, for.

Speaker 3: 38:07

For one like recovery, I guess you could say, yeah, let's focus on that one. Just because I'm thinking about it now, is there someone that it's more tailored to? That's like okay, yeah, you're in the gym every single day and you're pushing a lot of weight, or could or could that benefit almost anyone who just relatively frequents the gym?

Speaker 2: 38:26

Really anybody yeah. I mean it's not for sort of like just the hardcore gym goer. I mean, we all need, you know, certain what we call essential amino acids. They're essential because we have to take them in and so, you know, in a lot of them we can get in through our diet if we have a good diet. But a lot of people, surprisingly, don't if they're trying to do something like, you know, intermittent fasting or a keto based thing, typically there's some nutrients that kind of get lost in the shuffle because maybe you're not taking in enough calories, which means you're not getting in the right nutrients, or it's sort of focused on just specific things like more of like protein and fat and everything like that. So you have to be careful. But you know, the point is it's not just for, like, some hardcore athlete. I mean, everybody could benefit from from those I mean mineral deficiencies like magnesium, for example. It's a very common deficiency for all of us and so you know, and we can measure it if we need to, or give a little bit and see how it makes you feel, you know, and but usually a lot of people start feeling pretty good pretty fast when they get this.

Speaker 3: 39:27

It's really funny. You bring that up to the person we just had on before you as a mental health therapist in town and she was talking about the deficiencies in magnesium and vitamin B as well. So that this actually works really well together. But my next question is is that something? Is it exactly what you're saying is using it to supplement? Like you, you can't just not eat those things right and just only get it through the injection not the injections, but the infusions, right. Like it's not going to work the same, or could you? And just not the best way to do it.

Speaker 2: 39:59

Best way is always through the diet, always through the diet, I mean you encourage. I'd much rather have somebody be eating right and getting less infusions, to be honest with you because that's a healthier way to go. But, you know, based on stresses and activity level and all these different factors, you know it's definitely going to help you still, because just most of our lifestyles are geared toward go, go, go and some of us, a lot of us, focus less and less on our own bodies, and I'm guilty of that too. And that's kind of part of why I got kind of passionate about it, because then I can sort of see how it even helps me and you know, then it kind of helps shape how we can help everybody else.

Speaker 1: 40:37

So, right. I'm just very interesting. I was thinking the same thing like when it comes to like doing that the infusions, like it makes so much sense, especially for like people who have a dietary restriction and are like, well, I can't eat this, this, this, or I choose not to eat this. Yeah so in order to get those Like vitamins, like understand, pop it, like taking the vitamin pills works. I feel like every time I take those, I end up like pissing out like 80% of it.

Speaker 2: 41:11

Yeah, I mean that's true. I mean, a lot of them are water soluble, as we say, which means you are gonna get rid of what you don't need. But you can replenish it a lot easier through the IV.

Speaker 3: 41:20

Oh sure. So if I decided we did want to come in, do I need to be like an actual subscription patient If I wanted to get one of these infusions?

Speaker 2: 41:28

no, no, we we don't have, and not everybody is a you know Kind of a primary care patient of mine. I kind of welcome Whoever honestly that wants to come in. So I have tons that just come in for the infusions. Tom, you know plenty that come in just for the aesthetic piece, and then some come in for one thing and end up, you know, going down the rabbit hole of everything else. So sort of a mix of different things. And if you are sort of a concierge member Then you get discounts and some of those other services like these and everything, but no, you don't have to be. It's not that type of membership where it's that exclusive you can come in the door regardless. Good to know Interesting.

Speaker 1: 42:07

I'm just looking, I'm like seems like something will end up doing sooner rather than later.

Speaker 2: 42:12

Yeah, yeah for sure.

Speaker 1: 42:13

Yes, I mean, I still have to find a primary Doc we'll see there you go. Yeah, emily's been yelling at me All year, the past five years.

Speaker 2: 42:25

Yeah, some, you know, and that's common. I mean, some people are just looking for those routine physicals or labs or you know, but again we're still Beyond that. We kind of feel like there's something for everybody there, you know. Even if you don't feel like you. Just, it's not just about primary care. That is a good. I was kind of to call it the foundation, but you know there's so much more that we can kind of dig into if we wanted to. So yeah, really the focus is wellness. You know, you feeling your best, feeling well, wellness is sort of an umbrella term that means different things to different people, but again, it's really dialing in and that's part of the question what is kind of wellness mean to you? And let's try and get there you know right.

Speaker 3: 43:07

Yeah, seems like kind of touching on what a lot of the I guess more specifically with the physical therapist that we've had on in the past or touching on, is these, these aches and pains and the way that you feel and lethargy and stuff isn't it may be normal, but it's not, or maybe typical, but it's not normal.

Speaker 2: 43:21

Sure, yeah, absolutely no, I mean it's. It's not normal you know, and it shouldn't necessarily be the same. It's like oh well, we're just getting older and that's how it has to be. I mean, it really doesn't have to be that way. There's nobody that really has said that that's that's the case and there's nothing we can do about it. So you know, inflammation is a Another topic that has brought up a lot no more in the functional space, and you can look into a lot of different areas like gut health and gut inflammation and things like that that are, I'm sure, have been talked about previously. I mean, there's such a you know so much regarding our gut health that plays a role, and even just how we feel Mentally and physically, and so we can dive into that as well. You know I kind of even do a full-on analysis of everything going on there.

Speaker 3: 44:09

It's a we should have just had a doctor, dove staff and Buffy entries who was the mental health therapist that was on just built in the same Podcast. We're talking about you on a lot of the same stuff. That's awesome. I got health and everything too. So these are yeah, these are perfect back-to-back episodes that we're having here. Do you try that on purpose?

Speaker 2: 44:24

That's funny. Yeah, well, I don't know her, but I would love to meet her, because I mean, that's always a you know something, that we would probably end up going off on tangents for a few hours about it, but that's good that means like you know that's really an important aspect of you know overall health and wellness that often does get neglected on that traditional route with you know, depression, anxiety, like why are we really feeling this way?

Speaker 3: 44:47

Right.

Speaker 2: 44:47

It's dialing a little bit further, so there's ways to do that.

Speaker 1: 44:51

So I have a question for you. Yeah, talk about helping people be well and better in life. What would success look like for you? Like, because you you mentioned you don't want to take on too many people At one rush, but like, what would success look like for your practice?

Speaker 2: 45:07

It's a good question. Success to me, you know, I guess. I guess I'd have to look at that both. Just I mean maybe somewhat selfishly as a person. Oh yeah, I also bigger picture as a practice. So I can kind of look at that two different ways. But success from a practice standpoint would mean you know we're we're reaching the demographic that Otherwise has felt neglected or kind of pushed aside, you know, maybe from the traditional route, maybe from the functional, I don't know, but I mean feels like they have a welcome place to come and they're getting you know Sort of what's considered optimized care for them. From a you know, larger scale standpoint, I certainly envision this to be more than one location and I feel like that would be a sign of worry, a Feeling of success to me for that. But for, on a personal side, success to me I just feel like, is more of you know if I'm, if we're asking ourselves the question of what's what feels the best right now, today, yeah, and that's just a mental and physical wellness question that I think we have to ask ourselves more often, because success to me is not no longer is it a financial thing. I mean, there's still some of that Certainly we would all love to make a bunch of money. But I tell my kids this I have three boys. They're 13, 11 and 8, and that's great and that's wow.

Speaker 3: 46:34

Oh, that's what I'm saying. Yeah, wow, that's right.

Speaker 2: 46:38

And when I quit my job in the hospital largely from, you know, not always only from COVID I was working my way out anyway, but, you know, in the middle of COVID, I tell them the story. I was like I made more money I think it was 2020 More money than I've ever made in my life, that year. And it's not saying that to be arrogant, it's just that's how it is. You know I was miserable doing it. I was absolutely just burnt out, run down, absolutely, completely miserable and that's when I realized that you know that that's not success, right? Right, I had made all the money I thought I could make and, you know, or I was happy, you know, maybe I should just be completely happy because I just made more money that ever made in my life absolutely miserable. So I essentially brushed that aside and, you know, took the pay cut to do this to Kind of focus on what feels the best, you know, and can I? I don't feel like I can deliver good care and focus on wellness if I'm not doing that myself.

Speaker 3: 47:42

Right.

Speaker 2: 47:43

I wasn't doing that at the time, and so if I can, you know, get some financial Success out of that while blending those two, great, but that's never gonna be the only aspect of it for me. So success to me means I can come home. I still have energy for the family, you know, still have, you know, energy on the weekends, and so that's my goal is really to to get that Part of my life, you know, on a true wellness path, and so I feel like I've made a lot of good strides really since I quit doing the hospital and focusing solely on getting this practice. You know it's on its own successful path.

Speaker 3: 48:21

So yeah, I kind of plays in well with my next question then. So if you could tell you you're in yourself one thing, what would it be?

Speaker 2: 48:28

Hmm, probably that I mean you know that, that you know money's really not the only aspect of of you know Success right. I don't think, and I, you know, I was always kind of fixated on that for a while just to be completely honest, selfishly, and my wife has been good about sort of Redirecting me to be like. You know, this is really not what it's all about. You know we can enjoy there's so many other things to enjoy that you may be missing, and so I would probably tell myself, my younger self, to take a little bit of step back, relax a little bit. I think I still always would have gone into medicine, for sure. But you know, changing the perspective a little bit and slowing down would have been a welcome thing to do.

Speaker 1: 49:11

Yeah, definitely just interesting. That's my, that's my phrase, for this season is interesting. Is there anything you would like to shout out social media wise, or internet wise? Or people could find you.

Speaker 2: 49:25

Yeah, yeah, so our website's progress medical calm and we are posting a lot on, you know, facebook and Instagram. Typically, instagram is progress medical I am and you can find us on Facebook as well, so we post a lot there. I'm doing some, you know, different things through, like wwa y and small snippets, I think you there we recently just put one up on the website, so there's some things to look there where I kind of talk much faster or condensed about what we offer and what we do. But I think the main thing to understand and that's kind of we were posting a lot of different things. You know there was always an aesthetic thing and then maybe there was an IV over here and then you know everybody's kind of like what are you, you know, and so I really hope this helps kind of Package it up a little bit better and tell you know. So people know that we are sort of a full service practice that can focus anything from primary care to even sick care, to hormones and weight loss and functional aspects and IV hydration, everything just kind of sort of built, built on you know itself. And so to me that's why I kind of had the coin, the term progress medical, because everything is sort of a Moving forward and kind of changing and progressing and so I, you know, kind of look to Keep doing that through the practice and seeing where the next you know service or offering may be. So hopefully it continues to progress and grow and change based on what I feel like people need.

Speaker 1: 51:00

Yeah, that's right, I love it, thank you. I also want to thank all of you listeners for hanging out through the whole podcast. I just want to say, yeah, thanks. Like comment, share, subscribe all the things we are literally on all of the things.

Speaker 2: 51:15

Yeah, nice.

Speaker 1: 51:17

Yeah, even we were on the app that was formerly named Twitter. Oh yeah, at least I am. I don't know Tyler's, I'm not. I think it's just funny that they changed the name we are on threads, though, oh. Yes, we are, we're definitely on just because that's the great evening. But if it's involved with meta, we're definitely there. Nice, thank you for coming on, doc.

Speaker 2: 51:37

Yeah, thanks guys for so much it was great.

Speaker 1: 51:39

Really, it was a blast check them out, check out the website and Cheers, cheers.

Speaker 2: 51:45

Thanks, cheers everybody I.