In this episode of the Flex Diet Podcast, I’m diving into the nitty-gritty of blood work and why it matters for your health, performance, and longevity, especially if you're an athlete, bodybuilder, or serious about your training. Fresh off the ISSN (International Society of Sports Nutrition) conference, I’m joined by Michael Warner, a sharp coach at Marek Health and the owner of Set the Standard. Together, we unpack some of the most important markers in blood work, how training and nutrition can influence your results, and how to actually interpret those lab numbers in the real world. We also discuss the importance of hydration, the context behind the numbers, and why proactive health monitoring should be an integral part of every performance plan. And yes, we touch on the impact of PEDs (performance-enhancing drugs) and what they can do to your blood markers. Whether you’re optimizing for gains or longevity, this is a must-listen for anyone who wants to truly understand what’s going on under the hood. Sponsors: Tecton Life Ketone drink! https://tectonlife.com/ DRMIKE to save 20% LMNT electrolyte drink mix: miketnelsonlmnt.com
In this episode of the Flex Diet Podcast, I’m diving into the nitty-gritty of blood work and why it matters for your health, performance, and longevity, especially if you're an athlete, bodybuilder, or serious about your training.
Fresh off the ISSN (International Society of Sports Nutrition) conference, I’m joined by Michael Warner, a sharp coach at Marek Health and the owner of Set the Standard. Together, we unpack some of the most important markers in blood work, how training and nutrition can influence your results, and how to actually interpret those lab numbers in the real world.
We also discuss the importance of hydration, the context behind the numbers, and why proactive health monitoring should be an integral part of every performance plan. And yes, we touch on the impact of PEDs (performance-enhancing drugs) and what they can do to your blood markers.
Whether you’re optimizing for gains or longevity, this is a must-listen for anyone who wants to truly understand what’s going on under the hood.
Sponsors:
Available now:
Episode Chapters:
Flex Diet Podcast Episodes You May Enjoy:
Connect with Michael:
Get In Touch with Dr Mike:
Speaker: [00:00:00] Welcome back to the Flex Diet Podcast. I'm your host, Dr. Mike T. Nelson. On this podcast, we talk about all things to increase performance, add to muscle, and improve body composition. Do all of it in a flexible framework without destroying your health. Today on the podcast, I am back from the International Society of Sports Nutrition meeting, which was amazing.
So if you have a chance to go there next year in June. I would highly recommend it. We'll be having some guests that I got to see there. Once again, they'll be coming up probably in the next couple months here, so stay tuned for that. Today we've got Michael Warner and we're talking all about the role of blood work.
This can be for both health and performance everything from competitive athletes, even bodybuilders who are maybe using. Exogenous hormones or other compounds too. Just [00:01:00] what are some really good markers you should pay attention to for health and performance? So Michael Warner is a coach over at Meck Health and he also runs his own business at Set the standard, and really enjoyed this conversation.
We got into the weeds over different components and talked a little bit about how training and nutrition can impact this. I've been with my own one-on-one clients. We still do this looking at blood work now for probably about the past five or six years. Also with the help of Dr. Tommy Wood and what I found from my own clients, which we talk about in this podcast here, is there's some things you can get with an assessment.
Obviously my background is in exercise fizz, so I'm huge on what outputs can you test that gives you a lot of great and wonderful information. If you're trying to increase performance or just add more muscle or improve body composition, and like my buddy Dan [00:02:00] Garner has said often when you look under the hood at blood work, again, this is not for medical advice, this is for health and performance only.
It does give you some really good insights that you are not able to get any other way. And a lot of this you can get from just a basic CMP or. C, b, C with differential. Some of these tests are very inexpensive and most states allow you to run your own blood work in the us other countries, it does vary.
So even if you are not able to get some blood work from your physician, which hopefully you are just having other markers you can look at and start even with some basic blood work that you can pay for out of pocket which is usually cheaper than going through insurance. And if you don't have someone to look at it, you can even take that testing to your physician and have a chat with them about it too.
So, getting blood [00:03:00] work is super important. It's really nice now to see a lot of other companies that are showing up that allow you to do this and help you with interpretation. Like I said, I've been doing this now for about five or six years and it's been super beneficial and it's one of those areas where I feel like there's always.
So much more to learn. And what we talk about here on the podcast is how to look at this kind of more like a complete picture. And there's a time and a place to start with kind of what I call whack-a-mole testing. Hey, if your vitamin D is low, maybe you need more vitamin D. But what's the next level?
Like, what does that tell us? So for example, in the past when I looked at Vitamin D, I would just, think, hey, maybe you need a vitamin D supplementation. Now the next level down, I'm gonna ask them about how often are you outside? How often are you exposed to the sun? I think a Vitamin D test gives some idea of lifestyle also.
So we wanted to focus this podcast on what are some good [00:04:00] tests you should probably consider or at least ask your physician about or find another service that does testing. How can that be useful? And then especially if you are using exogenous compounds. How can this change it so you have an idea of the risk reward that you're paying, and a lot of times you're not able to tell the complete risk that you are taking on without doing blood work.
So I think you'll really enjoy this podcast with Michael Warner. And as always our sponsors here today, we've got electrolytes from Element. I was at the ISSN conference recently and. This is anecdotal, but I've repeated this experiment a few times. The first few days I did really good about having a lot of fluid, having a lot of electrolytes, and even though it was crazy busy, may have went out and had a few adult style beverages that night, I felt pretty good.
My HRV and everything was also pretty good. The last day. In all honesty, I didn't do a good [00:05:00] job with hydration. Maybe again, it was accumulation of fatigue since it was the last day of the conference. Well, HRV definitely dropped a fair amount on the last day, so I found that having more fluid, having more electrolytes really does seem to make a big difference.
And one thing I've played with clients is if your stress levels are higher, you probably need more. If you're eating real food, you probably need more sodium. So check out our friends over at Element. We'll have a link down below for them. Also if you're looking for a boost, but you don't want to use anything that has caffeine, might be later in the day, check out.
My friends over at Teton, they make an exogenous ketone drink. I had one of them this morning since I'm back home and, eh, I was got a lot of sleep last night, but still, eh, dragging a little bit today. So it can definitely help with that. They do have very cool stuff coming out that I can't tell you about yet.
[00:06:00] But it'll be out probably this September or so. So stay tuned. We'll have a lot more from them. You can use the code below, Dr. Mike to save yourself 15, 15, or 20%. I am an ambassador for them and do help them with some work there. So, without further ado. Enjoy this podcast with Michael Warner and if you want more, a lot more information from me, be sure to hop onto the newsletter, which is completely free.
Send you fun stuff to your email box. Try to make it very entertaining and also informative. Right now, probably 90% of my content goes out to the newsletter. You can join for free. We'll send you a cool gift. So hop onto the newsletter and enjoy this podcast with Michael Warner.
Dr Mike T Nelson: How are you today?
Michael Warner: Doing awesome.
Doing awesome. Thank you.
Dr Mike T Nelson: How are you? Yeah, we're just saying you're enjoying the Vegas life out there.
Michael Warner: Yeah. Yeah, definitely. Vegas is great. It's warm. The weather [00:07:00] is perfect right now, so it's really not too hot. It's right before it gets like unbearable,
Dr Mike T Nelson: I'd say. And how hot does it get there in the summer?
Michael Warner: I, it's over a hundred. I don't, I, maybe like one 10. You stop counting
Dr Mike T Nelson: once it's over a hundred. Yeah,
Michael Warner: exactly. It'll, like in Minnesota it
Dr Mike T Nelson: is below zero. Like we just don't fucking count anymore. Yeah,
Michael Warner: that is brutal. I could not, I'm not a cold person, so I could deal with the heat, not the cold.
Dr Mike T Nelson: I've the inverse, although I feel like I've gotten a little bit more adaptable as I get older.
But yeah, when I live here in the winter, most of the time it's not bad, but you get days where it's below zero for days on end, you're like. Okay this is pretty stupid. But then I go somewhere else like Costa Rica or places where it's hot and humid and I'm like, Ugh, I'm gonna die.
Michael Warner: Yeah. Yeah.
That, yeah. That's brutal. Fortunately it's not really, it's not humid over here. Yeah. It's a dry heat. Just stick your head in the
Dr Mike T Nelson: oven and you'll be okay. Exactly.
Michael Warner: Yeah. It's [00:08:00] bearable. The humidity is, I can't really do that either, so.
Dr Mike T Nelson: Yeah. The topic today we're talking about is looking at more or less like, it's like physique athletes and blood work.
And it seems like back in the day, I don't know, I feel like I'm old now, but I think 10 years ago I knew a couple of people that, would look at blood work and some of the top, at least IFPB guys at the time. But they were the weird outliers. They were like no one else really did that.
And I remember talking to a, let's say, retired professional guy. 'cause I dunno if you wants me to say his name. And his opinion was, he was one of the rare people who did a lot of blood work throughout his career and he seems to have gotten out pretty much unscathed. And he was, competing at the Olympia level for many years.
But he was like telling me some stories of the things he would see once some of his buddies he tried to get into, do blood work and like just some of the values and stuff he said were just astronomically horrible. But then he said on the other end of the spectrum, he'd have people that [00:09:00] he knew how much shit they were doing and he was shocked that some of their numbers weren't really all that bad.
And that's always stuck with me and I've seen that and just in my own practice a little bit, looking at different blood work from different people. It's so hard to predict. Like you, you would look at someone, you'd look at their history, you'd see some of the compounds they're using and you're like, oh my God, this guy or gal, this is gonna be a fucking train wreck.
This is gonna be a disaster. And you look at it and you're like. Oh, that's not too bad. And he, I remember one poor bastard just started doing legit, like a TRT dose. His HTL like plummeted. And I'm like, what the, and you realize that the amount I think of variability from one person to the next is massive.
And if you're not looking at least at some blood work I don't think you have any idea. I think the idea of the background that, I'm living generally healthy, I'm not using [00:10:00] too many things or other things, my blood work's gotta be good. Like that is definitely not true. And so I don't think you really know until you actually look at what's going on.
Michael Warner: Yeah, absolutely. I will say that historically people haven't really gotten lab work done now. These days, I think it's sexy to get the lab work done.
Dr Mike T Nelson: Yeah. It's almost like swung to the other end of the spectrum. It's like, bro, if you're not doing, if you can't show me your lab work, like what are you doing, man?
Michael Warner: Yeah, exactly. It's like the thing to talk about now, and I think it's probably swung so far onto the other side, that if you're a coach and you're not testing the labs, I would imagine you might even feel some sort of like imposter syndrome or like,
Dr Mike T Nelson: oh, for sure.
Michael Warner: Like, oh yeah, I should be doing this too, because I know people weren't checking.
I haven't been in the bodybuilding game for that long, but when I first started, I wasn't required to do lab work. I wasn't doing lab work on my own either. And yeah, it [00:11:00] just, it's blown up now. But I think you're right. When people live this, there, there is maybe this idea that when people are bodybuilding.
If they're going to the gym, they're lifting the weights, they're eating the boring food. Maybe very, the chicken, rice and
Dr Mike T Nelson: broccoli, bro. Yeah,
Michael Warner: yeah. Like I'm healthy, I'm all good. And we all know like bodybuilding really isn't the healthiest thing to do, especially when you're introducing these compounds.
So it is hard to know, like what sort of risks are you taking if you have no idea. Because there's some people, like you said, have so much genetic variability in terms of what they're susceptible to that you have no idea unless you look. So
Dr Mike T Nelson: what are some of the, you don't have to use names, but crazier things you've seen.
Just to give people an idea. Because again, like back to my first question, I think most people would be shocked at the amount of, I think just variability in general. There is, I was talking to a good buddy the other day and we're both [00:12:00] comparing notes about at the elite level of any athletics, the amount of.
Variability from one athlete in what they're doing for training and nutrition is wider than people realize. Their outputs, you could argue, are maybe very similar 'cause they're all competing at same position, say in the NFL or NHL or whatever they're, the top tier athletes, their output is there.
But you'll see some athletes that are very much like the nutrition is in, they got the chef, the cooks for 'em, their sleep's dialed in and you'll see the athlete next to 'em doing the same position. Granted, these athletes are usually early in their career, eating, licorice before a game or like their nutrition is like an absolute like trash bin fire.
And I think that would be shocking to most people to realize. I think blood work is very similar.
Michael Warner: Very, yeah, very much so. You could take, yeah, two different people doing the same, relatively the same thing, playing the same position, same age, [00:13:00] all of it. And their lab work can look. Completely different, just with some genetic predisposition.
Some people have or even, their history from being raised as a child. So the environment matters, all of it. So yeah there's wild differences. I think even without looking at the lab work. One thing that can be wildly different too is blood pressure alone and, oh, yeah. A lot of people don't even check that, which is a big one and a really easy one that people can check.
You go on Amazon right now and grab a blood pressure cuff, it's easy, there's a couple hurdles you gotta go through to get some lab work done, but a blood pressure cuff. Haven even been automated
Dr Mike T Nelson: now for like 40 bucks. I got a arm run around here somewhere that's, it's pretty damn good. Like you don't even have to know how to do blood pressure anymore.
Speaker 2: Right, right. Yeah. You don't,
Michael Warner: you don't have to take it manually. Put your arm in the sleeve. [00:14:00] Yeah. Hit start and you're good to go. Yeah, there, there's, I think, some advantages of knowing how and when to take it and the context in which it's taken, which sometimes people don't realize. But yeah, even blood pressure is a big one too, because again, you can have two people doing the same thing.
One person has really high blood pressure, the other doesn't, and it's obviously indicative of maybe something else that's going on that needs to be looked at. So, but back to the blood work, it's. So important just to check. It's like a report card on kind of what's going on under the hood.
It's like, you guys are driving a car and it's like, Hey, I'm gonna go on this like long trip or this performance race, but I'm just gonna check to see if I have wiper fluid, or like check the air pressure in the tires without looking under the hood. And it's like, doesn't really make sense. So you have to check it.
Dr Mike T Nelson: Most people just drive the car until the oil light shows up. And by that point, if you're out in the middle of nowhere, you're screwed. [00:15:00]
Michael Warner: Exactly. There's not too, I think that's the shift now that's been made. Yes. It's a lot more proactive. Right. It's, that's why it's sexy.
Like, oh, let's check this proactively. We're not, we are shifting away from this old school method and maybe Western medical approaches where it's like, Hey, you come to us when you're sick. This is sick healthcare. This is not proactive or preventative healthcare. So now we're seeing a shift, which is amazing to see.
And hopefully we'll start to, yeah. Prevent some people from going down like a path that will exacerbate any other underlying issues and lead to potentially catastrophic effects.
Dr Mike T Nelson: Do you think because it's become very. It's sexy to do kinda lab work again, that a lot of people looking at lab work are doing what I call just kinda whack-a-mole lab work.
They just like, Hey bro, just do this [00:16:00] panel. And then they just look for red shit on the report and they just read it back to the client and they're like this value was high, this was high, this was low. And that's, unfortunately, that's like their report very much, which I guess you could argue is better than nothing.
Right. At least hopefully they get a referral to their doc. They found something they should, find. But it also feels like to me, the more I keep learning about lab work or at least trying to learn more about it, the more interactions and looking at different things are almost never ending.
And it, it becomes more, I remember talking to Dan Gardner about this too. It calls it like bending the biomarker. Like how far can you take the current science and extrapolate it out? Knowing that this is an extrapolation of maybe these three things, but it allows you to get some idea of looking at patterns and try to target other systems instead of just, oh, this is high, this is low, this is high.
Like trying to, put it back in [00:17:00] more of a complete picture.
Michael Warner: Yeah, exactly. I do think that there are, there is clearly a level of incompetency with good with good intention. You like, Hey, we these, oh yeah, they're not trying to do it badly. Like we have all the great intentions on getting these labs done, but I just, you don't know.
What you don't know is that whole Dunning Kruger effect. So you there unfortunately. Isn't always a lot of context there when it comes to the labs that you're seeing and or maybe there's just not enough markers in general to paint this picture. It's like you're not really able to connect the dots here or you just don't have enough data points in general to understand what's been going on.
If somebody is quite dehydrated when they get their labs drawn, you're gonna see some markers that are like really elevated and maybe that'll draw concern. And I've seen it to the point of somebody's dehydrated, their labs come back, a lot of values in their [00:18:00] CBC are complete blood count, are really high.
Oh shit, I need to go donate. Then they go donate. And some people on those occasion are either anemic to begin with or just,
Dr Mike T Nelson: oops, we didn't look at your
iron.
Michael Warner: Yeah, sorry bro. Exactly. So there's just, the context is not all there and it's just important to make sure that you're. Going to somebody who can at least paint a broader picture and understand like, Hey, this is related.
These markers are related. This is why this could be up or down. And so yeah, bending those like biomarkers to understand what is influencing what, because I think people, what happens is we like to simplify things a lot for the sake of understanding very black and white, very robotic, okay, this marker's high, this marker's low, and almost leave it at that.
And when you start to complicate it and what marker influences what marker. And then how do you feel as a result of that? [00:19:00] It's, it creates confusion because there's so much to know and understand that it's, it, some people just don't dive in further to try to interpret it all.
Dr Mike T Nelson: Yeah. And what are some things people should do before they even get lab work?
Because I've seen. I've lost track of how many things I've seen with, creatinine levels, BUN, hydration. And you ask 'em, you're like, Hey, did you, what'd you do for hydration? Like, ah, what are you talking about? I just didn't drink any water when I went to bed. Or they said I can't eat anything.
And like, bro, did you like train the day before? Like, oh bro, I trashed my legs the day before I went in. Exactly. And they like, did anyone tell you like you, maybe you shouldn't train heavy the day before? 'cause that can alter some markers or like, no, like, talk a little bit about that and like, what are some things people should do before they even have lab work to try to make it more representative of what's going on.
Michael Warner: Yeah, exactly. Great question. So you talked about the training. This is probably in [00:20:00] no particular order, but if you are training, strength training the day before a lab or you even do some crazy cardio, whatever, you can see elevations in your liver enzymes specifically your, aspartate aspartate, aminotransferase and alanine aminotransferase, the a ST and a LT, whereas the a ST is more specific to skeletal tissue.
So I, you can see some elevations there, but you can see they're, they'll both be there, just take a couple days off of training Now for a bodybuilder or somebody who's like really active all the time, really to get the best sort of idea at a baseline. You would want to take almost up to like seven days off, sometimes even more.
Dr Mike T Nelson: Wow. Which
Michael Warner: is crazy. And like, who's gonna take good luck with
Dr Mike T Nelson: that, bro?
Michael Warner: Yeah. Who's gonna take a week off of training? So again, the context matters if you know that those markers are gonna be elevated, if you know that a ST is gonna be more present in skeletal tissue, if that ends up a little [00:21:00] bit higher on the labs, then you can understand.
All right, this may be related to training. Now of course, there's other liver markers like another one called Gamma Glutamyl transferase or GGT. Now, you would want to ideally get that too to see if there's actually some sort of liver stress going on. So it's not just training, but it's also, we mentioned hydration.
That's a large one as well too. If you go into the lab and you are completely dehydrated, which happens all the time, I tell people, Hey, make sure you're fasted, but you're well hydrated. They end up just like fasting and just not eating. I just heard
Dr Mike T Nelson: fasting.
Michael Warner: I know. And they just stop. They don't do it at all.
You will see quite high elevations in hematocrit hemoglobin. You'll see elevations in your blood urea nitrogen or your BUN creatinine. You'll see elevations in your blood glucose. Which is also gonna come as a result of like what's called the dawn phenomenon. So [00:22:00] obviously throughout the night you're not eating your brain needs glucose.
We need glucose to thrive and to function. The liver does a great job at producing that glucose. He hepatic glucose output. So in the morning it's very common to have a higher blood glucose reading, which is why I don't put a whole lot of stock in the fasting glucose reading. Ideally, we're gonna look at your A1C as well as your fasting insulin,
Dr Mike T Nelson: and it's a stressor going in.
Like, I freaking hate needles. I don't know why I, every time I have to donate blood, I'm like, okay, I look away. Don't tell me when you're gonna do it. They're like, are you gonna pass out? I'm like, I don't typically pass out, I just look like I'm gonna pass out. So I know like my stress hormones are higher than they should be, which is obviously gonna push glucose up to
Michael Warner: Exactly, yeah.
If you're stressed out, you're certainly going to drive that, cortisol, which is gonna drive that glucose. So there are many things that can [00:23:00] be influenced and give like a false positive if you're just simply dehydrated or if you're just simply like stressed out when you go to get the labs drawn in the morning.
And that can be both. Perceived stress, right? Being stressed from seeing a needle, being stressed from rushing. 'cause you gotta get the labs drawn when you gotta go to work or pick up the kids or whatever. And then, it could be also physical stress as well too. So training, being dehydrated taking your medications, that can also influence it as well too.
Whether it's taking, if you're on thyroid medication or are you taking your thyroid medication in the morning or are you not Typically we can understand what's going on there, but the timing matters of a lot of this stuff. Even as interesting as having an orgasm before the labs, you can see prolactin,
Dr Mike T Nelson: Oh sure.
As well. Yeah. It's be higher, right?
Michael Warner: Yeah, exactly. So you can see some elevations there too, which may throw it off as well. And then of course along with [00:24:00] medications that also comes along with like performance enhancing compounds. Are you taking a, an injection the morning of, are you taking it the night before?
Not just performance enhancing even like TRT. I've had plenty of lab work come back and male or female takes either their cream or an injection prior to the lab, and then they get in there and their test values are like 5,000 something crazy. Like, well, something's not right. So point is like, you probably, if you aren't aware of all these things, you might just have to speak with somebody who is aware.
That way you can understand what's going on. Fortunately, if you do meet with somebody who is aware, at least by the time the labs come back, you could start to like filter out and understand, Hey, what are the context? When did you get the labs? Were you hydrated? Did you take your drug? All this stuff.
So that way you can narrow down all right, like. I need to paint this full picture here. And if that understanding isn't there, that's where you can create a lot of misconceptions and then, [00:25:00] 'cause you see a lot of false positives or negatives and see what's going on there. So
Dr Mike T Nelson: do you use a urine sample also to try to look at hydration, like specific gravity?
So one thing I've started doing lately is tell them that okay, when you go in, be fasted, not training, blah, blah, blah, the other stuff. And then I specifically tell them you'll have to give a urine sample, so make sure you're hydrated. Otherwise you're gonna have to sit there until you are ready to give said urine sample.
And it's surprising how much more hydro most of those people are just because they know, oh crap, I can't leave until I give the year. Oh shit. Okay. Got it. Got it. Okay.
Michael Warner: Exactly. Yeah, that's usually one of the main ones. That's people tend to remember that like, hey, you're gonna have to give a urine sample, so make sure you drink plenty of water.
'Cause the fasting thing, they just hear fasting like you said, and they just don't drink any water. But yeah, we, we usually do check a urinalysis just to see specific [00:26:00] gravity or anything else and which can then lead you to understanding whether like they're the type of diet that they're on.
Right. If somebody is just low carb, do they have ketones in the urine? Things like that. So all of this incredibly important for insight into what else may be going on.
Dr Mike T Nelson: What is a good, if you don't have any issues, you're following up on it on via your doc. You're just looking at these, obviously we're just talking about health and performance metrics here.
We're not talking about pathologies or medical advice or anything like that. I. How often would you recommend someone get blood work? Does it is like once a year. Good enough? I've heard quarterly. I've heard twice a year. I've, and then it gets into people are competing. I've heard some people want to do it like in the worst possible case.
Like I've had some athletes do it, especially for bodybuilding, like right before a show, after a show. Like what are your general thoughts on that?
Michael Warner: Yeah, great [00:27:00] question. I think it heavily depends on the phase of life that you're in and whether or not you have some sort of athletic or performance endeavor or lifestyle change overall.
So if somebody, let's just say status quo not doing any sort of intense athletic or performance endeavor. Pretty standard across the entire year. If you can project that, I'd say once every six months is probably adequate now. For an athlete, or let's just say bodybuilder specifically, let's say the bodybuilder is not enhanced at all, you still want to make sure things are in a good spot.
I would say it's probably best to get them done at the beginning of this endeavor and going down into a diet and understanding, hey, how insulin resistant or sensitive am I with my blood pressure, all this stuff. What is my, do I have any [00:28:00] genetic predisposition to have anything going on? So before starting a prep, I think it's interesting to see it at the, during the middle as well too, when things are potentially like at their worst, that probably rings true more so for people who are enhanced.
And then afterwards as well. I think it's, I think it's great to do after, so I'd say probably quarterly. Is probably a good idea for somebody who is an en, not even just an enhanced athlete, just an athlete who does these performance and has these performance endeavors. Somebody's gonna run like a triathlon, a marathon or something like that.
That yeah, you've
Dr Mike T Nelson: got some big event. You're training because we know your stressors are gonna peak and then hopefully drop after that.
Michael Warner: Exactly. And then, yeah, for the enhanced, definitely before starting this kind of push and bringing all these drugs into your system, I like to see it at the peak.
What is it at its potential worst, and you can look at it maybe two [00:29:00] sides, one side, what potentially needs to be addressed. We know there's things that are gonna be off for sure. And it's not just necessarily like risk management, but then if you look at the flip side, I. Is there potential, some room to, to increase or to go higher or to like get more out of your performance by utilizing different things?
Then I definitely like to see it after as well too. So what do we need to address right after this show or the event date and then get it again a couple weeks later to see how are you managing those sort of stressors and what's going on unrelated to an a, a performance event? I would say if you are a casual anabolic or performance enhancing drug user, you should still use it in that sort of timeframe regardless of the particular event that you're doing.
You want to see what [00:30:00] these drugs are doing to your body, if anything needs to be managed and what it looks like after using them.
Dr Mike T Nelson: Would you agree that people, if they are going more the enhanced route, and let's say they're not doing it for competitive, so they don't have an absolute date, they're gonna be, on stage.
My argument is that they may don't wanna say it as like a closed feedback, but one of the options that you mentioned is the feedback that they get would, obviously performance changes, but also blood work changes that they could use blood work as a rough idea of the cost that they're paying. So I think of it similar like, like I use heart rate variability.
To me heart rate variability is a very good non-invasive marker of what is the cost of all the stressors you're doing on your nervous system. I think blood work could be used, and you probably already do this the same way I. [00:31:00] For people who are not necessarily competitive of, Hey, I added this amount of dose, or I've been on this for this period of time, we may want to check specific things a little bit more frequently just to make sure the cost that we think we're paying is what we're actually paying.
And if that exceeds that, okay, well now we have a decision to make. Is the cost, the risk reward ratio worth it. Where one of the things I see is people kind of armchair quarterbacking all of it going, ah, I did well on this amount. I'm just gonna go up to this amount. Ah, I have blood work done at four weeks.
I'm sure it's fine.
Speaker 2: Yeah, there's all, there's always that,
Dr Mike T Nelson: I don't know,
Michael Warner: there's always that for sure. If somebody is, depending on where their baseline knowledge is at, right? If they're. Not as aware, with all the context that we described earlier and even the things that you should do before [00:32:00] getting the labs drawn.
If you're not aware of any of this, and they're the ones sitting like quarterbacking this entire journey, and they're like, oh yeah I feel pretty good on this dose or this drug. I think I read on a Reddit for it forum. Maybe I should do X, Y, Z. Yeah. God forbid
Dr Mike T Nelson: they go on the internet. Oh my God, bill, the amount of things people have sent me to justify the weird shit they were doing is insane.
Speaker 2: Yeah, exactly. Like Muscle Mayhem 1, 2, 3 said I could do this.
Dr Mike T Nelson: Yeah. He said, I'm good, bro. I'm like, dude, you have no blood work to, you have not showed me any output or any marker of cost other than I can see your HRV is like really messed up now, and I don't know why. So I think we need to do something more in depth to at least get a handle on it.
And they're like no, I'm good.
Speaker 2: Yeah, like what's good. It's that relative to you? Is that relative to what
Michael Warner: Yeah, exactly. What are you comparing it to? So it can be really challenging and this is why you have to have like [00:33:00] somebody who's aware of these things, who could look at it objectively and say, Hey, like, here's where you should draw the line.
I think anybody knows that when you're using any type of enhancement, there's gonna be some risk involved. The challenge is people think they know all of the risks and they usually don't, right? They usually don't know all the risks. They don't even know all the markers to check, to verify what risks they think are there.
And that's where the problem lies, especially if they're handling those risks, not just for themselves, but for somebody else. And then it gets even more convoluted if. It's for a female and they're aware of what's, what could potentially happen there.
Dr Mike T Nelson: Yeah. Because some of these drugs especially, obviously these can cause side effects in guise.
These, some of those side effects potentially could be permanent. There's even a small percentage of people that [00:34:00] go on TRT as a male who may never be able to go off. Like I don't, it's, I don't know if you know what the percentage is. I've heard it's like single digits. I've never found a good number.
It's not everyone by far. It's definitely not the norm. But it's happened, so I think it is a risk. And then, if females, especially any, testosterone type ester and other compounds can have, permanent effects that may not be reversible. And I just, that's like one of my biggest pet peeves is, my biased opinion is everyone should.
Make an intelligent decision. Do your homework. Yes. Sometimes compounds can be illegal, whether it's performance, enhancing drugs, psychedelics, whatever. I think people should have the right to decide what it is they want to do, as long as they're educated and they have someone they're working with who's a professional in that area, who understands the things that they don't understand, who knows what to look for and can explain, here's the pros, here's the cons of what you're gonna [00:35:00] do.
And then it's up to you to decide, like, and I think that's an individual decision. Like for me personally, I don't, you haven't used any peptides. I haven't used any HRT, not Sinai. I never will. May have done five glasses of ayahuasca in Costa Rica, which I would not necessarily recommend anyone else either.
Just for whatever reason. That's my risk reward tolerance profile. Everybody's gonna have their own, just for God's sakes. Just be educated about. What the pros and cons are. 'cause I see a few people who just assume that this is all gonna have pros and no cons. And as like physiology just doesn't work that way.
There's just, there's no free lunch. There is pros and there are cons. And those could be radically different for individuals too.
Michael Warner: Very much so. Yeah. I don't have a number in terms of the percent of guys who now just have to commit to TRT. There are several that [00:36:00] started and just don't feel good no matter what.
Dr Mike T Nelson: Yeah. There's that too. Who wanna go off. Yeah. Which isn't talked about a whole lot. I think it was one of the stats I saw, the guys who went on TRT for two years, like 40% of them I think wanted to go back off again. Because they probably realized that it didn't completely absolve them of all their lifestyle issues.
Michael Warner: Right. It's not a panacea. Yeah. Not this silver bullet. I think there, there's definitely variability between that, right? Oh, yeah. So yeah, you're going to your primary care doc, right? I was talking to a client yesterday, goes to his primary care doctor. Their sort of protocol is immediately, once they're on testosterone, they are put on a, an aromatase inhibitor, and then they're also telling them to inject once weekly, and then when they go back for their lab work, like if they, their testosterone doesn't fall somewhere between like three and 600 or 500.
Then if it's not in there and it's [00:37:00] higher, then they're way too high. Then they have to cut their dose in half. Oh, wow. So there's definitely like. There's a, an approach between that for the guys who are like, I want to come off it, it, a percentage of those guys may just not have the appropriate guidance while being Oh, a hundred percent.
Right. A hundred percent. That has to be considered too. But there are a percentage of people who do have the most appropriate guidance, I would say, and still just don't feel great. Sometimes that's even for their own like personal reasons, like,
Dr Mike T Nelson: nah,
Michael Warner: I'm just tired of being dependent on something.
I don't want to have to do it, or I want to see if I can come off. And some of them try and some of them are successful and some of them aren't.
Dr Mike T Nelson: Yeah. I've seen, again, won't name any names. A professional bodybuilder was on seemingly everything under the sun and several years competed at a pretty high level.
I. Miraculously was able to get off of everything. Have [00:38:00] a family, have kids. I've seen other people go on a dose, like I said, of TRT, not able to go off like to, to me, like those ends of the spectrum, like just boggles the mind of how much variability we just don't understand, I think in humans at this point.
Michael Warner: Yeah, absolutely. I think especially in terms of fertility, so I think if
Dr Mike T Nelson: yeah, fertility especially, which is definitely outside my wheelhouse.
Michael Warner: Yeah, I think if anybody is going to go down this road of performance enhancing a few things they should probably keep in mind. One, to know that TRT is not.
Birth control.
Dr Mike T Nelson: Yeah.
Michael Warner: It's not gonna stop you. It if it wa, if Dr. T's birth control, there'd be a lot more people on it. I think they be a lot less kids wasn't
Dr Mike T Nelson: in Australia at one point, like trying to pass it as a birth control for guys or something like that. They could be a completely made up story.
Speaker 2: Sure. That's crazy. Apologies. Geez, everyone
Dr Mike T Nelson: in Australia.
Speaker 2: Yeah. There'd be a [00:39:00] lot less kids around if Yeah.
Michael Warner: Birth control. But they should, there are really cool clinics out there. I don't know if all of them, but there's one called like Give Legacy, where you can literally just go to their website and get an at-home sperm test kit.
Oh wow. So you can just see your baseline fertility to begin with. Just see if there's really any issues. 'cause I think there's a lot of people and a lot of misconception that think that. It's either the TRT or their drug use that may influenced their, their fertility to begin with. Which, not gonna say that may not be the case, but some people confuse that with their already preexisting, like low levels, and they're just not, they don't have as much volume or they don't, their motility is off, morphology is off something.
So there's kids out there where you can just do an at-home sperm test and see where you're at to begin with prior to even going on this journey.
Dr Mike T Nelson: Oh, that's cool.
Michael Warner: Yeah, so really cool. I would say if anybody's even curious about their fertility to do that. And [00:40:00] then even if they still to decide to pursue, then you can do it throughout.
You can do it maybe after your cycle or competitive endeavor, whatever it is, just to check and see like what your kind of status is.
Dr Mike T Nelson: Oh, that's great. Oh, go ahead.
Michael Warner: Oh, no, I was just say that's a big one, I think, and just people are kind, confused between the two. Like, Hey, if I go on this, like I'm not gonna be able to have kids.
Like, no, you are. And another one is that I think a big misconception is people think that they have to come off of testosterone in order to have kids.
Dr Mike T Nelson: I
Michael Warner: am saying this mainly for guys. Yeah. Yeah. That's specific to, to guys. So if you are on testosterone, you don't have to come off now. You can't necessarily be blasting like five, 600 milligrams of testosterone a week or something like that.
But you certainly don't have to come off. We don't have people come off of their testosterone when they're trying to conceive. [00:41:00]
Dr Mike T Nelson: Yeah. I. Would you agree? They may have to at some point, but you definitely don't have to start there as the baseline assumption,
Michael Warner: correct? Yeah, absolutely. I think some people just do either need to come off.
I just think it hap like more often than not, people can get away with lower doses while also utilizing things like HCG or fsh. All the things. So, yeah.
Dr Mike T Nelson: Awesome. If someone's listening to this, and we'll start with both males and females, like what should be. Because I get this question a lot. I had this question this morning.
Hey, I am going to my doc. What blood work should I request? And if I know someone, I'll even ask clients now like, Hey, we can, order some blood work from other, companies, obviously you work for Merri Health. So our company's out there that do it now and I can look at it.
I have a MD PhD, I keep on retainer to review my stuff too. Obviously it's just for health parameters. If there's anything off, you're gonna go back to your physician. But even if people [00:42:00] have a appointment with their doc, I'll say, Hey, when is your appointment? And I'll send them a list of, and I would, request this.
This is gonna be a little bit trickier to get, this would be nice to have, but odds are you're probably never gonna get it. Like, what would be some of the, yeah, definitely get this, you shouldn't have any problem getting this from your doc, through some of the, this would be nice to have, but from a standard physician, if you go in, it's gonna be a little bit more difficult to get.
Michael Warner: Yeah, great question. I always encourage, if possible if possible, to have a conversation with them first to understand a little bit more background.
Dr Mike T Nelson: Totally.
Michael Warner: Right. If, for example, if somebody's taking thyroid medication, well we probably want to see all your thyroid markers. Yep. I generally like to see them anyway, but yeah, just as a sort of a general list, obviously the complete blood count, comprehensive metabolic panel, so your CBC, your CMP when you look at metabolic status, so you look at your A1C, [00:43:00] ideally you can get fasting insulin as well, right?
Not just Yeah. Fasting glucose. A full lipid panel. This includes like apo, lipoprotein B. That one might be a little tough to get sometimes. Yeah, I was
Dr Mike T Nelson: say, do you think that, I've changed my opinion on this where I. I'm trying to get more and more people to do that, which I think you would probably be in agreement.
I've, I know Peter ATT is a big fan of it and a bunch of other people I follow are kinda like, yeah. It's definitely worthwhile.
Michael Warner: Absolutely. Yeah. I would highly recommend and encourage people to ask for apo lipoprotein B anytime that they look at their cholesterol or bad cholesterol or just their whole lipid profile. Please. That's a whole
Dr Mike T Nelson: nother podcast.
Michael Warner: Yeah. That's another podcast. And then if they can if we stay on the lipids, if they can get lipoprotein a, that would be great too. If there are plenty of people who have elevated. LDL cholesterol [00:44:00] and they're like, I swear my value, like my diet is so good, they'll go over their diet with me and then lo and behold, like, we'll check their lipoprotein A and then it is high.
And I'm like, well, so it's like this predisposition, this genetic predisposition to have elevated, LDL cholesterol value. So that one is also great too. I don't think it's that common to get at all. I don't really see it on normal panels from like your primary care. I. Outside of lipids.
Of course, when we look well, we will see some of the markers in your CMP when it comes to kidney function. One, one cool one. I'd say for anybody who's like in performance related sports or anything, even just more outside of aggressive sports, even if you're into hiking all the time or running whatever, cystatin C would be awesome.
Yeah, I would agree with that too.
Dr Mike T Nelson: For kidney function, right?
Michael Warner: Yeah, exactly. For kidney function. Why? 'cause we discussed how. You can have elevations in whether [00:45:00] the liver enzymes due to training, things like that. You can have elevations in some of your BUN and creatinine if somebody's dehydrated or if somebody's consuming a lot of protein.
Well, cystatin C is not gonna be influenced by muscle mass. It's not gonna be influenced by protein intake. So it really does give you this great baseline as to layers. How is my kidney function actually good. Yeah, and side note
Dr Mike T Nelson: on that, if you're. Testing the high level athletes who will get very pissed if they have to go back in for another blood draw and don't care how much it costs.
Like just doing a cystatin C may save them a trip back in because like you said, they have another marker to show kidney function and you could probably argue with their doc that they might've been just dehydrated going in. So, so, absolutely. I may have learned that lesson. Yeah. Yeah,
Michael Warner: Yeah.
Absolutely. That is a great one to check. There's also another, there's two other markers there, like SDMA and [00:46:00] A-D-M-A-S-D-M-A is more specific to the kidney, but both of those markers are indications of endothelial like integrity. So when it comes to, oh, cool vasoconstriction or vasodilation those ones are great to check.
Those probably more obscure markers that you're not really gonna see. You
Dr Mike T Nelson: said SDMA and a DMA.
Michael Warner: Correct.
Dr Mike T Nelson: Okay. Correct. Okay, cool. I'll have to check in notes. I'm not familiar with those, so that's great. Yeah.
Michael Warner: Great. Marker to check iron panel. Anemia panel, please. For the love of God. Every please, for the love of God, get an iron panel that includes, I see that one missed so
Dr Mike T Nelson: many times now.
It just I wanna pull my hair out.
Michael Warner: Yes.
Dr Mike T Nelson: Even in guys and females, like for two different reasons, but it's like, it's dirt cheap. It's so cheap.
Michael Warner: I know. I just please get an iron panel that includes, your iron saturation. Please include ferritin. Ferritin. Yes. That is a major one.
So, there just, there's so many. I saw [00:47:00] bodybuilders lab panel yesterday and his iron levels were off the, it was an alert they're way, there was in red, it was off the charts. It was super high. And on LabCorp. Their panel. You can see like previous lab history, when they may have gotten it before you didn't have any like, previous labs.
And I'm like, dang, this is a bodybuilder who's gotten other labs before, but no iron panel. And like this guy might have like hemochromatosis outside of his other like use. So iron panel, extremely important, especially for females, especially premenopausal. Please get that.
Dr Mike T Nelson: In that case, was his ferritin okay or was that whacked too?
No, his,
Michael Warner: so his ferritin was actually low. Ah. Which is interesting. Yeah. So
Dr Mike T Nelson: the ferritin is a rough marker for stored form of iron. My little air quotes here.
Michael Warner: Yes, exactly. Yeah. So that, I thought that was interesting. So it was it wasn't my client, but I've, I'm curious to see like more background to the guy.
Yeah,
Dr Mike T Nelson: yeah. What
Michael Warner: did he donate recently or [00:48:00] what's going on there? So, very curious. Sex hormones, that's a pretty. Pretty big one, almost an obvious one that we want to get. Ideally it's a highly sensitive test too, so especially for the guys out there who are
Dr Mike T Nelson: Yeah, so explain that. You're talking about for testosterone levels, correct?
Yeah,
Michael Warner: exactly. So if anybody's gotten a test before, and let's say they're on testosterone and it shows a greater than sign 1500 and you just don't know the number, it just says greater than 1500. It's probably because it's just, it's not a sensitive or highly sensitive test. So there are specific tests out there, like A-L-C-M-S test or E-C-L-I-A test that wouldn't necessarily, either, they, either a sensitive or it's not.
And so it's gonna give you an exact number of what the value is. Same with estradiol. Are you just testing total estrogen? Are you testing estradiol? Some people can test estro. So there's different. Sensitive tests that you can get, which are incredibly important to get for specificity. Do [00:49:00] not be the person that is gonna take these enhancements and decide not to get a sensitive test and know exactly where your values are at.
Right? So please get a sensitive test and it'll give you the exact number of testosterone nanograms per deciliter. It'll tell you exactly where your estradiol is at. It'll tell you, we want to get progesterone, your neuro steroids as well too. So we want to see these values specifically without having just a greater than 1500 or just like, a range.
So sex hormones are. Are definitely a big one there. You can also include, I mentioned neurosteroid, so progesterone does fall in there as well as really specifically DHEA and pregnenolone. So these are produced mainly in the adrenal glands. A lot to do with cognitive function and mood or memory, even blood glucose regulation.
So those are helpful to [00:50:00] get, I think usually people aren't really ever testing pren alone. DHEA is pretty common though. Yeah. DHA is
Dr Mike T Nelson: pretty common.
Michael Warner: I'll see that one quite often. So, along with the sex hormones, neuro steroids there. Gosh, what else am I'm probably missing something else. I'm just trying to think of general markers that you
Dr Mike T Nelson: Yeah, I just say potentially a thyroid panel.
We're probably getting into a little bit more specific things. You talked about that. We talked about that already, but I, most of the time people are like, oh, I can't seem to lose weight. I'm like, yeah, just check your thyroid, because either way, if there's an issue, we wanna know about it. If it's normal, then we know that, wasn't it?
Because,
Unfortunately it's usually women who are like, my thyroid is all goofed up, and sometimes that happens. That is a real thing. And you would want to thyroid panel with T four and T three and maybe in some extreme cases, reverse T three. And so you can either rule it in or rule it out that you know you can go either way.
If there's something there, you wanna find it. If it's not there, then you, hey, you're good.
Michael Warner: And that's where that conversation is helpful. Right? [00:51:00] Like, hey, do you have a family history of like hypothyroid or Hashimoto's? And have you ever checked your thyroid antibodies? So yeah, a full thyroid panel is always ideal.
I don't reverse. E three is great. I think it's right now it's like sexy to check, Hey, you should always check reverse T three. Yeah. Do you think
Dr Mike T Nelson: that's useful? I keep, I go back and forth on it all the time. I don't have people normally check it, but I have had people check it in a few cases.
Michael Warner: Is there a utility?
Sure. But can you get, can you manage somebody's symptoms and manage thyroid function while knowing free T three, free T four TSH like, yeah, I think you can do it without seeing reverse T three. Okay. We've done it plenty of times. It can be helpful, but if you're already doing everything to manage like appropriate thyroid function you can do it without seeing reverse T three in my opinion.
Cool. Awesome. I think that another one that would be great. A little like, like a bonus is a homocysteine. Yes. That would be great to see. I know that [00:52:00] one's probably a little bit more popular now, I think with all the genetic testing and the M-T-H-F-R all that. But it does fall in line with more of the endothelial integrity and basal constriction or reverse dilation.
So if I can lump that into an inflammatory marker that could, predispose somebody to some cardiovascular risk, I would add that one in there too.
Dr Mike T Nelson: Do you think c-peptide is a useful one as like a 24 hour marker of insulin? Since fasting insulin can be so variable, although it's probably gonna be, give you a ballpark of where the person is.
I.
Michael Warner: Right. C, so C-reactive protein. Yeah, I would,
Dr Mike T Nelson: or C peptide,
Michael Warner: oh, I'm sorry. Yeah, sorry. Yeah. CRP
Dr Mike T Nelson: would be good to get too. I agree. Yeah.
Michael Warner: CRP would be great to get, I think it would be, yeah. I don't, I really don't see it that often, to be honest. Oh, okay.
Dr Mike T Nelson: Interesting. Yeah.
Michael Warner: Yeah. I really just see like fasting insulin and A1C.
Could it be helpful? Yeah, absolutely. [00:53:00] We can get 'em all Now
Dr Mike T Nelson: we're getting more into the specific, 'cause you could talk for hours on end. It seems like every time you turn around there's another new test that may or may not have the greatest data behind it either.
Michael Warner: Yeah, exactly. Then you kinda get like lost in the sauce, right?
You're like you're in the weeds paralysis by analysis potentially. But there, I think generally, yeah, I think CRP is like a general marker that should probably always be checked as well too. So, the problem is that a lot of doctors don't. Usually, I think we probably covered markers that they're probably not even gonna check.
Having a clinic or somebody like yourself to know, like what markers to check, having a conversation with somebody who knows these things is always gonna put somebody like on the initial path to the, to, it's the right start first. So that way they know, okay, here's what I'm gonna get, here's what, how I know what to do prior to taking the test.
And then when you get [00:54:00] the values back, like, alright, what was the context that these were taken in? What's your history? And just to create more of a, like a visual as of what's going on here. So ideally the conversation is had first, it happens where I get these values back from a primary care and it's like, you gotta piece together what's happening, and hey, try to get your doctor to test X, y, z marker to see if we can look at this too. And unfortunately, I we're just, I don't know if we're ever gonna get there where they're just gonna test whatever, whenever. Ideally, you're, like, Hey, they're my labs. I wanna see the markers.
Can you please just test this? And no questions asked. I don't know if we're gonna get there with the, your primary care. Maybe some of them will, but that's why places like Merrick are great. We can test whatever whenever no questions asked. We'll probably encourage you to even check more.
Dr Mike T Nelson: Yeah. So tell us about Merrick. It's, and people can do it online. Correct. And they can [00:55:00] go from anywhere.
Michael Warner: Yeah. That's the great thing about it. And anywhere in the us right? So, okay. So
Dr Mike T Nelson: it is just US based. Yeah. Okay. Just US
Michael Warner: based. So merrick health.com, we are, i'd say the best telemedicine company out there.
So you're gonna come to us and like we have our sort of core competencies that we work with, and they are listed out on the website there. But anybody who's looking to improve optimize, not just improve. And this is not just, again, we are proactive, preventative, healthcare, whether that's cognitive function, and that's just general performance.
And that's sexual performance in health. That's fat loss or weight loss. It's regenerative. So in terms of like healing, we talk about healing peptides reducing inflammation overall. So we manage hair, whether it's hair loss. So there's a ton of things that I'm probably missing here off the top of my head.
But the point is that you're gonna be introduced to an entire network of health [00:56:00] coaches and providers who. Are up to date, who care about the people who are gonna ask you all these questions. Get a history on you. Understand what lab markers will be best and most useful to check. And then once we get those labs back, we're gonna sit down with you, we're gonna discuss all the lab markers.
You'll actually get a really cool report outlining what those markers are. 'cause a lot of times people see the lab markers, they're like, cool. I don't know what to make of this. Yeah,
Dr Mike T Nelson: yeah. I dunno. This is like Greek man.
Michael Warner: You'll get your own fancy report that'll outline like what these markers are, what they're good for checking, and then you'll see our ranges versus the Lab Corp.
Or typical Western medical ranges because there's ranges that are optimal. As you are very well aware testosterone values. When you go to your doctor now it's between three and like 900. And if you're anywhere in between there, then you're good. Right? So we have our own aggressive ranges where people are most optimal.[00:57:00]
So we'll discuss all those and then we'll discuss along with the provider what sort of treatments in like a phasic approach based on your comfort that we feel like would be best to get you feeling looking your best.
Dr Mike T Nelson: Cool. That's awesome. Yeah, and it is nice that there is a lot more options like American telemedicine now, and correct me if I'm wrong, I think I always, there's always like two or three states that change.
There's New York and Vermont or something like, I can't remember, but New York's always one of 'em. There's one other state where
Michael Warner: New Jersey and I think Rhode Island or like,
Dr Mike T Nelson: maybe that's what it was. Yeah. Where you can, every other state, you can test your own blood work. So like what I do with people is I may send 'em a link and be like, Hey, you can get these cheaper than the insurance rate, but you as an individual have the right to buy them, to bring them in to get tested.
And then you're required to share them with your physician, your healthcare provider. Which is nice. The downside is your insurance probably isn't gonna cover [00:58:00] it, but in pretty much every state you can also get your own labs. You can discuss them with a professional. So you can still be proactive with this, which I think is something that most people are probably not aware of, obviously is options like Merrick and Telehealth also too, where you can, work with professionals too.
So it's nice that it's becoming more aware that there are many options that people can do, where I think in the past it was like, oh, my doc doesn't wanna run a vitamin D test, I'm hosted. Right? So now you, it may cost you a little more money, it may cost you a little bit more time, but if you want to be more proactive, which we both would agree, is definitely the way to go, you have a lot more options now than you've ever had before, which is great.
Michael Warner: Yeah. Ex e Exactly. It's nice. I feel like we're in the best time to be in right now when it comes to like, looking at your health markers and having somebody who is like an advocate for your health other than yourself. And I think that's where like Merrick does, like America, our providers, our health coaches fill [00:59:00] that gap because as an individual who's out there, like you don't really know what to ask.
Dr Mike T Nelson: Yeah. Problem, like me going into my cpa being like, Hey, what should I ask about the tax code? I don't freaking know what I'm supposed to ask me about the tax code.
Michael Warner: Yeah, exactly. Like I, I don't know. I have a tax person for that I'm gonna trust. Yeah,
Dr Mike T Nelson: yeah. That's why I pay him a bunch of money.
Michael Warner: Yeah, exactly.
So Right. We could be that advocate for you and help you understand why. And that's I think the biggest thing when it comes to like. Understanding or coaching. It's like we're not just telling you, Hey, this marker is good. Okay, see you later. It's here's where the markers could be. Here's what influenced the markers, here's the lifestyle things that you could do.
Here's the things that you could take to influence these markers. It's like the why and the rationale behind it all, and the coaching that really help to just bring people more insight and then build more confidence and then what we do. And then when you see the results, it's like, okay, like it all makes sense now.
Thank you for being transparent. It's like there's nothing [01:00:00] to hide here. And it seems like when people go to their doctor and they're just like not getting the answers or not getting the results, there's always like, the saddest part is when people are like, well, I guess it's just me. Something's just wrong with me, or whatever. And they think that's the case when a lot of times it's not, you just don't have the best care or know what questions to ask. So that's what we're here for.
Dr Mike T Nelson: Yeah. And my last comment is a lot of these things are also very. Modified by lifestyle too, which I think doesn't get enough love because people get tired of hearing the basics all the time and,
right.
I'm sure
you've seen this a lot where like I can almost interview females a little bit more trickier, but Definitely guys, and be like, tell me about your sleep. Tell me about your nutrition. Tell me about your training. Give me a resting heart rate or a VO two max surrogate test. I can almost predict their testosterone levels now pretty damn accurately.
Because
we know like if they're stressed, their nutrition's a floating trash bin fire. They're sleeping six hours a night drinking four cups of coffee. I. I can almost [01:01:00] guarantee their testosterone is dog shit.
Michael Warner: Yeah, absolutely. And that's evidenced by the people who think that testosterone is gonna be this panacea.
Right, right. And they start on it and they're like, let's not doing shit. For me, it's like, well, like what's everything? Go to the gym look like. You need
Dr Mike T Nelson: to lift, you need to like, you need to still do the things.
Michael Warner: How to do the thing. It's not gonna do the work for you. And that's the challenge.
So yeah, there is a lot of, I it's sexy and nice to know, hey, where, like, where's the magic pill? Or like, what's the magic peptide now? Or what else can we take that's gonna do the work for us? But yeah, unfortunately you're not gonna get that from us here. Or anybody who's like, knows their stuff, it's, they're gonna make you do the basic work.
Dr Mike T Nelson: Yeah. But on the flip side though, there have been in cases, the guys I've worked with, I'm sure you've worked with a ton of them too, who, decide to do TRT. They've done lifestyle change, they've made some progress. It hasn't been quite enough. And in some cases been, very life changing.
Like they feel better. When you feel better, you're odd to [01:02:00] making it to the gym or better you start doing more, habit changes and I think a lot of that is also just psychological, like someone who is proactive enough who's gonna spend the money to look at it, they're probably at that point in their life where they're gonna be able to make other changes also.
And at kind of that threshold where they're like, okay, now I'm at a point where this is a priority to my life. I am gonna dedicate some time and have to spend some money on it too. So, which is also a positive.
Michael Warner: Very much so that sort of lifestyle change, and it's like, it happens in like aphasic approach, right?
You,
Dr Mike T Nelson: yeah.
Michael Warner: You don't have the energy to work out, but you need the, like, you need to go work out to get the energy and so it's like you need the food. Same vice versa. So. Yeah. When you start seeing those results and seeing those lifestyle changes happen, whether that's a result of like optimized hormone replacement therapy, you really, it makes, it's like a chain reaction and psychologically makes a huge difference.
And then it's just one small [01:03:00] step one day at a time where you start linking better days together, weeks and months, and you become a different person. So it is really life changing. I got an email yesterday of some guy that's like, oh my God, like this is the best thing that's ever happened to me. And it's really cool when that happens.
Dr Mike T Nelson: Yeah. That's awesome. Yeah. Awesome. Well, thank you so much for your time. Tell us more about your business. Do you do consulting? Like how do people work with you? What do you Exactly. Do you do?
Michael Warner: Yeah. No, thank you for having me. I so yeah, I work as a health coach within within Merrick Health, but also I do consulting on the side as well.
If people are just interested in asking whatever questions that they have about their current sort of routine. I also don't just consult, but I also have my own like coaching business as well too, to take some people fully on for nutrition training lab interpretation, hormone optimization, that, that whole thing as well too.
So I work in kind of two capacities there, but yeah, you can find me at set, the standard [01:04:00] fitness.com. You could also find me on the Merrick Health website as well too. Or on, on Instagram, on all the socials. You can just look up my name. But yeah that's how I operate in the health coaching space and I love it.
Dr Mike T Nelson: Awesome. Well, thank you so much for all your time and yeah, given us all the options and everything today. I really appreciate it. Thank you so much. Awesome.
Michael Warner: Yeah, thanks so much for having me. Had a great time.
Dr Mike T Nelson: Thank you.
Speaker 3: Thank you so much for listening to the podcast. I really appreciate it. Big thanks to Michael Warner for coming on the podcast and sharing all of his wonderful knowledge with everyone. You can check out all of his stuff at his personal site, set the standard fitness.com. We'll make sure to put a link to everything he's got going on below.
You can also check him out via Merrick Health and even if you hire him or hire Merrick or hire myself or someone to. Look at blood work, I would highly recommend that you do this. In a perfect world, everyone will be able to get blood work from their physician. [01:05:00] If you can do that, all the better. But a lot of times that's not possible.
Maybe due to financial constraints or finding a good physician. I would still encourage you to do some blood work for health and performance. Obviously, if anything is out of range there, you want to have a good discussion with your physician. But at least then you would know and you can bring your blood work to your physician.
Have a chat about what are your options there. Like I said in the intro, there are some things that you can really only see by blood work. Again, it does not have to be super fancy. There are a ton of advancing things you can look at through blood work and even GI testing that are very useful. But even if you are limited on cash.
You can go a long ways with a basic hormone panel A CMP CBC with differential. Just start there. Even if you're really strapped for cache A CMP and A CBC with differential can tell you a lot is [01:06:00] much better than doing what I call the ostrich method of just sticking your head in the sand and not looking at anything.
So big thanks to Michael Warner for sharing all of his information here. As always, check out our friends over at Element for electrolytes Teton for Tasty exogenous ketones. Each can has 10 grams of a ketone ester. It's a little bit different than the ketone salts. The esters allow you to get a much higher level of blood ketones and a short fashion.
Use the code, Dr. Mike, save some money there. I am an ambassador for them. I do advisement for them also. So full disclosure on that, hop onto the newsletter. If you want more information from myself. It's totally free. About 90% of my content goes out to the newsletter. And thank you as always for listening to this podcast.
Really appreciate it. If you could do us a favor by hitting the like, and subscribe and download and all that wonderful [01:07:00] stuff, if you're watching this on YouTube, hit subscribe there. One thing I'm trying to do coming up this quarter is to grow the YouTube side of a content distribution. So by hitting subscribe there, that goes a long way to help me out.
With that, if you have someone who would be interested in this, please forward it to them. Share it online. As always, thank you so much for listening. We really appreciate it. Big thanks to Michael Warner for sharing all of his info. And we'll have many more really cool podcasts coming up here in the near future.
Thank you so much. We'll talk to all of you again very soon.
Speaker 4: There's something wrong with his hearing aid. Yeah. What's wrong? I can't hear with it. Oh, no wonder. It's too far away.
Speaker 5: This podcast is for informational purposes only. The podcast is not intended as a substitute for professional medical advice, [01:08:00] diagnosis, or treatment. You should not use the information on the podcast for diagnosing or treating a health problem or disease, or prescribing any medication or other treatment.
Always seek the advice of your physician or other qualified health provider before taking any medication. Or nutritional supplement, and with any questions you may have regarding a medical condition, never disregard professional medical advice or delay in seeking it. Because of something you have heard on this or any other podcast, reliance on the podcast is solely at your own risk.
Information provided on the podcast does not create a doctor patient relationship between you and any of the health professionals affiliated with our podcast. Information and statements regarding dietary supplements are not intended to diagnose, treat, cure, or prevent any disease. Opinions of guests are their own, and this podcast does not endorse or accept responsibility for statements made by guests.
This podcast does not make any representations or warranties about guest qualifications or credibility. Individuals on this podcast may have a direct or indirect financial interest in products or services referred to [01:09:00] therein. If you think you have a medical problem, consult a licensed physician.