Peptides, Performance & Personalized Health: The Future of Longevity Medicine with Myles Spar, MD

[00:00:00] Dr. Myles Spar: We're seeing TikTok ads with influencers who are hawking a beauty product on one and then a peptide and lined up with peptides that they're injecting into themselves, calling themselves like "Dr. D," and there's no doctor anything in their background. And then people are listening to them and injecting themselves with things they order from a TikTok link from some company. Um, that's really concerning to me. Really concerning to me. This is Next Level Health. I'm your host, Dr. Melinda Ring, director of the Osher Center for Integrative Health at Northwestern University. On this show, we explore ways to take actionable steps towards optimizing our health with leaders in the integrative, functional, and lifestyle medicine fields who believe in science-backed and time-tested approaches to well-being. Let's take your health to the next level.

[00:00:57] Dr. Melinda Ring: Today we're zooming out and asking a question that I think a lot of people are quietly—or not so quietly—wondering: Where do we actually stand in longevity medicine right now? Because if you open social media or read the headlines, it can feel like we've found the secrets to aging: peptides, NAD, stem cells, AI-driven biomarker dashboards, continuous tracking of everything from glucose to sleep stages to recovery scores. Longevity medicine is hot. Investor money's pouring in. Influencers are giving advice. Patients are showing up to me with spreadsheets of their labs and wearable data. But what is truly advancing healthspan and what's premature? How do we stay focused on what actually works? My guest today is a good friend of mine, Dr. Myles Spar. He's someone I deeply respect in the world of personalized and performance medicine. Myles is board certified in internal and integrative medicine, and he's worked with elite athletes, high performers, and patients in free clinics. He's a leader in men's health, co-editor of the book "Integrative Men's Health," and he currently serves as Chief Medical Officer at WndrHLTH, where he focuses on root-cause, participatory care to help reverse chronic illness and promote longevity. Myles brings something I think we desperately need at this moment: perspective. Myles, I'm so glad you're here.

[00:02:27] Dr. Myles Spar: Me too. Good to be here. Thank you.

[00:02:29] Dr. Melinda Ring: So, good to see you. So you and I have known each other for a long time now. We've been in this field long enough to see trends come and go, trends and everything comes and goes. So what feels different for you about this moment in longevity medicine compared to even like five or 10 years ago?

[00:02:49] Dr. Myles Spar: Sure. Well, I think a bunch of things. Number one, just the term—I think, to me, longevity medicine is making understood what you and I have been doing for so long. And so I think finally this idea of preventive medicine based on data that's very personalized, it's very proactive—which we've been calling integrative medicine because that does emphasize that we integrate other traditions other than Western medicine, and that's still important—but that's been kind of folded into longevity medicine. Now people understand that when we talk about longevity medicine, a lot of them didn't really understand us when we tried to explain what integrative medicine was, or when the functional medicine folks explained that, or even lifestyle medicine. So I feel like longevity medicine encompasses all of that because it's not so much about the tools that are included in the name; it's about the goal. And so that resonates more with people. So I think one exciting element is people who really need to drive this movement understand, "Oh, this is medicine that's about helping me stay healthier longer, helping me perform better," which was ultimately always the goal of integrative, functional, and lifestyle medicine. We were focusing on the tools we used, but that's fine if we needed the PR to make this a more commonly understood field, but it's still all about Leroy Hood's 4P Medicine from back in the day. That preventive, participatory, personalized approach—I'm all for it. So, that's a big change: that people understand what we've been talking about for so long and what we're passionate about, and that's about not waiting until you're sick to intervene, not relying on the sick-care system that we have. I think the other exciting thing is now everyone understands, as I just explained, but there's also science to this. There's a lot of science to what we've been saying for years—and we've always had the science—but there's more science than ever about the role of nutrition and eating right, the role of exercise, the role of brain health and brain training, and the role of optimizing sleep. There's now a lot more evidence on how that impacts healthy aging, aka longevity. And there's the ability to synthesize it all. So we might've had all that data and we might've been able to personalize an approach from data, but we had no idea how to synthesize it all. But with AI—I hate to bring AI into everything, I know...

[00:05:07] Dr. Melinda Ring: I love AI though, I gotta say, but yeah.

[00:05:10] Dr. Myles Spar: Yeah. It gives us these tools so now we can make sense of all of this data that we've all been collecting from the Matrix and everything else we've been doing with patients to personalize a plan. So I think that's why it's a unique time. It's not just a trendy thing. It's a time that we've been waiting for to get to do what we've been trying to do.

[00:05:29] Dr. Melinda Ring: Longevity. Yes. It's like sort of the hot new term, but maybe it used to be called anti-aging medicine. And does that mean something different to you? Like do you think it has a different feel to it?

[00:05:42] Dr. Myles Spar: Yes, very much so. And I teach in all these spaces, right? I teach in the integrative, functional, and in what used to be called the anti-aging space, or regenerative aging space. It has a real different feel. I think longevity medicine has a lot more legitimacy to it because it's about how we stay healthy longer and decrease those number of years of morbidity. You know, the average person has 13 years of decrepitude. Actually, women have more years than men because women live longer than men, but not necessarily healthier years. So longevity connotes that we're talking about healthy aging, not just aging longer. And ideally, those of us who are really expert in this field aren't talking about preventing death, and we're not talking about shiny things that are supposedly anti-aging that haven't been proven. We're talking about the major issues of lifestyle that actually extend healthspan. And to me, that's longevity medicine. It's different from anti-aging, which was more about trying all these different interventions to prevent death. That isn't what longevity medicine is about.

[00:06:54] Dr. Melinda Ring: And then  I'm guessing you would say the same thing about the term biohacking. Is it?

[00:07:01] Dr. Myles Spar: I've never liked that term. I feel like, you know, like we learned in our training—I mean, you were one of the first people to do the integrative medicine fellowship—there just isn't a "hack." Maybe there'll be a hack that makes us not have to exercise and eat right and sleep, but guess what? That doesn't exist. It probably won't exist. And we need to be as healthy as we can if it does come out that it exists. So a "hack" implies that you can shortcut what we know makes a difference. And I just don't believe that exists.

[00:07:31] Dr. Melinda Ring: I a hundred percent agree. So, uh, you mentioned one thing when you were just talking about science. Yes. Great. That we have growing science. I feel like in a lot of ways, like when we think about exercise science, for example, or nutrition science, that, yes, there's more science, but there's also more confusion about it because it's sort of like, okay, wait. So now we're supposed to be doing zone two training. Oh. But now, hi. But HIIT training was the exercise to do, and Oh, fasting is good for you. Oh, no, we shouldn't be doing that. You know? So it seems like while there's more science, it's like creating a lot of noise. Not noise, but like a lot of confusion. And I, I'm curious again, from your perspective, Maybe there's something to all of that, but it's more about what is right for the individual person that personalization, or do you think that there's like, oh no, you know, we used to think we should be doing this, but now it's clear we should be doing this.

Like we're, we're, what's happening with this plethora of information that we're getting?

[00:08:36] Dr. Myles Spar: No, great point. I think it's about personalization. I think that for some populations, Zone 2 is better; some need HIIT, depending on your goals. So it's depending on the individual and your goals, and that's where we are needed as humans and as people who are trained, not just influencers. Nothing against influencers, but influencers who aren't trained and AI aren't going to provide that personalization. Getting to know an individual—getting to know what their goals are, what they've tried, what they really want to achieve, what matters to them—that's the context. And then looking at their genes, their microbiome, their blood test results, their functional test metrics, like their VO2 max and their strength. Then we could say, "Oh yeah, for you, you want to win at a triathlon, you need to do this training. Oh, you want to lose body fat? You need to do this. Oh, you want to prevent heart disease? You need to do this." So, yes, everything is true: HIIT training is true, Zone 2 is true, ketogenic is true for certain people. That's why it's confusing, because they're all true for segments, but we're getting to personalization, not just by group, but by individual. And that's where it becomes much more clear.

[00:09:44] Dr. Melinda Ring: I think it also changes even for an individual over time. So like, you know, when I'm, I, I was just teaching some faculty and I was saying like, okay, ketogenic diet, like you mentioned, it's like, well. There's some good data for ketogenic diet. People lose more weight on it in the short term for a calorie controlled other diet. But what I then see is sustainability is an issue. Like I, I dunno, and I, I've had a lot of patients who have done keto, done it successfully, they miss their carbs and then it's not like a long-term life for that, you know, life, diet. And so yes, it may be right for the individual. For a particular goal, but maybe not forever and ever.

[00:10:27] Dr. Myles Spar: Great point. Yeah, absolutely. Depends on what's going on at that time. For sure.

[00:10:32] Dr. Melinda Ring: You brought up. Some of the many measures we can measure continuous glucose, and now over the counter continuous glucose monitoring. Um, we have heart rate variability you can do with your AA ring. You can do a VO two max and sleep stages and home inflammatory markers and hormones like throughout the month. Epigenetic age, age, body composition, sleep stages, all kinds of things. It was like an unprecedented amount of information that is available. What do you think about this? Like, is this a good thing? Is it paralyzing to some people? Like how do we handle like this massive amount of data if we don't have a Myles Spar sitting in front of us to help us piece through it? Like, what do we do with all of this?

[00:11:20] Dr. Myles Spar: That's where, yes, I think it is good. I honestly do, and I think that's where the AI is helpful. It's not the answer, but that's where it can help you and me as the clinicians to look at a patient's goals and where they're at right now. We can decide what to personalize. But yeah, the more data helps us get to that precise personalization that we were never able to do before. Obviously everyone can't do everything, but the more data you have—at least having your genetics, your microbiome, and some essential biomarkers to get a background—then if you can do things like metabolomics, that gets to this amazingly granular detail that can measure what's going on in your body way before it would show up in a regular blood test. So anyway, there are a lot of these tests, yes, I do think are really helpful. But which ones to do in which order? That's where you need a clinician like one of us to say, "Well, what are your goals? What are we trying to achieve? And what are you willing to do?" Because if you're not willing to change your diet or take some supplements or change your sleep habits or your circadian habits in general, or work on brain functioning or take probiotics—whatever it is—then there's no point doing a bunch of testing. So it depends on what you're willing to do and what your goals are, but I do think it's helpful, I hate to say it, to get all of these...

[00:12:35] Dr. Melinda Ring: It's okay. Yeah. I'll have patients who come in and they'll be like, you know, I wanna do this function. I read about this, I wanna do this functional medicine test. Or you know, like a food sensitivity test, which we know has questionable validity. And then I'm like, well, are you willing to do an elimination diet on the other end? Because if you're not, we shouldn't be doing this kind of test. So the other thing I have seen, and I've even seen this with my husband, is, sometimes that data, it. Can be negative or can increase anxiety. So like I, I know, uh, Michael, he was wearing the aura ring.

He came down one morning, he's like, oh, I slept great last night. And then he looked at his sleep score and he was like, oh, I'm tired. Uh, 'cause it was a low score. And I'm like, you know what? I don't think this data is helping you or serving your goals. So maybe let's put that to the side for you. So do you like, what are some of the pitfalls with some of these monitoring sorts of things, do you see anxiety or like overload? Like what are, what are some of the risks of having too much information?

[00:13:43] Dr. Myles Spar: I—no, that's absolutely a thing. I think it's different from blood biomarkers and some of the other markers from the wearable data for sure. And that's an issue that I think is only going to get worse, that we're always kind of tapped into all of this data about how we're doing—our CGM and our—I mean, you know, I'm ridiculous. I have here my Whoop band, my Oura ring, and my Apple Watch. It's crazy. And I have my CGM on. It's ridiculous, but I love it. It absolutely happens, like with Michael, where you're like, "Oh, I thought I was well-rested; now I know I'm not." And it's just fatiguing and it's overwhelming and it's confusing. So I think doing it for a couple weeks at a time to actually try little experiments in those couple weeks is best. Try not drinking. A lot of my patients did Dry January and we kept up with these metrics to see what impact that had on heart rate variability or on sleep quality. Do it with intention as an N-of-1 experiment. Don't just wear them every day just to wear them, just to have something to do while you're having your coffee. Do it with intention and don't do it all the time. Absolutely take breaks from all of that wearable data and then try again when you decide, "I'm going to try not eating sugar" or "I'm going to try not eating after dinner." But do it with a real scientific approach. Like, "I have a hypothesis that when I eat after dinner I don't sleep as well," so test it out. But the blood tests, you know, it's interesting—that's a different category because now we can test things like P-tau 217, these tests that are predictive of things like Alzheimer's 10 years later. And I would've said those just increase anxiety—and in some people they do. I have one patient who told me, "I want to do it, but my wife won't sleep at night if I get this done and it's elevated." So for her, it's like, "I'm not doing it." But I think you and I have learned, unlike some of our conventional medicine colleagues—and I'm a primary care doctor, nothing against most primary care docs, but many of them didn't learn what we learned—that a lot of this is actionable. Dale Bredesen and others have shown that most of what we can measure actually is actionable in terms of lifestyle changes that might be more likely to be implemented if we have some of that information.

[00:15:55] Dr. Melinda Ring: So if these blood tests that you're talking about are these blood tests that somebody could theoretically go go to their primary care or other doctor and get just like through their regular lab or quest or LabCorp, or are these specialized tests that really need to be done by somebody in the longevity space. So

[00:16:16] Dr. Myles Spar: I don't think they need to be specialized; I think they need to be done by a doctor who's comfortable interpreting them. I don't think they should be done just online without anyone interpreting it. I'm happy that there's a democratization of access to tests, but I really don't like it when there's access to tests without someone to interpret and explain it. Because that does cause the anxiety that you mentioned, and that's really not fair, in my opinion, to offer it without a clinician going over it. It doesn't have to be a doctor; it has to be a trained clinician. It could be a nutritionist, an NP, or a PA. Having said that, it doesn't have to be a longevity expert. A preventive-minded clinician can learn how to look at these tests. How do you look at an APOE test? And if it's APOE 4 homo- or heterozygous, what do you do about that? They don't have to go through the whole Dale Bredesen ReCODE program to know, "Oh, there are some things you can do early on to try and prevent some brain changes." So I don't think it has to be an expert in everything. And by the way, there's not one "longevity expert." That's another thing that bugs me. Medicine is everything, just like integrative medicine is everything. We don't want longevity medicine to be about a personality and one expert. There's expertise in brain aging, hair aging, ovarian and hormone aging, men's health and aging, and heart aging. So there are so many different experts. All you need is any clinician that's willing to do a little education in some of those aspects of aging and ordering tests that they learn about how to interpret. 

[00:17:57] Dr. Melinda Ring: If somebody is adequately trained in longevity medicine, there's not a fellowship. It's not a board certification. Like where, where do we know, uh, how do we know?

[00:18:09] Dr. Myles Spar: Right, that's a really good point. I get concerned about people who do one weekend and call themselves longevity medicine clinicians. There are more extensive training programs that don't require a full fellowship, so A4M has some good ones. So if you're a patient, I would look for someone who's done at least some modules of training from a place like A4M. Then there's a nonprofit called the Healthy Longevity Medicine Society, which is great. That was started by Dr. Evelyne Bischof, who's working in an academic medical center and has started this along with others to promote education that's very unbiased. She's not in a for-profit place, and they provide very good education that they update. This is not a giant commitment if you're a clinician out there; it's something that's free online. There are modules that give you a good introduction. Having some structured curriculum of the science to this is key. That's the thing—if there's one branding problem longevity medicine has, it's that there are a lot of clinicians and even non-clinicians, frankly, calling themselves longevity medicine experts. They're either influencers or they've done a weekend course at a non-CME type of event and suddenly think that they can hang up their shingle.

[00:19:26] Dr. Melinda Ring: Yeah, I feel like we used to worry about that in integrative medicine, people hanging up their integrative medicine shingle and rebranding with that. But now I think that's what's happened in longevity because it's the big, the big buzz. All the books and all kinds of stuff. So if we go back to, you know, our heart of stuff too, you, you talk about majoring in the majors. Those basic kinds of things. So in a world that is obsessed with cutting edge innovations, um, and interventions, why, why do you, are those still the foundation? if somebody's spending thousands of dollars on peptides, but sleeping five hours a night, like, why is that an issue? Why did the basics still move the needle more than anything else?

[00:20:13] Dr. Myles Spar: Yeah, great question, because that's what the science says, right? Some of the shiny objects—first of all, there's nothing really proven to extend lifespan. All those shiny objects—rapamycin and peptides and all that—none of those are proven to extend any days of life. And to the extent that they can contribute to healthspan, maybe they contribute months where the "majors" contribute years, and we know that. Your diet and your nutrition, obviously sleep—or what we call chronobiology—are hugely important. Brain health is very important, looking at things you can do to assess very early on any chinks in that armor of cognition. And nowadays, exercise is a huge part of what we do: moving and measuring all aspects of your ability to move well, to be flexible, to have good core strength and good muscle mass. Now we know power is associated with longevity. So, assessing that—and then that sense of what we call flourishing: joy, meaning, purpose. Those are the five pillars, and we know that's what contributes to a healthy life. We have on our board Bob Waldinger from Harvard; he's the psychiatrist and head of the longest study of human aging, which has shown that connections are the most important things to people flourishing and feeling satisfied with their life—that they're living a well-meaning life. Peptides aren't going to do that. They're just not. I mean, you could take oxytocin and feel a little bit huggy for a moment, but it's not going to do that. Those are maybe icing on the cake. If you're doing everything and dialed in with all those five things and you still want to compete in Hyrox and do really well, fine—look into the peptides. I'll leave that up to you. But where I work and what my passion is, it's not about that. We're not doing stem cells or peptides or NAD or anything where I work. Those aren't contributing nearly as much as these fundamental changes, if the care plan is dialed into where you need to improve based on those tests we talked about and based on your "why."

[00:22:17] Dr. Melinda Ring: That. Fascinating. 'cause I, you know, I know you're working with, motivated population and like, honestly, my initial thought would be like, oh, they're coming to you and they're gonna be like, what? You want me to just change my diet? Oh, you want me to sleep? Where's the injections and all the other stuff? So the shiny stuff. So, how do they respond when you're like, you know, really, let's focus on these big five and here's why. And those other things are not what we do

[00:22:48] Dr. Myles Spar: They respond really well because we do this deep phenotypic assessment. We get 12,000 markers, believe it or not, three times a year on them. So it's a deep dive into their ability to move and perform, with VO2 max and DEXA scans and all that, so that we are able to say, "Here's where you're great." These are celebrities, professional athletes, CEOs, and founders. You think you are a master of the universe in all these domains, but guess what? There are chinks in your armor, and we found them, and we're going to help you. And the way to help you is not to take a bunch of peptides; it's to dial in these things. And then they get it, and they see that. And if they do the program, it always moves the needle.

[00:23:33] Dr. Melinda Ring: That's amazing.

[00:23:35] Dr. Myles Spar: Yeah, it's so exciting, Melinda. It really is. We have one person who, again, thought he was great and all that, but his blood sugar was not great. And we know blood sugar has a million issues and causes all sorts of metabolic issues—we even call Alzheimer's "Type 3 diabetes." And so he was finally willing to work on his blood sugar and dialing that in, which he had never done before. But there were two interesting things about him. One is, with regard to the blood sugar, we got it down and he was so strict, working with our nutritionist. And then he said, "You know what? I'm not willing to live that way. Like, you have the flourishing pillar and I wasn't flourishing. I was eating exactly what you told me to eat, and so we need a middle ground. I don't care how many healthy years it's going to add; I need to be able to eat and not stress as much." And so it was great; we found that middle ground. He also said with his exercise, "I cannot add one minute to my exercise regimen, so you can change whatever you want, but I'm not adding one minute." And that's what we did. We just changed what he was doing. He's an older gentleman, so what was important was lean muscle mass and increasing muscle mass to prevent sarcopenia and bone loss. That happened very significantly: he gained like five pounds of lean muscle in a year because of the workout that we did without adding any time. So it's all about that personalization.

[00:24:58] Dr. Melinda Ring: You've mentioned a few gentlemen who have participated in the program and your focus for a lot of your career has been on men's health. And we know that men on average engage the healthcare system less than women. Like you mentioned earlier, they die earlier and. Are you seeing, or do you think that the surge in longevity interest is pulling more men into caring about their health into proactive care

[00:25:24] Dr. Myles Spar: So we're very mixed. We're probably half-and-half men and women, while most integrated practices are more women, traditionally. A lot of the longevity practices were more men. I think that's going to change. I think we are now seeing a reaction, luckily, to the "bro-longevity" kind of mindset for various reasons. It's about time, because it shouldn't be that bro-longevity kind of attitude. The other thing is I think there's really an outcry appropriately from women understanding what hormonal shifts do in terms of symptomatology that we haven't really given good credence to or acknowledged. And that really affects longevity and affects things that we would just chalk up to aging—which could be anything from itching skin to brain fog to hearing changes. We're built based on the expertise of 60 of the world's best scientists in every aspect of aging, which is amazing. So one is Jen Garrison, who's this expert in ovarian age, and she's taught me a ton. She's at the Buck Institute, and she talks about how changes in age—not just menstruating or not—this is starting at menarche going up until death. Ovarian function actually doesn't just stop at menopause. There's still important things going on. So if a woman has a surgical oophorectomy, that affects things; if they don't, that affects things. We're learning, and I think there's more and more interest from women in longevity, luckily, because they're finally getting some of the answers they weren't getting before.

[00:27:07] Dr. Melinda Ring: Yeah, it's interesting if you look back at, you know, the history of just research, you know, traditionally research has focused on, has included. Middle-aged men, like the common cohort, excluding women because of that hormonal stuff. And that's led to issues in and of itself. And now we're in a menopause moment. And it's, it's all about like, oh, just everybody should be taking menopause hormones. We miss the boat with the Women's Health Initiative. And, you know, nobody was talking about it. But I, I think again, too, that's almost getting, narrowing it to such a OneNote. Response to women's health. Like, oh, if you do, you just need to do this. I mean, it's better than not talking about it, but it's also like such a small part of what women's health needs too.

[00:27:58] Dr. Myles Spar: Yeah, I think it's a great point. I think since COVID, for men, there was a focus on men's emotional wellness. Men suffered a lot from COVID; they didn't have the connections that women did, by and large—and this is obviously generalizing. So there was this—and then the Me Too movement brought out that men don't know how to not be a jerk and men don't know how to connect with each other. And so the last few years, I think, have been about, "How do we help men be like decent men?" And now we're like—okay, we kind of overcorrect and we're like, "Oh, the poor men." So I think now there's all this science that's come out. Finally we realized the WHI led us all astray, and so now we're realizing, like you said, there's a lot more about women's aging than we knew before and we're starting to understand it. So hopefully we'll just look at everybody.

[00:28:54] Dr. Melinda Ring: Let's pivot to talk. About some of the things that are dominating the headlines, because I do very much trust your opinion. Talk about those shiny things, the peptides, the NAD injections, the stem cells. Like what do we do with all of this? Because I'll tell you like I've, I've lurked in some Facebook groups I see patients telling each other like, to do this, oh, this is what I'm getting from this online pharmacy. And, uh, you know, and, and oh, I feel so great and, you know, and, and all this stuff. So like, what about, and, and now we have to separate this from like the GLP ones, which are now FDA approved. And so I'm not. In my mind there, maybe there's something there, but I do this, yeah. So what do you do with these peptides and injections and stem cells and IV infusions and, uh, blood cell washing and all this stuff? Like what, what, how, how do you counsel your patients on this?

[00:29:54] Dr. Myles Spar: Yeah. Well, number one, I don't want to paint all of those things with one brush; they're all a little bit different. But I start with, like I said, let's get the foundations intact, right? And those are kind of icing on the cake if you're truly dialing in these majors that we talked about. There's some of them that I just feel like there's just no science, like IV NAD—there's just no science to it. I think it's a waste of time and money, potentially dangerous, but at least dangerous to your wallet. I don't know enough to comment on stem cells, honestly, but the colleagues I respect the most are not doing it, so that tells me a lot. And I have access literally to the world's leading scientists and none of them are advocating for it. That tells me something.

[00:30:33] Dr. Melinda Ring: It's important.

[00:30:34] Dr. Myles Spar: Yeah. And I mean, they're all researchers, and I—again, I want there to be some amazing silver bullet, but we don't have it yet. Peptides are a different story. There's such a heterogeneous group of them, right? Like GLP-1 is a peptide. There are thousands of peptides. Some of them are FDA-approved medications—like Thymosin alpha-1 is approved for hepatitis in many countries. And so there are ones that have human studies that are good, but most of them don't have good human studies. The good side is they're mostly very safe because they're really small molecules. By definition, they're under 50 amino acid chains and they are signaling molecules. They're not exogenously taking over a whole mechanism in the body; they're coaxing the body to do what it does naturally in the same pulsatile, circadian way. That doesn't mean they're harmless, though. But what's more concerning is what you said: Let's say that I'm talking about if you have an actual peptide that is actually what it says and it's clean. But we're seeing TikTok ads with influencers who are hawking a beauty product on one and then a peptide, and lined up with peptides that they're injecting into themselves, calling themselves like "Dr. D," and there's no doctor anything in their background. And then people are listening to them and injecting themselves with things they order from a TikTok link from some company. That's really concerning to me. Really concerning to me. People just injecting themselves with God knows what. But if you get an actual peptide that actually is from a source that's reputable—and you have, as a clinician, to be very careful in documenting where you're getting it from—then there are some exciting potential uses for a lot of these. But again, I think that's where it's leading-edge medicine that you and I are comfortable with, and that's most oftentimes medicine not based on human randomized control trials. So you have to acknowledge to the patient and to yourself: there are some mechanistic, plausible ways it could work, there are animal studies, maybe there's a small human study, but that's about all you have to go on. And as long as you're comfortable with that and your patient's comfortable with that and you feel it's appropriate, I'm not against all peptides. I think there's a role for some of them. But again—like BPC-157 is one that there are a couple early human trials for. I've used it quite a bit and seen really great effects. Again, that's anecdotal, but I've seen a lot of my colleagues recover from orthopedic surgeries happening much faster, or recovering from a sprain and avoiding orthopedic surgeries for rotator cuff tears and things like that. I haven't seen these human studies, but these are from animal studies attesting to it, and that safety profile is really good orally. It's really great for indigestion and upper digestive issues. So that's one that I feel like I'm willing to take the risk on, explaining to my patients that we don't know everything that you know about a pharmaceutical.

[00:33:54] Dr. Melinda Ring: Interesting. Okay, so that's, I think you made a really interesting point too, that they're supporting the system and the signaling rather than being the signal, like when we think about taking a hormone that it is not the same thing as taking a hormone. It is more like modulating the system that regulates hormones, for example.

[00:34:18] Dr. Myles Spar: Exactly. Like, I wouldn't advocate taking growth hormone, but the growth hormone-releasing hormones are just coaxing your body to make its own growth hormone in the same pulsatile fashion it would normally make it.

[00:34:31] Dr. Melinda Ring: When I first met you, you had won this Brave Well Award for the nonprofit that you had started and really to increase access to integrative, personalized, holistic whole person care. A lot of these cutting edge interventions aren't covered by insurance. The people who are probably at the highest risk for accelerated aging because of their societal situations, uh, have the least access. Is there a future when longevity medicine can move out of the that space? Do you see it ever becoming something that's scalable and meaningful for public health?

[00:35:12] Dr. Myles Spar: Yeah, absolutely. And I should say, where I'm working now, WndrHLTH, that is our goal—is to create a much more accessible version. We've started—we're only a year old—so we started with this very high end where we're doing 12,000 markers recommended by these 60 scientists. And we're doing all that to figure out what matters so that we can distill it into a version, hopefully later this year or early next year, that is—it won't be free, we are for-profit—but in the hundreds of dollars as opposed to multi-thousands of dollars. Because we'll learn from these hundred people that we're treating now what really matters. Of all those measures, what do you really need and what interventions really matter for what kind of person? Which of all those markers does Melinda need? Which one does someone else need? Depending on their goals, their genetics, their past medical history, and what they're working on for that next block of time. So, that's part of what we're trying to do, and we're actually helping fund the research of our scientists to help do that. We're also helping to find out what is free and available, like the whole flourishing pillar that we work on. There's a lot that isn't out there for people to understand how impactful working on connectedness to each other—and to whatever you want to call source, the universe, whatever—is. So there's a lot about that. So that's my other big passion. I'm actually teaching a course at the University of Arizona on connectedness and health—basically, awakening to consciousness and health. Because there's a lot of evidence from Lisa Miller and others on the impact of that on physical health, and then people like Gabor Maté on the impact of all that on mental health and of using that kind of work to deal with trauma. So all of that is not requiring a giant investment. And so I think that is important—that we use all of the higher-end testing to learn what's really essential that could be much more accessible.

[00:37:14] Dr. Melinda Ring: Yeah. I love that. I love that. Uh, like I'm not surprised you're teaching that course 'cause that's, that's just who you are. That's perfect. Right now in this season of your life, what does healthy mean to you? And what's one small, doable action that our listeners could take this week to move their own version of healthspan, not just lifespan, so that they get to their next level of health.

[00:37:41] Dr. Myles Spar: For a long time, as we're in our 30s and 40s, we just want to achieve, we want to achieve, we want to achieve. And then I felt like I changed to this—like, yeah, I want to achieve, but I want to be seen as achieving, so I want to be about appearance and admiration. And now I'm like, "You know what? I just want to be." I trust that, at my core, I'm okay. And I need to have that be my North Star. So that's where I'm at right now. And I think one thing I would say: Move after every meal. Move for 10 minutes—15 if you can, but at least 10 minutes—after every meal. That will help your blood glucose by 20 or 30 percent. It'll get you moving, which we all need to do more of. And ideally do it outside because you'll get sunlight, you'll get nature, and then if you can do it with another person outside, you're getting everything.

[00:38:32] Dr. Melinda Ring: Goodness. what I'd recommend. 10 minutes, that's it. At every meal. Walk outside with somebody for 10 minutes after every meal. That would be perfect. Do dogs count?

[00:38:41] Dr. Myles Spar: Yes. Yes, I think any being, any sentient...

[00:38:44] Dr. Melinda Ring:  Anything. Okay. Well, Myles, thank you for joining me today. This is exactly the kind of grounded, thoughtful conversation that longevity medicine needs. Not hype, not fear, but clarity and remembering that longevity isn't about chasing every new intervention. It's about aligning your habits, your data, and your decisions with the kind of life that you want to lead. So thanks for listening, and I will see you next time on Next Level Health.Thank you for joining me on this episode of Next Level Health. I hope you found some inspiration and practical insights to enhance your wellness journey. Don't forget to leave a comment on YouTube or review on Apple Podcasts. I'd love to hear your thoughts and suggestions for future topics or speakers. Be sure to follow Next Level Health with me, Dr. Melinda Ring as we continue exploring the path to healthier, happier lives together.