Rational Wellness Podcast

Dr. Michael Aziz on Targeting Aging: Diet, Fats, Testing, Hormones, Peptides, and Practical Longevity Strategies
 
Dr. Ben Weitz introduces the Rational Wellness Podcast and interviews Dr. Michael Aziz about longevity and treating aging as a modifiable biological "syndrome," referencing the hallmarks of aging and the need for broad approaches because organs age at different rates. Aziz highlights major aging accelerators—processed foods, refined carbs/sugar, seed oils, poor sleep, and stress—criticizes low-fat guidelines and the Seven Countries study, and argues saturated fats (e.g., butter, coconut) are not the main driver of heart disease, which he frames as inflammation and oxidized/sticky cholesterol, emphasizing advanced lipid testing. He outlines a basic longevity lab panel (A1C, fasting insulin, hs-CRP, liver tests, advanced lipids) and discusses insulin resistance, GLP-1 drugs and side effects, muscle preservation, exercise/HIIT, and dietary moderation of grains and keto-style choices without processed meats. The conversation covers hormones, bioidentical replacement, peptides, senolytics (fasting, fisetin, quercetin, low-dose naltrexone), NAD/NR/NMN, supplements, sauna, tadalafil, metformin, and berberine.
 
00:59 Meet Dr Michael Aziz
02:51 Is Aging a Disease
04:14 Hallmarks of Aging
04:54 Measuring Biological Age
05:56 Biggest Aging Accelerators
06:18 Diet Pitfalls Sugar Oils
07:54 Keto Done Right
08:59 Saturated Fat Debate
12:37 Cooking Fats and Seed Oils
14:19 Low Fat Guidelines Myth
15:06 Vegetarian Diet Concerns
16:27 What Really Causes Heart Disease
18:01 Longevity Lab Testing
18:33 Insulin Resistance and GLP1s
19:31 GLP1 Side Effects
20:42 Muscle Mass for Longevity
21:08 Omega 6 Ratio Explained
22:21 Coconut Oil and Cholesterol
24:20 Perfect 10 Diet vs Keto
25:43 Whole Grains and Mediterranean Diet
27:52 Grains And Gluten
28:54 Mediterranean Vs French Diet
29:59 Dairy Benefits And Risks
30:39 Hormones And Aging
31:43 Peptides For Longevity
34:28 Senescent Cells And Senolytics
36:08 Fasting Strategies Explained
37:43 NAD NR And NMN
39:23 Supplements And Mitochondria
41:04 Overhyped Longevity Treatments
43:08 Metformin Berberine And Sugar
45:27 Exercise For Longevity
47:00 Future Of Anti Aging Medicine
48:37 Mediterranean Diet Revisited
50:42 Final Takeaways And Where To Find Him
51:47 Podcast Wrap Up And Next Steps
 
Dr. Aziz is a board-certified internal medicine physician, author, and broadcast media commentator.  He practices at Lenox Hill Hospital in New York City. He spent decades integrating conventional and functional medicine with a focus on identifying and treating the underlying causes of chronic diseases. Dr. Aziz first became nationally known with his 2010 book, The Perfect 10 Diet, in which he challenged a number of prevailing ideas about dietary fat and nutrition, and his newest book, The Ageless Revolution. His website is MichaelAzizMD.com.
 
Dr. Ben Weitz  is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure. Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.

Diarrhea: Root Causes, Testing, and Treatment Strategies with Dr. Ilana Gurevich
Dr. Ben Weitz introduces the Rational Wellness Podcast episode on diarrhea and its complex differential diagnosis, featuring naturopathic gastroenterology specialist Dr. Ilana Gurevich. They discuss defining diarrhea using the Bristol Stool Chart and distinguishing acute from chronic cases, including when to investigate (about 4–5 days for new onset). Gurevich outlines an acute workup using LabCorp's rapid GI Pathogen Profile PCR stool test, notes limitations and false positives, and explains her approach to chronic diarrhea evaluation, including GI-MAP with optional bile acid testing (OMX), pancreatic elastase and steatocrit for fat malabsorption, and assessment for SIBO/SIFO and H. pylori (emphasizing conventional confirmation and virulence factors). They cover bile acid malabsorption and treatment with bile acid sequestrants and fibers, exocrine pancreatic insufficiency and enzyme dosing, microscopic colitis requiring diagnostic colonoscopy biopsies and budesonide, carbohydrate malabsorption breath testing, hydrogen sulfide SIBO uncertainty, the role of stress/nervous system and motility, and supplement causes like excess magnesium or vitamin C.
00:00 Podcast Intro
00:59 Why Diarrhea Is Complex
01:52 Meet Dr Gurevich
02:39 Acute Loose Stool Workup
03:07 Fast PCR Stool Panel
04:47 Treating Blastocystis
06:16 Defining Diarrhea
07:46 Acute vs Chronic Timeline
08:49 Food Triggers and EPI
10:18 Testing Limits and False Positives
11:03 Cholera PCR Story
13:56 GI Map and Bile Acids
 
15:45 Bile Biome Explained
 
18:25 Bloating Points to SIBO
18:54 Provoking Stool Tests
 
20:25 Biofilm Protocol Details
 
23:19 Large Bowel Dysbiosis Targets
 
24:24 Small Bowel Workup and H pylori
 
25:46 SIBO SIFO Testing
 
26:12 Organic Acids Debate
 
26:44 Pancreatic Enzymes Trial
28:19 PERT Dosing Basics
 
30:40 Bile Acid Diarrhea
 
 
33:46 Microscopic Colitis Clues
 
 
37:15 Treating Microscopic Colitis
 
 
39:28 Sugar Intolerance Breath Tests
 
 
40:02 Hydrogen Sulfide SIBO
 
 
43:55 Food Sensitivity Panel Critique
 
 
45:11 Nervous System Bucket
 
 
46:21 Motility And Transit
 
 
48:11 Wrap Up And Where To Find
 
Dr. Ilana Gurevich is a naturopathic physician, who specializes in gastroenterology. She's in Portland,
 
Oregon and she's the co-host of the excellent Turd Nerds podcast. She runs her practice out of
 
OpenWellness PDX. 
 
 
 
 
 
 
Dr. Ben Weitz  is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure. Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.

An Integrative Approach to Parkinson's: Gut-Brain Axis, Toxins, Pro21 Diet, Testing & Key Supplements | Dr. Karin Duncan
Dr. Ben Weitz introduces a Rational Wellness Podcast episode on Parkinson's disease with naturopathic physician Dr. Karin Duncan, who is launching the Integrative Neurology Wellness Center in Hayden, Idaho in partnership with the Northwest Parkinson's Foundation to provide accessible integrative care. They discuss Parkinson's as more than dopamine deficiency, emphasizing toxins, inflammation, mitochondrial dysfunction, oxidative stress, and the gut-brain axis, with increasing young-onset cases. Duncan explains clinical diagnosis, limits of DaTscan, and her reliance on the CND/Syn-One skin biopsy for alpha-synuclein. They cover prodromal symptoms (constipation, loss of smell, REM sleep behavior disorder), alpha-synuclein and Lewy bodies, and her evaluation approach including nutrient and inflammatory labs, omega-3/6 targets, iron, thyroid/hormones, microbiome testing, and caution with detox. They review ProPD symptom tracking, Pro21 diet (avoid dairy, beef/pork/chicken, fried/refined/canned foods), exercise, glutathione, DHA, low-dose lithium, vitamin D/K2, LDN, and careful use of methylene blue, plus community and mental health support.
Dr. Laura Mischley's Pro 21 diet was published: Beyond MIND and Mediterranean Diets: Designing a Diet to Optimize Parkinson's Disease Outcomes.  
Laura Mischley's Parkinson's symptom tracking (Pro-PD) app can be found here:  lauriemischley.com/pro-pd-app
00:00 Podcast Intro
01:02 Parkinsons Overview
02:30 New Clinic Foundation
04:41 Toxins Call to Action
07:41 Young Onset Cases
08:37 Diagnosis Testing Tools
12:49 Prodromal Warning Signs
14:44 REM Sleep Explained
16:32 Constipation Mechanisms
20:29 Alpha Synuclein Gut Brain
24:25 Tracking Symptoms ProPD
29:28 Lewy Bodies Basics
30:07 Integrative Lab Workup
31:45 Methylene Blue Safety
34:02 Omega Fats Targets
36:50 Iron Thyroid Hormones
38:38 Gut Testing Dysbiosis
39:59 SIBO Testing Alternatives
41:28 Microbiome Testing Roadmap
43:47 Stool Tests and Gut Function
46:02 Diet Strategy and Pro 21
48:57 Pro 21 Foods to Avoid
51:09 Toxins and Detox Caution
53:13 Supplements That Move the Needle
59:58 Probiotics Targeted Not Empirical
01:01:24 Exercise and Realistic Outcomes
01:04:15 High Tech Therapies and Palliation
01:05:33 Methylene Blue Safety and Dosing
01:08:45 LDN and Mental Health Support
01:11:25 Tremors Vagus Nerve and DBS
01:13:10 Build Your Care Team
01:15:09 Resources and How to Connect

Karin Duncan is a naturopathic physician who recently launched her new office, the Integrative Neurology Wellness Center in Hayden, Idaho in partnership with the Northwest Parkinson's Foundation to provide accessible integrative care to patients with neurodegenerative disorders. Her website is the Integrative Neurology Wellness Center and her phone is 208-480-4692.


Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure. Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.

The HRT Questions Most Women Never Get Answered with Karen Martel | Rational Wellness Podcast 481
Perimenopause to Menopause: Testing, Progesterone First, and Evidence-Informed HRT with Karen Martell
Dr. Ben Weitz introduces the Rational Wellness Podcast and interviews hormone specialist Karen Martell about perimenopause and menopause, emphasizing that midlife hormonal shifts affect metabolism, sleep, mood, cognition, bone and cardiovascular health. Martell says perimenopause can begin in the mid-30s, often with declining progesterone from less frequent ovulation, leading to heavy periods, insomnia, anxiety, and perceived "estrogen dominance," while estrogen later becomes erratic and then declines toward menopause around age 51. She critiques common responses like birth control, hysterectomy, and symptom-only medications, and recommends combining bloodwork with saliva or urine metabolite testing (e.g., DUTCH) when cycling. For HRT, she prefers transdermal estradiol over oral estrogen, discusses progesterone delivery options and sensitivities to oral metabolites, addresses testosterone (often compounded; injectable preferred), and notes roles for DHEA and pregnenolone. She also covers vaginal therapies, dosing based on both symptoms and protective lab ranges, and cautious later-life initiation.
 
00:00 Show Intro and Mission
00:59 Why Midlife Hormones Matter
02:23 Perimenopause Starts Early
03:18 Progesterone Drop Signs
06:17 Testing Hormones and Thyroid
08:02 Bad Advice and Quick Fixes
09:33 When Supplements Aren't Enough
10:52 Starting Progesterone Therapy
12:49 Best Hormone Testing Methods
15:36 Endocrine Disruptors Cleanup
17:40 Choosing Estrogen Delivery
18:43 Pellets and Testosterone Risks
22:27 Progesterone Forms and Dosing
25:21 Why Avoid Oral Estrogen
27:00 Estradiol for Life
27:38 Estriol vs Estradiol
30:23 Patch vs Cream Dosing
31:56 E4 Estrogen Debate
33:39 Cycling Progesterone
35:38 DHEA and Pregnenolone
37:39 Vaginal Hormone Options
40:18 Optimizing HRT Levels
43:52 Starting HRT After 70
47:45 Perimenopause Timing Tips
50:19 Where to Find Karen


Karen Martel is a Certified Hormone Specialist and Transformation Nutrition Coach and the host of The Hormone Solution podcast, which focuses on perimenopause, menopause, hormone replacement therapy, metabolic health, weight loss resistance, and thyroid health.  Her website is KarenMartel.com.  


Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure. Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.

What are the Functions of Microbial Gases, Hydrogen, Methane, & Hydrogen Sulfide with Dr. Tom Fabian | Rational Wellness Podcast 480
Gut Microbial Gases Beyond SIBO: Hydrogen, Methane, and Hydrogen Sulfide as Signaling Metabolites
Dr. Ben Weitz introduces the Rational Wellness Podcast and interviews Dr. Tom Fabian, PhD, to discuss gut microbial gases beyond the usual SIBO framing. They explain that hydrogen, methane, and hydrogen sulfide are normal microbial metabolites with potential signaling roles, alongside key microbiome products like short-chain fatty acids (especially butyrate), which fuels colon cells, supports tight junctions, regulatory T cells, and helps maintain an anaerobic colon environment. Fabian notes metabolomics (e.g., GI-MAP stool add-ons) can provide functional insight beyond which microbes are present, highlighting butyrate producers such as Faecalibacterium and Roseburia. They review controversies in breath testing interpretation, discuss methane biology and debated links to constipation, and emphasize emerging research that hydrogen sulfide is widely produced (often from cysteine metabolism), supports colon mitochondria and anaerobiosis, may relate to stress responses and longevity, and that excessive sulfur restriction may be misguided; fiber and polyphenols may mitigate protein-driven hydrogen sulfide.
00:00 Show Intro
00:59 Why Gut Gases Matter
04:04 Microbiome Metabolites
05:52 Butyrate Deep Dive
09:07 Measuring SCFAs
13:20 Hydrogen and Breath Tests
19:12 Hydrogen Benefits
28:19 Methane and Motility
31:06 Sponsor Break
32:13 Methanogens Explained
35:24 Hydrogen Sulfide Science
50:59 Clinical Takeaways
 

Dr. Tom Fabian has a PhD in molecular biology and who has spent many years researching the microbiome and translating the scientific literature into practical applications for functional medicine practitioners.  Currently, Dr. Fabian serves a consultant and science advisor with Diagnostic Solutions Laboratory.


Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure. Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.