I'm a cardiologist. After 40, stop guessing about your health. These numbers tell you whether you're building a long, vibrant life — or quietly declining without knowing it.
I run these on myself. I run them on every patient I care about. Most are cheap bloodwork. All are available now. And together, they paint a picture no standard annual physical will ever give you. Print this. Bring it to your next appointment. Your 60-year-old self will thank you.
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𝗙𝗮𝘀𝘁𝗶𝗻𝗴 𝗜𝗻𝘀𝘂𝗹𝗶𝗻
Target: below 5 μIU/mL. Ideal: 3-4.
This is the 10-year warning bell your standard panel completely misses. Your glucose and A1c can look "normal" for a decade while your pancreas is working overtime to keep them there. Fasting insulin catches insulin resistance 5-10 years before your A1c moves. By the time A1c rises, the damage is already extensive.
𝗛𝗢𝗠𝗔-𝗜𝗥
Target: below 1.0.
Calculated from fasting insulin and fasting glucose. The single best measure of insulin sensitivity. Above 1.0 and your metabolism is already under strain. Above 2.5 and you're insulin resistant — even if every other number looks fine.
𝗛𝗯𝗔𝟭𝗰
Target: below 5.4%.
Not below 5.7% — that's the threshold where medicine calls you "prediabetic." By then you've been metabolically compromised for years. Optimal is below 5.4%. Blood sugar mastery is longevity mastery.
𝗧𝗿𝗶𝗴𝗹𝘆𝗰𝗲𝗿𝗶𝗱𝗲 : 𝗛𝗗𝗟 𝗥𝗮𝘁𝗶𝗼
Target: below 2. Ideal: below 1.
Your metabolic health crystal ball. This ratio predicts insulin resistance, cardiovascular risk, and metabolic syndrome better than any single lipid number alone. A ratio above 3.5 is a red flag regardless of what your total cholesterol says.
𝗔𝗽𝗼𝗕
Target: below 80 mg/dL for moderate risk. Below 60 for high risk.
I've written about this extensively. ApoB counts every atherogenic particle hitting your artery walls. A 2024 analysis found 54% of patients had dangerous levels that standard LDL testing completely missed. If you only know your LDL, you're driving with one eye closed.
𝗟𝗽(𝗮)
Test once in your lifetime.
100% genetic. 1 in 5 Americans are elevated. Triples heart attack risk independently of everything else on this list. Diet and exercise cannot lower it. The 2026 ACC/AHA guidelines now recommend everyone be tested. Most never have been.
𝗵𝘀-𝗖𝗥𝗣
Target: below 1.0 mg/L.
You can have perfect cholesterol and inflamed arteries silently preparing to rupture. hs-CRP measures the fire behind the plaque. The JUPITER trial proved that finding and treating inflammation saves lives — even when lipids look fine. If this number is elevated, your mouth, your gut, your metabolic health, and your visceral fat are the first places to investigate.
𝗩𝗶𝘁𝗮𝗺𝗶𝗻 𝗗
Target: 50-80 ng/mL.
Not the bare minimum of 30 your doctor accepts. Suboptimal vitamin D is linked to higher inflammation, weaker immunity, increased cardiovascular events, worse mood, and poorer outcomes across nearly every disease I treat. Supplement D3 with K2 — without K2, calcium deposits in your arteries instead of your bones.
𝗧𝗲𝘀𝘁𝗼𝘀𝘁𝗲𝗿𝗼𝗻𝗲 (𝗧𝗼𝘁𝗮𝗹 + 𝗙𝗿𝗲𝗲)
Men: optimal range 600-1000+ ng/dL total.
Declining testosterone is an independent predictor of cardiovascular death in men. It's tied to insulin resistance, arterial stiffness, visceral fat accumulation, and systemic inflammation. DHEA-S drops 10-20% every decade after 30. Tracking these isn't about vanity — it's evaluating your body's systemic resilience.
𝗕𝗹𝗼𝗼𝗱 𝗣𝗿𝗲𝘀𝘀𝘂𝗿𝗲
Target: below 120/80. Aim closer to 110/70.
Every point above optimal is cumulative arterial damage. Buy a home cuff. Measure morning and evening, seated quietly for five minutes, arm at heart level. White-coat readings in the office miss what's really happening. The smartest $40 investment in cardiac self-care.
𝗩𝗢𝟮 𝗠𝗮𝘅
Men over 40: above 40 mL/kg/min. Women over 40: above 35.
Cardiorespiratory fitness is the single strongest predictor of all-cause mortality — stronger than smoking, diabetes, or heart disease as individual risk factors. A landmark study in JAMA found that extreme fitness was associated with the lowest mortality with no upper limit of benefit. You can estimate VO2 max with a timed mile, a rower test, or a wearable. Get faster every year.
𝗡𝘂𝗺𝗯𝗲𝗿 𝗼𝗳 𝗠𝗲𝗱𝗶𝗰𝗮𝘁𝗶𝗼𝗻𝘀
Target: as few as possible.
Every medication you're on should be earning its place. I just wrote about five commonly prescribed drugs that do more harm than good with long-term use. Bring your full medication list to every appointment. Ask: "Do I still need this?" Deprescribing is one of the most powerful and underused tools in medicine.
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Thirteen numbers. Most available through cheap bloodwork and simple tests. Get them once or twice a year. Here's what I want you to understand: these numbers don't just tell you where you are. They tell you where you're heading. A fasting insulin of 8 today becomes diabetes in five years. An ApoB of 120 today becomes a heart attack in ten. An hs-CRP of 3 today means your arteries are inflamed right now — regardless of how healthy you feel. The standard annual physical checks a fraction of these. It was designed to find disease that's already there. This panel finds the disease that's coming — years before it arrives.
What gets measured gets improved. Optimize with the foundation I write about every week on this platform:
Zone 2 cardio plus resistance training 3-4 times per week. High-protein whole-food nutrition. Sleep 7-9 hours — non-negotiable. Morning sunlight. Stress management. And the targeted supplements I've covered in detail — creatine, magnesium, CoQ10, D3+K2, glycine, omega-3, psyllium husk.
The breakthroughs coming in the next decade — gene editing for cholesterol, cellular reprogramming, senolytics that clear senescent "zombie" cells driving inflammation and aging, GLP-1 drugs rewriting metabolic medicine — will be most powerful for people who've already built the metabolic foundation to receive them.
The future of medicine is personalized. But it starts with knowing your numbers today. Print this list. Book the bloodwork. Own the data. Prevention isn't passive. It's the most aggressive thing you can do for the decades ahead.
High blood pressure? Try this simple breathing trick.
James Nestor suggests: Breathe in for 5-6 seconds through your nose (belly expanding), exhale for 5-6 seconds while humming. Do this for 3-4 minutes.
He’s seen people drop their blood pressure by 20 points in minutes thanks to a surge of nitric oxide that dilates blood vessels.
It’s temporary unless you make better breathing a habit, but it’s an easy first step to take control.
Slow breathing with humming significantly boosts nitric oxide production in the sinuses, which dilates blood vessels and can lower blood pressure rapidly, as shown in studies on resonant breathing techniques.
Credit: @MrJamesNestor on @drchatterjeeuk’s podcast. Full episode:
He's a professor of biology who has studied cancer for over 30 years.
His message? Cancer isn't bad genes or bad luck. It's damaged mitochondria.
This flips everything you've been told about how to treat and prevent cancer: 🧵
1/ Cancer rates are rising. Why?
- 1,676 people die daily from cancer in the U.S.
- Young, seemingly healthy people are diagnosed more than ever.
- Billions spent, yet the war on cancer has failed.
Seyfried: We are hitting the wrong target.
2/ Mainstream dogma: cancer is a genetic disease caused by DNA mutations.
NEWS: The Supreme Court just gave the federal government the power to turn away asylum seekers at the border before they ever set foot on American soil.
In a 6-3 ruling in Mullin v. Al Otro Lado, the Court held that a migrant standing in Mexico has not "arrived in the United States" under federal immigration law until he physically crosses the border. Until that moment, the government owes him no inspection and no chance to apply for asylum.
The decision clears the way for the Trump administration to revive "metering," the practice of stationing officers at ports of entry to cap how many asylum seekers are processed each day and block the rest from crossing.
Justice Alito, writing for the majority, rested the case on the ordinary meaning of a single phrase. To arrive in a place is to enter it, he reasoned, and "that conclusion does not change because someone or something blocks entry."
Justice Sotomayor, in a scathing dissent joined by Justices Kagan and Jackson, said the ruling lets the Executive Branch "circumvent all these mandatory procedures by having U.S. immigration officers stand at the border and physically block noncitizens from setting a foot onto U.S. soil." That holds, she wrote, "even if the asylum seeker is certain to be persecuted, or killed, if she is turned away." She accused the majority of an interpretation "driven almost entirely by a fixation on a single word: 'in.'"
Alito was joined by the chief justice, Thomas, Gorsuch, Kavanaugh, and Barrett. The three liberal justices dissented.
A defence contractor has figured out how to track you without ever needing your name, face, or numberplate.
The product, SignalTrace, instead listens to the devices you're carrying, and their sensor clips onto existing cameras your city has likely already got mounted.
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Its full name is ELSAG SignalTrace, made by Leonardo.
The product page subheading is, verbatim: "Identify Suspects by the Electronic Devices They Use."
In surveillance tech this is actually refreshingly honest.
They aren't even trying to hide it.
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The honest truth is that you don't need to know who someone is to track them.
You just need a combination of things they always carry that nobody else does.
70 cars might have an iPhone; only 1 has this iPhone + an Audi head unit + specific Bose headphones + a Garmin.
RFK Jr. once said: “They’re making $60 billion a year selling us vaccines, but they’re making $500 billion a year selling the remedies for the injuries caused by vaccines.”
“This is a really great business plan for [pharmaceutical] companies. You make people sick, and then you sell them the lifetime cure.”
This interview, which originally aired on September 17, 2020, was removed by YouTube for “medical misinformation.”
But was it really “misinformation,” or was RFK Jr. leading viewers to an inconvenient truth?
In just about every industry, a great product makes you rich beyond belief, except one: medicine.
The rules for enrichment work differently here. And the reason why is exactly what they don’t want you to know. 🧵
There’s a principle that I’m sure you’re familiar with: once you see it, you can’t unsee.
No industry built to solve a problem ever actually solves it. Think about it—a cure for the problem is a death sentence for the paycheck. The cancer charity that beats cancer has to close its doors. The dating app that finds you a partner just lost a paying user.
So problems don’t get solved. They get managed. Indefinitely.
And nowhere has this been turned into more of an art form than medicine.
We’re taught to see healthcare as a race toward cures. Brilliant minds, billions in research, all pointed at making disease disappear.
But that’s not how it works.
Let’s take a look at how the business model actually works. It’s actually pretty simple.
A cured patient stops paying. A managed patient pays forever.
When those two incentives collide, take a guess at which one usually wins.
IN JAPAN, LAZINESS IS CONSIDERED A DISEASE AND PEOPLE TREAT IT WITH THESE 7 METHODS:
1. KAIZEN — THE ONE-MINUTE RULE
1. KAIZEN — The One-Minute Rule
Start so small your brain can't say no.
One push-up. One sentence. One minute.
Tiny habits bypass resistance and compound fast.
Progress > pressure.
2. IKIGAI — Your Reason to Wake Up
Stop asking "what should I do?"
Start asking "why do I get up?"
Purpose fuels energy. When your why is clear,
discipline becomes effortless.
If you can hold a wall sit for 2 minutes, your legs, metabolism, and future self will thank you. One of the most underrated exercises for healthy aging. Here are 7 reasons why: 👇🏻 1) Builds powerful legs
Builds powerful legs
Wall sits strengthen your quadriceps, glutes, calves, and supporting muscles without needing any equipment.
2)Improves muscular endurance
Holding a wall sit teaches your muscles to resist fatigue, making everyday activities easier.
@Eliojgm No es eso, a continuación explicaré lo que sucedió. Mi tutor es especialista en sismo resistencia y es ingeniero civil, yo ví ese tipo de fallas en la materia de sismo resistencia. hago hilo para explicar lo ocurrido. Pido Rt para que muchos entiendan lo sucedid ya que hay desinf
@Eliojgm Entendamos que un sismo no es el movimiento telúrico, es la liberación repentina de energía producto de la perdida de equilibrio de las placas, esa energía es disipada en forma de ondas mecánicas sinusoidales, unas con mayor resistencia a la otra por los ángulos de propagación
@Eliojgm Las estructuras están diseñadas para soportar esa propagación, algunas para absorberlas mediante otros sistemas sismoresistentes. La estructura es diseñada para ondas armónicas, en este caso hubo algo poco común que fue la detonación de dos sismos casi al mismo instante
Excited to share our big step towards decoding the brain’s thoughts!
When we were first injecting the microbubbles for the scan, I was surprised by the coldness of the saline flowing through my veins - it was my first IV.
And before you ask: no, the bubbles don’t tickle. (1/n)
We scanned the blood flow inside the brain using microbubbles+ultrasound.
What is really striking to me about the imaging is how interpretable and physical the data feels. You can just see the actual microbubbles flowing through the brain in the ultrasound acquisitions!
We expect the data to contain a wealth of information about brain activity.
Here are videos decoded from the brain by researchers using fMRI (NeuroClips, 2024) - a similar kind of readout of the brain:
@hasbeenhopless1 @restitutorII Si nous avons appris sauf les crétins comme toi qui récite par coeur sans comprendre et qui alors sont "bien diplômés" prenant la place des gens qui comprennent, les "sales techno" (donc mal diplômés).
@hasbeenhopless1 @restitutorII Sytème "ingénieux" pour réfraichir dans l'immédiat mais surtout pour transmettre les maladies !
Ce système était ingénieux pour l'époque mais pas pérénisé car entraine sont lot de problèmes.
@hasbeenhopless1 @restitutorII Seuls les crétins (genre bac général Littéraire, Economie, "Sciences" en ne faisant que des "maths" et en récitant par coeur des equations & définitions sans les comprendre ni les appliquer) & "écolo" (sauce LFI) trouvent ce système "génial à appliquer encore "aujourd'hui" !