In this episode, Dr. Regina Druz is joined by Dr. Jennifer Roelands — a board-certified OB-GYN who practices integrative gynecology and longevity medicine — to reframe GLP-1 agonists (semaglutide and tirzepatide) as a form of hormonal replacement therapy rather than simple weight-loss drugs. They unpack why perimenopausal women experience sudden weight resistance despite clean nutrition and disciplined exercise, how microdosing can lower inflammation and insulin resistance without sacrificing muscle or facial volume, and why a structured medically supervised program — not a med-spa shortcut — is what turns these medications into durable cardiovascular and metabolic wins. The conversation also covers thyroid autoimmunity, adrenal hormones, PCOS, and practical on-boarding and off-boarding protocols.
🎬 Watch on YouTube: This episode is now available on the Own Your Heart Health YouTube channel. Subscribe to be notified.
Dr. Regina Druz (00:02) Welcome to Own Your Heart Health. I'm Dr. Regina Druz, your holistic cardiologist. This week we dive into common heart health concerns, uncovering root causes and unpacking scientific discoveries and controversies. The information provided does not constitute medical advice — please contact your healthcare practitioner before making any changes that may impact your health.
Today I'm joined by a wonderful guest. When we attended a conference together, I didn't know her at all, but she came up to me and said, "Hi, I'm Dr. Jennifer, and I really like the things you're talking about — can we connect?" What we're discussing today is exactly why Dr. Jennifer is here. She is an integrative gynecologist and longevity physician, and this is an amazing opportunity for us as women to understand how our life cycle factors into our longevity. The exciting part is that we have options today that we didn't have just a few years ago — options that bridge hormonal optimization and longevity optimization. In my opinion, these are game changers for women, especially women in perimenopause and menopause. Dr. Jennifer, welcome to the show.
Dr. Jennifer Roelands (01:42) Thank you. I'm so excited to be here — and yes, you're a gem. That's why I approached you. Integrative cardiologists are hard to find.
Dr. Regina Druz (01:51) I wish there were more of us. We're actually training some physicians to become integrative cardiologists, so that's always a good sign. Jennifer, I ask every guest the same opening question: how did you grow up to become an integrative gynecologist?
Dr. Jennifer Roelands (02:08) I have a somewhat unique story. No one on either side of my family even graduated from high school. I was raised in a traditional Italian family where the expectation was to get married and have babies. My parents married at 16 and 17 and never finished school. I grew up as an unusual military kid who thought, "I don't know what I'm supposed to do when I get older." At 17 or 18, I didn't have a boyfriend, so the marriage-and-babies path wasn't going to work out. I tried this college thing, fumbled my way into medicine, and discovered that I loved helping people and loved science. I became an OB-GYN because it's a cool specialty — you walk with patients through the whole lifespan, then with their daughters and mothers too.
I entered the integrative world when I was struggling with infertility. A patient came to me in the exact same situation — she couldn't get pregnant, fertility doctors had dismissed her with "you're young, it'll work out." I ran my own labs and realized I had PCOS and Hashimoto's. My thyroid antibodies were a thousand and my TSH was totally normal. I helped that patient explore things more deeply — what should I eat, is it not just about medication? When I took an Institute of Integrative Nutrition class, it felt like a complete medical education I'd never received. Ultimately, my patient conceived spontaneously, and I ended up conceiving with Clomid. Once you see this, it's hard to unsee it.
Dr. Regina Druz (04:40) Yesterday I watched a Netflix documentary on plastic detox that focused on fertility. Decades of plastic contamination, microplastics — they are found in placenta, in breast milk; they affect genital development of babies and lead to low sperm count. It was absolutely fascinating. An investigator ran a small field trial with six couples, and without spoiling it, the results were striking. What struck me is that it examined the environment through both the lens of contamination and the broader lens of diet, exercise, and body composition.
Cardiology is backing into this truth one study at a time. We just had an article published in the Journal of the American College of Cardiology linking consumption of ultra-processed foods to incident cardiovascular events. The more ultra-processed food people consumed, the more heart attacks and strokes they had. What was fascinating is that the authors used an index called NOVA, which evaluates food processing rather than the ingredients themselves — so certain foods we would consider healthy ended up in the ultra-processed category. No wonder patients — and clinicians — are confused about nutritional strategy. So, Jennifer, as an integrative gynecologist, what is your framework for hormonal balance and optimization?
Dr. Jennifer Roelands (07:19) Most patients come in saying, "I think I have a hormonal imbalance." They're typically referring to sex hormones — estrogen, progesterone, and sometimes testosterone. Not every woman realizes testosterone is in that category, because we've demonized it. But in whole-body medicine, thyroid matters enormously. Metabolic hormones — fasting insulin, leptin — are just as critical for hormone balance as estrogen or progesterone. I describe it to patients as a symphony: every instrument has to play together. If the violin goes rogue, you can hear it above everything else.
In our type of medicine we are always the "why" seekers. Why does this lab look the way it does? Why do you have persistent thyroid symptoms even though your TSH is normal? Did anyone look at a full thyroid panel? Did they check antibodies? Thyroid antibodies are missed all the time — patients are told they have Hashimoto's and have never had antibodies measured. That's part of the diagnosis. If antibodies stay high, symptoms persist, so we ask: is it gut inflammation? Environmental toxins? Other hormones derailing the thyroid? Autoimmunity is essentially one problem wearing different costumes — which organ did the immune system decide to attack? Thyroid, pancreas, joints? It's the same fundamental issue.
PCOS is the perfect example of hormones needing to be treated as a system. High testosterone leads to insulin resistance, which drives inflammation, which raises testosterone further. Giving a PCOS patient a birth control pill doesn't stop her from gaining weight, or from experiencing brain fog and anxiety from inflammation, because two of the three corners of the triangle were never addressed.
Dr. Regina Druz (10:28) This framing matters enormously, because when women come to me with new hypertension, chest pains, weight gain, or disrupted sleep and ask for "hormones," they usually mean estrogen, progesterone, maybe vaginal replacement, occasionally testosterone. They aren't thinking about adrenal hormones, which powerfully affect blood pressure regulation, water retention, and the autonomic nervous system of the heart. They aren't thinking about thyroid, which is tied to autoimmune activity that translates into vascular risk. And they're often not thinking about metabolic hormones at all.
Dr. Regina Druz (12:46) I was recently at a conference where a nutritionist made a point that stuck with me. She said the new medications — Ozempic, Zepbound, Wegovy, and related agents — should not be thought of as weight-loss medications. They should be thought of as hormonal replacement therapy, because there is an age-related decline in the endogenous hormones these medications agonize. That reframing is profound. Jennifer, you've been using these in your practice. What are you seeing?
Dr. Jennifer Roelands (12:46) I see predominantly perimenopausal and menopausal patients — and I'm in perimenopause myself, so I naturally attract people who say, "She knows what's going on." This population is now developing insulin resistance and inflammation precisely as estrogen declines. I describe insulin to patients as the bouncer of the bar — it decides whether glucose goes in to make energy, or goes to storage. Estradiol is the bar manager who tells the bouncer what to do. When the bar manager leaves, the bouncer starts making his own decisions, and that is not good.
So you have insulin resistance, inflammation, and lowering estrogen cascading into weight gain. Women tell me, "I am doing everything — I'm eating clean, I'm exercising." They often don't recognize that they're losing muscle because they're not doing resistance training. When GLP-1s exploded in use a couple of years ago, patients started telling me, "I don't meet the insurance BMI criteria, but I want to try a low dose." With compounding, we could prescribe off-label to patients who needed to lose 10, 15, 20, 30 pounds — not the 200-pound trial populations — and who really had metabolic dysfunction to correct. That's how I started microdosing.
Dr. Regina Druz (15:37) Let me unpack this for listeners. Compounding pharmacies are allowed to provide medications containing active ingredients from FDA-approved drugs, particularly during shortages — and we had several with semaglutide. That allowed clinicians to manipulate dosages. Currently, with the FDA no longer recognizing shortages, a well-established pathway for microdosing comes directly from the manufacturer. At Holistic Heart Centers we use LillyDirect, which provides vials of tirzepatide (brand name Zepbound; the diabetic formulation is Mounjaro). From a vial you can draw any amount, which is technically what microdosing means — any dose below the official starting dose.
This is off-label use of an FDA-approved medication, which physicians are permitted to do. Jennifer, when you refer to microdosing, which agent, what starting dose, and what patient profile leads you to choose this strategy?
Dr. Jennifer Roelands (18:35) First, who chooses microdosing? Often it's a patient about to start HRT — it will take a couple of months for HRT to optimize her body composition, and she wants the weight-loss process going in parallel, because it's hard to stay motivated at the gym when nothing is moving. So question one is always: is this for weight loss, or for another indication? I have patients with binge eating disorder for whom decrease in food noise has drastically changed their lives — that's a neuroinflammation pathway, not a weight goal, and the doses are very small.
Next I assess rate of weight loss desired and current lifestyle. If a patient tells me, "I eat terribly, I have four kids, I'm running through drive-throughs," I'm not going to push higher and higher doses. You'd be pushing a boulder uphill. I usually start with semaglutide at 0.25 mg — the starting dose — or even half of that. The dose is weekly. I always ask if they've used GLP-1s before, because if they were previously on 0.75 mg three years ago, starting at half the starting dose today won't do much for them.
On off-boarding, in my experience it goes better to wean than to stop cold turkey. The body went from an endogenous hormone with a short half-life to a weekly injection, and if you pull it abruptly, patients tell me the food noise roars back. That's a predictable biologic response.
Dr. Regina Druz (22:01) This is exactly right. In the original clinical trials, which did not use microdosing, patients were on full pharmacological doses for 12 to 18 months. People sometimes expect miraculous results in weeks, but these are part of a hormonal replacement strategy. The medications potentiate hormones that the body naturally makes and which decline with age.
What I've observed as someone who used microdosing myself, and who is now on the initial Zepbound dose, is a clear anti-inflammatory effect at the low doses. In cardiology, we have a parallel concept with statins — what we call pleiotropic effects: vascular-stabilizing properties that are independent of the dose-related lipid effect. There's growing recognition that semaglutide and tirzepatide have pleiotropic effects too — in the central nervous system, in the vascular endothelium. Trials show favorable vascular effects that track with the drug, not with the weight loss. Are you seeing this anti-inflammatory effect in your patients?
Dr. Jennifer Roelands (25:03) Exactly the same thing. Patients on low doses tell me, "I didn't lose a lot of weight, but the puffiness is gone. My joints feel better. My brain is clearer. It's like someone melted the inflammation away." That tells me we're moving in the right direction — because the goal for this population is to lower the two biggest drivers, insulin resistance and inflammation.
Let me give you an example. I had a patient who was absolutely dialed in — macros, micros, protein, fiber — and could not lose weight. When I dug into the mind-body side, she told me she had lost her 19-year-old son to cancer and had never been the same. In traditional medicine, adrenal measurement is a disaster — it's essentially not recognized. She wanted to try a low dose of a GLP-1 because she felt inflamed. She took half the starting dose, did nothing else, and lost 10 pounds in six weeks. Nothing dramatic. But her brain fog lifted, and she told me, "My brain feels ready to process this trauma." I sent her to a hypnotherapist, and she maintained her weight after coming off the GLP-1. She needed a biological nudge to access trauma work.
Patients report their asthma improves. Arthritis improves. Patients on immunomodulatory biologics report they don't need them as often. We know GLP-1s lower inflammation — we simply don't yet know how broadly. Diabetics are the classic example: they don't just improve glycemically, they report other comorbidities improving too.
Dr. Regina Druz (28:15) This connects to something integrative and functional medicine does well — tissue-level thinking. A functional medicine colleague of mine used to say, "In traditional medicine we look for issues with tissues; in functional medicine we look for tissues with issues." In cardiology, we're finding that GLP-1 agonists reduce cardiac events — and increasingly the evidence suggests this is independent of weight loss, through cardiometabolic remodeling. In heart failure with preserved ejection fraction, these medications appear to reduce the volume of epicardial adipose tissue — the fat that sits on top of and infiltrates the heart — and shut off its inflammatory signaling.
Are you aware of any formal studies on microdosing? I searched the literature and found only sporadic observational reports.
Dr. Jennifer Roelands (31:09) Right — mostly observational, nothing that meets the randomized controlled trial gold standard. I have no doubt Eli Lilly will eventually run formal microdosing or low-dose trials, especially now that they have direct-to-consumer offerings. The original FDA approvals were for obesity and diabetes — not perimenopause, not chronic inflammatory conditions, not binge eating. Formal evidence for those uses is not yet there, though it would be enormously valuable.
Dr. Regina Druz (33:09) It would be valuable. And since we're both integrative physicians, it's important to emphasize that these medications truly shine as part of a structured program. When we work with patients on insulin sensitivity, personalized nutrition, sleep, stress, and movement — and treat the medication as an enhancement rather than the entire strategy — three things happen. One: we get a deeper result than medication alone. Two: we can often use a lower dose, with fewer side effects. Three: when the medication is eventually tapered, the foundational skills allow patients to maintain their gains.
Dr. Jennifer Roelands (35:14)
Yes — and my answer to the patient who says, "Doc, just give me the drug, I'll sort the rest out," is, "Then you can probably get it online." I don't allow patients in my practice to just do anything, the same way I wouldn't let them self-manage hypertension or diabetes medications. The downside to the current landscape is that there are a million online companies, med-spas — gyms these days have a salesperson on the corner. You can access it, but you won't get sustainable weight loss or sustainable health optimization.
When I used GLP-1s myself in early perimenopause — eight pounds appeared out of nowhere — I was the person who ate asparagus for breakfast. But I discovered behaviors I hadn't noticed: if I had a second glass of wine I was more likely to have dessert. When I actually counted my fiber, I was at 15 grams — embarrassing. I thought I was doing fiber and protein correctly, and I really wasn't. That's information you only get through a clinical relationship.
Patients come to me saying, "I did a med-spa program, nobody follows up, I got off and had to get right back on." I ask, did they measure your hormones? Your fasting insulin? Your CRP? Your metabolic markers? If none of those got better on the GLP-1, we were probably on the wrong dose or even the wrong drug — semaglutide is different from tirzepatide, which is different from retatrutide. You have to see the biomarkers move to know you're on the right medication, the same way you check blood pressure to know if a blood pressure pill is working.
Dr. Regina Druz (40:20) Another critical issue: these medications, at full pharmacological doses in clinical trials, did not spare skeletal muscle. Up to 40% of the weight lost came from lean mass, which is not where anyone wants to be. With microdosing and medical supervision we can prioritize fat loss over muscle loss — in our patients, typically only about 4% of weight lost is muscle. Part of that is timing: microdosing avoids exposure to full pharmacological doses from day one, so the body can adjust. Patients can structure their nutrition better because food noise is quieter and they can make deliberate choices — more fiber, better protein, better decisions. Jennifer, what's your favorite microdosing protocol?
Dr. Jennifer Roelands (40:20) One more thing on muscle — and specifically face loss. I do aesthetics, so this is real. Patients say "I want to lose 10 pounds this month," and I say, "No, you don't." At 25 you'd get it back; at 55 you won't. If you lose weight too fast, it comes out of your face too, and the only option then is to fill it back in. Preserve the real estate.
I typically start with semaglutide. If someone doesn't tolerate GLP-1s on a small dose — severe nausea, constipation, exhaustion — giving them tirzepatide is not going to fix that. Tirzepatide in my experience has less nausea, but if someone flat-out feels awful on semaglutide, escalating to two hormones isn't the answer. Tirzepatide is also generally more expensive. Starting with semaglutide is a safer test of the waters.
If the patient has food-related behavioral patterns — raised in a culture where food equals love, or where they had to clean the plate, or craving fast food at the smell of it — I find tirzepatide works a little better, likely because of the GIP hormone component.
My typical rhythm: the patient gives themselves the first shot in the clinic so I know they can do it. I send them home with one dose. We reassess at two weeks. How much weight moved? How did you feel? How much of the nutrition guidance did you implement? Then we set up a four-shot rhythm, one monthly visit, with access to me by email or phone. I always prescribe Zofran for backup nausea — sometimes a patient gets the flu three days after a shot, or a college student finishes exams eating caffeine and donuts and needs rescue. I have a very direct conversation about fiber and constipation — don't wait three to five days, it does not get better on its own.
At the four-week mark we discuss: dose up, hold, or even scale down. If someone lost six pounds in the first month I might slow them down to preserve real estate. By month two we talk about off-boarding — spacing out doses, decreasing the dose, or moving to maintenance. A few of my patients do maintenance, one shot every three to four weeks, purely to keep inflammation at bay. That's deeply off-label and not formally studied, but it works clinically.
Dr. Regina Druz (46:26) Even conventional obesity experts now say we go as fast or as slow as the patient can tolerate. I tell my patients: this is not a race. There are no brownie points for escalating your dose every month. You may stay on the same dose for two months. This is a form of hormonal replacement, and since we can't reliably measure these endogenous hormones in a living patient, each individual becomes their own calibration. The slower we go, the better patients seem to respond — because they get the time to dial in the foundation.
If a patient lands on a maintenance dose, do they typically come off it entirely, or is some residual dosing helpful?
Dr. Jennifer Roelands (48:19) The majority of patients off-board completely. They figured out the why — they're now on HRT, they're lifting weights, sleeping, getting fiber, getting protein, moderating alcohol — and the medication is no longer needed. The small number who stay on maintenance, I re-engage every six months with full biomarker labs. If nothing has changed, I mail them a six-month vial supply from the pharmacy; by that point they know how to draw up the medication.
For patients where the drug stops working, we troubleshoot: maybe tirzepatide is the better option, maybe thyroid is suboptimal, maybe hemoglobin A1c is too high and the GLP-1 is trying to be the whole cake instead of the icing. GLP-1s are the icing. The foundation has to be there or the medication can't do its job. Once the foundation is dialed in, patients often come down to very low doses — someone on 0.25 mg with six-pound monthly loss and beautiful labs may drop further, not higher. That kind of personalization is what you cannot get from mass-volume med-spa prescribing.
Dr. Regina Druz (50:57) This point cannot be overstated. All hormonal replacement therapy — and GLP-1 agonists (semaglutide, tirzepatide, the dual-incretin agents, and retatrutide as a triple agonist) are hormones — shines when the foundation is dialed in. Bringing HRT onto unprepared terrain is when side effects appear and strategies backfire. The same principle applies to peptides. These medications are FDA-approved peptides in their chemical structure. What we're seeing in culture right now I call "shiny object syndrome" — people want a shortcut, a magical injectable — without putting in the foundational work. Unfortunately, some patients learn in their own skin that time favors those who take the time to prepare. Jennifer, last words for our listeners.
Dr. Jennifer Roelands (52:53) I want to emphasize something our colleague Dr. Shaw discussed in a recent interview: some peptides interact with other peptides, and stacking them incorrectly cancels their benefit. You can't throw BPC-157 into a shot with another peptide and assume both will work — you may have just neutralized one of them. Cycling matters. Timing matters. Without supervision, patients are wasting money and undermining results. It has to be a personal approach, and it has to be medically supervised.
Dr. Regina Druz (54:00) Building the foundation is not glamorous, it is not sexy, it is work, it doesn't make headlines — but it gets you far. I always use the house analogy: you need a roof, but there is no roof without a foundation. Jennifer, thank you so much — enormously informative. To our listeners, if you have questions, please post them; we do our best to respond. We can't provide medical advice, but we can guide your thought process.
Dr. Jennifer Roelands (54:56) Thank you so much.
Dr. Regina Druz (54:58) Thank you for tuning in to Own Your Heart Health with Dr. Regina Druz. This podcast is powered by Holistic Heart Centers. If you enjoyed the show, please rate and review us on your favorite podcast platform. To learn more about our services, visit holisticheartcenters.com and subscribe to our YouTube channel — the link is in the show notes. See you next week.
Integrative Gynecologist | Longevity Physician | Board-Certified OB-GYN
Focus: Perimenopause, Menopause, PCOS, Hormonal Optimization, GLP-1 Microdosing
Training: Institute of Integrative Nutrition | Conventional OB-GYN Residency
holisticheartcenters.com HeartWell.ai — AI-powered cardiovascular risk assessment Address: 55 Bryant Avenue, Suite #6, Roslyn, NY 11576 Phone: 877-511-5166 YouTube: @reginadruzmd | Instagram: @dr.reginadruz Podcast: Own Your Heart Health — available on all major platforms
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The information in this transcript is for educational purposes only and does not constitute medical advice. The discussions about stem cells, exosomes, peptides, and regenerative therapies reflect the clinical experiences and opinions of the physicians involved. These treatments are not FDA-approved for all applications discussed. Individual results vary. Please consult your licensed healthcare practitioner before making any changes to your health regimen.
]]>In this episode, Dr. Regina Druz is joined by Dr. Jennifer Roelands — a board-certified OB-GYN who practices integrative gynecology and longevity medicine — to reframe GLP-1 agonists (semaglutide and tirzepatide) as a form of hormonal replacement therapy rather than simple weight-loss drugs. They unpack why perimenopausal women experience sudden weight resistance despite clean nutrition and disciplined exercise, how microdosing can lower inflammation and insulin resistance without sacrificing muscle or facial volume, and why a structured medically supervised program — not a med-spa shortcut — is what turns these medications into durable cardiovascular and metabolic wins. The conversation also covers thyroid autoimmunity, adrenal hormones, PCOS, and practical on-boarding and off-boarding protocols.
🎬 Watch on YouTube: This episode is now available on the Own Your Heart Health YouTube channel. Subscribe to be notified.
Dr. Regina Druz (00:02) Welcome to Own Your Heart Health. I'm Dr. Regina Druz, your holistic cardiologist. This week we dive into common heart health concerns, uncovering root causes and unpacking scientific discoveries and controversies. The information provided does not constitute medical advice — please contact your healthcare practitioner before making any changes that may impact your health.
Today I'm joined by a wonderful guest. When we attended a conference together, I didn't know her at all, but she came up to me and said, "Hi, I'm Dr. Jennifer, and I really like the things you're talking about — can we connect?" What we're discussing today is exactly why Dr. Jennifer is here. She is an integrative gynecologist and longevity physician, and this is an amazing opportunity for us as women to understand how our life cycle factors into our longevity. The exciting part is that we have options today that we didn't have just a few years ago — options that bridge hormonal optimization and longevity optimization. In my opinion, these are game changers for women, especially women in perimenopause and menopause. Dr. Jennifer, welcome to the show.
Dr. Jennifer Roelands (01:42) Thank you. I'm so excited to be here — and yes, you're a gem. That's why I approached you. Integrative cardiologists are hard to find.
Dr. Regina Druz (01:51) I wish there were more of us. We're actually training some physicians to become integrative cardiologists, so that's always a good sign. Jennifer, I ask every guest the same opening question: how did you grow up to become an integrative gynecologist?
Dr. Jennifer Roelands (02:08) I have a somewhat unique story. No one on either side of my family even graduated from high school. I was raised in a traditional Italian family where the expectation was to get married and have babies. My parents married at 16 and 17 and never finished school. I grew up as an unusual military kid who thought, "I don't know what I'm supposed to do when I get older." At 17 or 18, I didn't have a boyfriend, so the marriage-and-babies path wasn't going to work out. I tried this college thing, fumbled my way into medicine, and discovered that I loved helping people and loved science. I became an OB-GYN because it's a cool specialty — you walk with patients through the whole lifespan, then with their daughters and mothers too.
I entered the integrative world when I was struggling with infertility. A patient came to me in the exact same situation — she couldn't get pregnant, fertility doctors had dismissed her with "you're young, it'll work out." I ran my own labs and realized I had PCOS and Hashimoto's. My thyroid antibodies were a thousand and my TSH was totally normal. I helped that patient explore things more deeply — what should I eat, is it not just about medication? When I took an Institute of Integrative Nutrition class, it felt like a complete medical education I'd never received. Ultimately, my patient conceived spontaneously, and I ended up conceiving with Clomid. Once you see this, it's hard to unsee it.
Dr. Regina Druz (04:40) Yesterday I watched a Netflix documentary on plastic detox that focused on fertility. Decades of plastic contamination, microplastics — they are found in placenta, in breast milk; they affect genital development of babies and lead to low sperm count. It was absolutely fascinating. An investigator ran a small field trial with six couples, and without spoiling it, the results were striking. What struck me is that it examined the environment through both the lens of contamination and the broader lens of diet, exercise, and body composition.
Cardiology is backing into this truth one study at a time. We just had an article published in the Journal of the American College of Cardiology linking consumption of ultra-processed foods to incident cardiovascular events. The more ultra-processed food people consumed, the more heart attacks and strokes they had. What was fascinating is that the authors used an index called NOVA, which evaluates food processing rather than the ingredients themselves — so certain foods we would consider healthy ended up in the ultra-processed category. No wonder patients — and clinicians — are confused about nutritional strategy. So, Jennifer, as an integrative gynecologist, what is your framework for hormonal balance and optimization?
Dr. Jennifer Roelands (07:19) Most patients come in saying, "I think I have a hormonal imbalance." They're typically referring to sex hormones — estrogen, progesterone, and sometimes testosterone. Not every woman realizes testosterone is in that category, because we've demonized it. But in whole-body medicine, thyroid matters enormously. Metabolic hormones — fasting insulin, leptin — are just as critical for hormone balance as estrogen or progesterone. I describe it to patients as a symphony: every instrument has to play together. If the violin goes rogue, you can hear it above everything else.
In our type of medicine we are always the "why" seekers. Why does this lab look the way it does? Why do you have persistent thyroid symptoms even though your TSH is normal? Did anyone look at a full thyroid panel? Did they check antibodies? Thyroid antibodies are missed all the time — patients are told they have Hashimoto's and have never had antibodies measured. That's part of the diagnosis. If antibodies stay high, symptoms persist, so we ask: is it gut inflammation? Environmental toxins? Other hormones derailing the thyroid? Autoimmunity is essentially one problem wearing different costumes — which organ did the immune system decide to attack? Thyroid, pancreas, joints? It's the same fundamental issue.
PCOS is the perfect example of hormones needing to be treated as a system. High testosterone leads to insulin resistance, which drives inflammation, which raises testosterone further. Giving a PCOS patient a birth control pill doesn't stop her from gaining weight, or from experiencing brain fog and anxiety from inflammation, because two of the three corners of the triangle were never addressed.
Dr. Regina Druz (10:28) This framing matters enormously, because when women come to me with new hypertension, chest pains, weight gain, or disrupted sleep and ask for "hormones," they usually mean estrogen, progesterone, maybe vaginal replacement, occasionally testosterone. They aren't thinking about adrenal hormones, which powerfully affect blood pressure regulation, water retention, and the autonomic nervous system of the heart. They aren't thinking about thyroid, which is tied to autoimmune activity that translates into vascular risk. And they're often not thinking about metabolic hormones at all.
Dr. Regina Druz (12:46) I was recently at a conference where a nutritionist made a point that stuck with me. She said the new medications — Ozempic, Zepbound, Wegovy, and related agents — should not be thought of as weight-loss medications. They should be thought of as hormonal replacement therapy, because there is an age-related decline in the endogenous hormones these medications agonize. That reframing is profound. Jennifer, you've been using these in your practice. What are you seeing?
Dr. Jennifer Roelands (12:46) I see predominantly perimenopausal and menopausal patients — and I'm in perimenopause myself, so I naturally attract people who say, "She knows what's going on." This population is now developing insulin resistance and inflammation precisely as estrogen declines. I describe insulin to patients as the bouncer of the bar — it decides whether glucose goes in to make energy, or goes to storage. Estradiol is the bar manager who tells the bouncer what to do. When the bar manager leaves, the bouncer starts making his own decisions, and that is not good.
So you have insulin resistance, inflammation, and lowering estrogen cascading into weight gain. Women tell me, "I am doing everything — I'm eating clean, I'm exercising." They often don't recognize that they're losing muscle because they're not doing resistance training. When GLP-1s exploded in use a couple of years ago, patients started telling me, "I don't meet the insurance BMI criteria, but I want to try a low dose." With compounding, we could prescribe off-label to patients who needed to lose 10, 15, 20, 30 pounds — not the 200-pound trial populations — and who really had metabolic dysfunction to correct. That's how I started microdosing.
Dr. Regina Druz (15:37) Let me unpack this for listeners. Compounding pharmacies are allowed to provide medications containing active ingredients from FDA-approved drugs, particularly during shortages — and we had several with semaglutide. That allowed clinicians to manipulate dosages. Currently, with the FDA no longer recognizing shortages, a well-established pathway for microdosing comes directly from the manufacturer. At Holistic Heart Centers we use LillyDirect, which provides vials of tirzepatide (brand name Zepbound; the diabetic formulation is Mounjaro). From a vial you can draw any amount, which is technically what microdosing means — any dose below the official starting dose.
This is off-label use of an FDA-approved medication, which physicians are permitted to do. Jennifer, when you refer to microdosing, which agent, what starting dose, and what patient profile leads you to choose this strategy?
Dr. Jennifer Roelands (18:35) First, who chooses microdosing? Often it's a patient about to start HRT — it will take a couple of months for HRT to optimize her body composition, and she wants the weight-loss process going in parallel, because it's hard to stay motivated at the gym when nothing is moving. So question one is always: is this for weight loss, or for another indication? I have patients with binge eating disorder for whom decrease in food noise has drastically changed their lives — that's a neuroinflammation pathway, not a weight goal, and the doses are very small.
Next I assess rate of weight loss desired and current lifestyle. If a patient tells me, "I eat terribly, I have four kids, I'm running through drive-throughs," I'm not going to push higher and higher doses. You'd be pushing a boulder uphill. I usually start with semaglutide at 0.25 mg — the starting dose — or even half of that. The dose is weekly. I always ask if they've used GLP-1s before, because if they were previously on 0.75 mg three years ago, starting at half the starting dose today won't do much for them.
On off-boarding, in my experience it goes better to wean than to stop cold turkey. The body went from an endogenous hormone with a short half-life to a weekly injection, and if you pull it abruptly, patients tell me the food noise roars back. That's a predictable biologic response.
Dr. Regina Druz (22:01) This is exactly right. In the original clinical trials, which did not use microdosing, patients were on full pharmacological doses for 12 to 18 months. People sometimes expect miraculous results in weeks, but these are part of a hormonal replacement strategy. The medications potentiate hormones that the body naturally makes and which decline with age.
What I've observed as someone who used microdosing myself, and who is now on the initial Zepbound dose, is a clear anti-inflammatory effect at the low doses. In cardiology, we have a parallel concept with statins — what we call pleiotropic effects: vascular-stabilizing properties that are independent of the dose-related lipid effect. There's growing recognition that semaglutide and tirzepatide have pleiotropic effects too — in the central nervous system, in the vascular endothelium. Trials show favorable vascular effects that track with the drug, not with the weight loss. Are you seeing this anti-inflammatory effect in your patients?
Dr. Jennifer Roelands (25:03) Exactly the same thing. Patients on low doses tell me, "I didn't lose a lot of weight, but the puffiness is gone. My joints feel better. My brain is clearer. It's like someone melted the inflammation away." That tells me we're moving in the right direction — because the goal for this population is to lower the two biggest drivers, insulin resistance and inflammation.
Let me give you an example. I had a patient who was absolutely dialed in — macros, micros, protein, fiber — and could not lose weight. When I dug into the mind-body side, she told me she had lost her 19-year-old son to cancer and had never been the same. In traditional medicine, adrenal measurement is a disaster — it's essentially not recognized. She wanted to try a low dose of a GLP-1 because she felt inflamed. She took half the starting dose, did nothing else, and lost 10 pounds in six weeks. Nothing dramatic. But her brain fog lifted, and she told me, "My brain feels ready to process this trauma." I sent her to a hypnotherapist, and she maintained her weight after coming off the GLP-1. She needed a biological nudge to access trauma work.
Patients report their asthma improves. Arthritis improves. Patients on immunomodulatory biologics report they don't need them as often. We know GLP-1s lower inflammation — we simply don't yet know how broadly. Diabetics are the classic example: they don't just improve glycemically, they report other comorbidities improving too.
Dr. Regina Druz (28:15) This connects to something integrative and functional medicine does well — tissue-level thinking. A functional medicine colleague of mine used to say, "In traditional medicine we look for issues with tissues; in functional medicine we look for tissues with issues." In cardiology, we're finding that GLP-1 agonists reduce cardiac events — and increasingly the evidence suggests this is independent of weight loss, through cardiometabolic remodeling. In heart failure with preserved ejection fraction, these medications appear to reduce the volume of epicardial adipose tissue — the fat that sits on top of and infiltrates the heart — and shut off its inflammatory signaling.
Are you aware of any formal studies on microdosing? I searched the literature and found only sporadic observational reports.
Dr. Jennifer Roelands (31:09) Right — mostly observational, nothing that meets the randomized controlled trial gold standard. I have no doubt Eli Lilly will eventually run formal microdosing or low-dose trials, especially now that they have direct-to-consumer offerings. The original FDA approvals were for obesity and diabetes — not perimenopause, not chronic inflammatory conditions, not binge eating. Formal evidence for those uses is not yet there, though it would be enormously valuable.
Dr. Regina Druz (33:09) It would be valuable. And since we're both integrative physicians, it's important to emphasize that these medications truly shine as part of a structured program. When we work with patients on insulin sensitivity, personalized nutrition, sleep, stress, and movement — and treat the medication as an enhancement rather than the entire strategy — three things happen. One: we get a deeper result than medication alone. Two: we can often use a lower dose, with fewer side effects. Three: when the medication is eventually tapered, the foundational skills allow patients to maintain their gains.
Dr. Jennifer Roelands (35:14)
Yes — and my answer to the patient who says, "Doc, just give me the drug, I'll sort the rest out," is, "Then you can probably get it online." I don't allow patients in my practice to just do anything, the same way I wouldn't let them self-manage hypertension or diabetes medications. The downside to the current landscape is that there are a million online companies, med-spas — gyms these days have a salesperson on the corner. You can access it, but you won't get sustainable weight loss or sustainable health optimization.
When I used GLP-1s myself in early perimenopause — eight pounds appeared out of nowhere — I was the person who ate asparagus for breakfast. But I discovered behaviors I hadn't noticed: if I had a second glass of wine I was more likely to have dessert. When I actually counted my fiber, I was at 15 grams — embarrassing. I thought I was doing fiber and protein correctly, and I really wasn't. That's information you only get through a clinical relationship.
Patients come to me saying, "I did a med-spa program, nobody follows up, I got off and had to get right back on." I ask, did they measure your hormones? Your fasting insulin? Your CRP? Your metabolic markers? If none of those got better on the GLP-1, we were probably on the wrong dose or even the wrong drug — semaglutide is different from tirzepatide, which is different from retatrutide. You have to see the biomarkers move to know you're on the right medication, the same way you check blood pressure to know if a blood pressure pill is working.
Dr. Regina Druz (40:20) Another critical issue: these medications, at full pharmacological doses in clinical trials, did not spare skeletal muscle. Up to 40% of the weight lost came from lean mass, which is not where anyone wants to be. With microdosing and medical supervision we can prioritize fat loss over muscle loss — in our patients, typically only about 4% of weight lost is muscle. Part of that is timing: microdosing avoids exposure to full pharmacological doses from day one, so the body can adjust. Patients can structure their nutrition better because food noise is quieter and they can make deliberate choices — more fiber, better protein, better decisions. Jennifer, what's your favorite microdosing protocol?
Dr. Jennifer Roelands (40:20) One more thing on muscle — and specifically face loss. I do aesthetics, so this is real. Patients say "I want to lose 10 pounds this month," and I say, "No, you don't." At 25 you'd get it back; at 55 you won't. If you lose weight too fast, it comes out of your face too, and the only option then is to fill it back in. Preserve the real estate.
I typically start with semaglutide. If someone doesn't tolerate GLP-1s on a small dose — severe nausea, constipation, exhaustion — giving them tirzepatide is not going to fix that. Tirzepatide in my experience has less nausea, but if someone flat-out feels awful on semaglutide, escalating to two hormones isn't the answer. Tirzepatide is also generally more expensive. Starting with semaglutide is a safer test of the waters.
If the patient has food-related behavioral patterns — raised in a culture where food equals love, or where they had to clean the plate, or craving fast food at the smell of it — I find tirzepatide works a little better, likely because of the GIP hormone component.
My typical rhythm: the patient gives themselves the first shot in the clinic so I know they can do it. I send them home with one dose. We reassess at two weeks. How much weight moved? How did you feel? How much of the nutrition guidance did you implement? Then we set up a four-shot rhythm, one monthly visit, with access to me by email or phone. I always prescribe Zofran for backup nausea — sometimes a patient gets the flu three days after a shot, or a college student finishes exams eating caffeine and donuts and needs rescue. I have a very direct conversation about fiber and constipation — don't wait three to five days, it does not get better on its own.
At the four-week mark we discuss: dose up, hold, or even scale down. If someone lost six pounds in the first month I might slow them down to preserve real estate. By month two we talk about off-boarding — spacing out doses, decreasing the dose, or moving to maintenance. A few of my patients do maintenance, one shot every three to four weeks, purely to keep inflammation at bay. That's deeply off-label and not formally studied, but it works clinically.
Dr. Regina Druz (46:26) Even conventional obesity experts now say we go as fast or as slow as the patient can tolerate. I tell my patients: this is not a race. There are no brownie points for escalating your dose every month. You may stay on the same dose for two months. This is a form of hormonal replacement, and since we can't reliably measure these endogenous hormones in a living patient, each individual becomes their own calibration. The slower we go, the better patients seem to respond — because they get the time to dial in the foundation.
If a patient lands on a maintenance dose, do they typically come off it entirely, or is some residual dosing helpful?
Dr. Jennifer Roelands (48:19) The majority of patients off-board completely. They figured out the why — they're now on HRT, they're lifting weights, sleeping, getting fiber, getting protein, moderating alcohol — and the medication is no longer needed. The small number who stay on maintenance, I re-engage every six months with full biomarker labs. If nothing has changed, I mail them a six-month vial supply from the pharmacy; by that point they know how to draw up the medication.
For patients where the drug stops working, we troubleshoot: maybe tirzepatide is the better option, maybe thyroid is suboptimal, maybe hemoglobin A1c is too high and the GLP-1 is trying to be the whole cake instead of the icing. GLP-1s are the icing. The foundation has to be there or the medication can't do its job. Once the foundation is dialed in, patients often come down to very low doses — someone on 0.25 mg with six-pound monthly loss and beautiful labs may drop further, not higher. That kind of personalization is what you cannot get from mass-volume med-spa prescribing.
Dr. Regina Druz (50:57) This point cannot be overstated. All hormonal replacement therapy — and GLP-1 agonists (semaglutide, tirzepatide, the dual-incretin agents, and retatrutide as a triple agonist) are hormones — shines when the foundation is dialed in. Bringing HRT onto unprepared terrain is when side effects appear and strategies backfire. The same principle applies to peptides. These medications are FDA-approved peptides in their chemical structure. What we're seeing in culture right now I call "shiny object syndrome" — people want a shortcut, a magical injectable — without putting in the foundational work. Unfortunately, some patients learn in their own skin that time favors those who take the time to prepare. Jennifer, last words for our listeners.
Dr. Jennifer Roelands (52:53) I want to emphasize something our colleague Dr. Shaw discussed in a recent interview: some peptides interact with other peptides, and stacking them incorrectly cancels their benefit. You can't throw BPC-157 into a shot with another peptide and assume both will work — you may have just neutralized one of them. Cycling matters. Timing matters. Without supervision, patients are wasting money and undermining results. It has to be a personal approach, and it has to be medically supervised.
Dr. Regina Druz (54:00) Building the foundation is not glamorous, it is not sexy, it is work, it doesn't make headlines — but it gets you far. I always use the house analogy: you need a roof, but there is no roof without a foundation. Jennifer, thank you so much — enormously informative. To our listeners, if you have questions, please post them; we do our best to respond. We can't provide medical advice, but we can guide your thought process.
Dr. Jennifer Roelands (54:56) Thank you so much.
Dr. Regina Druz (54:58) Thank you for tuning in to Own Your Heart Health with Dr. Regina Druz. This podcast is powered by Holistic Heart Centers. If you enjoyed the show, please rate and review us on your favorite podcast platform. To learn more about our services, visit holisticheartcenters.com and subscribe to our YouTube channel — the link is in the show notes. See you next week.
Integrative Gynecologist | Longevity Physician | Board-Certified OB-GYN
Focus: Perimenopause, Menopause, PCOS, Hormonal Optimization, GLP-1 Microdosing
Training: Institute of Integrative Nutrition | Conventional OB-GYN Residency
holisticheartcenters.com HeartWell.ai — AI-powered cardiovascular risk assessment Address: 55 Bryant Avenue, Suite #6, Roslyn, NY 11576 Phone: 877-511-5166 YouTube: @reginadruzmd | Instagram: @dr.reginadruz Podcast: Own Your Heart Health — available on all major platforms
If you enjoyed this episode, please rate and review us on your favorite platform — it helps more people find the show. Apple Podcasts | Spotify | YouTube
The information in this transcript is for educational purposes only and does not constitute medical advice. The discussions about stem cells, exosomes, peptides, and regenerative therapies reflect the clinical experiences and opinions of the physicians involved. These treatments are not FDA-approved for all applications discussed. Individual results vary. Please consult your licensed healthcare practitioner before making any changes to your health regimen.
]]>In this episode, Dr. Regina Druz is joined by Dr. David Furman — Stanford-trained immunologist, data scientist, and creator of the iAge (Inflammatory Age) metric — to explore the biological roots of cardiovascular and brain aging. Dr. Furman explains why standard inflammation markers like hs-CRP miss the chronic inflammatory proteins that most accurately predict disease, and how proteomic testing can reveal silent arterial stiffening and organ aging years before clinical symptoms appear. The conversation covers the 1000 Immunomes Project, a landmark 17-year study at Stanford, and introduces two groundbreaking technologies: an AI-based organ aging model derived from routine blood labs, and a NASA-developed microgravity cell culture platform that functions as a personal digital twin for future aging.
🎬 Watch on YouTube: This episode is now available on the Own Your Heart Health YouTube channel. Subscribe to be notified.
Dr. Regina Druz (00:02): Welcome to Own Your Heart Health. I'm Dr. Regina Druz, your holistic cardiologist. This week, we dive into common heart health concerns, uncovering root causes and unpacking scientific discoveries. Please remember that the information provided does not constitute medical advice — consult your healthcare practitioner before making any changes to your health regimen.Today I am joined by Dr. David Furman, a societal entrepreneur and prolific researcher whose goal is to redefine how we approach biomarkers of longevity. His work centers on testing that allows us to choose actionable steps for extending not just our lifespan, but our health span. Dr. David, welcome to the show.
Dr. David Furman (01:17): Thank you so much for having me, Regina.
Dr. Regina Druz (01:20): I always ask my guests: how did you grow up to become who you are today? Tell us your story.
Dr. David Furman (01:31): I was born in Argentina, moved to Israel when I was young, and by 17 or 18 I was deeply immersed in arts and music. I wanted to create impact in humanity. My father convinced me that studying biology rather than medicine would allow me to affect far more people. So I pursued biology, then immunology, then became a data scientist. Stanford recruited me while I was finishing my PhD. After analyzing data from the 1000 Immunomes Project — which we launched in 2007 — I realized that most of the signal pointed to the biology of aging. That realization shifted my entire focus around 2012.
Dr. Regina Druz (03:47): People may not appreciate that one of the primary systems that ages as we get older is the immune system. Can you explain what is happening with the immune system, and what the 1000 Immunomes Project was designed to discover?
Dr. David Furman (04:31): The immune system is one of the most important determinants of how rapidly other organ systems age, because it senses the environment and reacts to it — producing what we call systemic chronic inflammation. Inflammation is the silent enemy that drives cardiovascular disease, Alzheimer's disease, musculoskeletal conditions, and metabolic disorders. By 2000 we knew very little about which biomarkers were causally linked to this process. Over the past 25 years we have learned that the immune system is truly a hub for aging — hallmarks like cellular senescence and epigenetic changes are largely driven by inflammation.The 1000 Immunomes Project was designed to provide solid science around this. We recruited 1,000 relatively healthy, ambulatory individuals and secured over $70 million from federal agencies. The study ran for 15 to 17 years, allowing us to prospectively identify biomarkers of systemic chronic inflammation that predict morbidity and mortality.
Dr. Regina Druz (06:29): Were these participants volunteers from the general public, or patients from the Stanford healthcare system?
Dr. David Furman (06:41): Completely healthy volunteers who came in for a flu vaccine. People with serious uncontrolled disease were excluded, although those with well-managed conditions — hypertension being very common in individuals over 65, for example — were included. This design allowed us to prospectively predict who developed various conditions as the study progressed.
Dr. Regina Druz (07:25): Most of my patients have had high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) measured. These are the classic inflammation markers. But the immune system aging and chronic inflammation you describe — is that the same thing we see on a standard blood panel?
Dr. David Furman (08:04): The key distinction is acute versus chronic inflammation. For roughly two decades, research has shown that hs-CRP and IL-6 are very poor predictors of non-communicable diseases. Cardiovascular disease can be predicted only marginally better than chance using hs-CRP, and most cardiologists no longer rely on it. These markers do rise dramatically with acute infection — a cut finger, a flu — but systemic chronic inflammation shows up as entirely different proteins in the blood. Because there was a gap in knowledge, we took an unbiased approach: we measured hundreds of thousands of parameters from those thousand individuals to find the most predictive ones.
Dr. Regina Druz (09:43): What did you find? Which biomarkers emerged as the most important predictors of aging?
Dr. David Furman (11:05): Out of all the data we analyzed — gene expression, proteins, cell frequencies, metabolites — proteins were the most predictive of chronological aging and disease risk. The single most predictive protein was not IL-6. It was CXCL9, also called MIG. CXCL9 circulates in the blood, increases with age, and causes damage to the endothelium — the inner lining of blood vessels. Elevated CXCL9 is associated with cellular senescence of the endothelium, left ventricular hypertrophy, and arterial stiffening.The second key protein is eotaxin, also known as CCL11. Eotaxin-1 is produced largely in response to airborne exposures — air pollution, cooking vapors, allergens. Macrophages in the lungs produce it, and it enters the bloodstream where it crosses the blood-brain barrier easily. There it causes cognitive dysfunction and is associated with dementia and memory loss.The other three important proteins are gamma interferon (involved in immune system activation), GRO-alpha, and TRAIL. TRAIL is particularly interesting: it sensitizes senescent cells to undergo apoptosis. Low TRAIL means senescent cells are not being cleared, and they accumulate throughout the body — a core driver of tissue aging.
Dr. Regina Druz (14:23): Fascinating. CXCL9 — is it produced by immune cells, or by the endothelium itself as it ages?
Dr. David Furman (14:39): In the textbook, CXCL9 is produced by immune cells to call lymphocytes to a site of infection. But in aging, what we see is that damaged endothelium itself produces CXCL9 — and then that CXCL9 damages neighboring endothelial cells. You get a propagating senescence signal: more senescence leads to stiffer tissue, higher vascular resistance, elevated pressure on the heart, and eventually hypertrophy — which is very difficult to reverse.
Dr. Regina Druz (15:38): We can measure endothelial dysfunction and plaque progression in clinical practice. Recently, AI tools have been able to detect inflammation in epicardial adipose tissue — the fat surrounding the heart, sometimes abbreviated EAT. When this tissue infiltrates the cardiac muscle it leads to stiffening and a syndrome called heart failure with preserved ejection fraction (HFpEF), strongly linked to obesity. At what age should people begin testing these proteomic markers? Because someone could have a beautiful lipid profile, normal hs-CRP, and no cardiac hypertrophy on ultrasound, and yet already carry these protein signatures of endothelial dysfunction.
Dr. David Furman (17:30): That happens all the time. We conducted a study in 150 people who were matched for CRP, BMI, and every conventional cardiovascular risk factor. Those with elevated Inflammatory Age — our metric — had measurable arterial stiffening on pulse wave velocity testing and increased left ventricular changes, despite having no clinical symptoms and never presenting to a clinic for cardiovascular concerns.The molecular and cellular changes that precede disease begin 15 to 20 years before any clinical presentation. I would say the early 30s is a reasonable starting point for measuring these biomarkers — that is when we can intercept the molecular trajectory of disease before it becomes irreversible.
Dr. Regina Druz (20:00): What are the most powerful interventions? What can actually be changed, and on what timeline?
Dr. David Furman (21:02): There are several layers. Layer one is the foundation — the one-size-fits-all baseline that everyone must establish first. Without it, advanced interventions provide no benefit and may even cause harm. Layer one includes: quality sleep and sleep hygiene; regular movement (sedentary behavior measurably raises inflammation); time in nature (even viewing greenery reduces inflammatory markers in peer-reviewed studies); and a whole-food diet rich in nutrients.From a dietary standpoint, refined wheat products — bread, pasta — are among the strongest drivers of organ aging in our data. Dairy products are also inflammatory. Conversely, berries and small fish are highly beneficial. Microplastics from plastic food storage accumulate in blood and tissues and are now recognized as contributors to inflammation.Layer two is fine-tuning based on your specific protein deviations. For example, if your eotaxin is elevated, we investigate your air quality at home and at work and recommend air purification. Each deviated protein has a corresponding environmental or behavioral trigger.Layer three involves newer technologies — including AI-based organ aging analysis from standard labs, and the microgravity-based digital twin technology.
Dr. Regina Druz (25:47): Resilience is the word I always come back to. The foundation has to come first. Patients often tell me: I exercise, I eat well, I don't smoke, I sleep, I manage stress — why is my blood pressure still elevated? The honest answer is that effort intensity does not always match the cellular processes already in motion. The proteome gives us a window into those processes so we can address them specifically.
Dr. Regina Druz (27:00): Tell me more about the organ aging AI. Is this an algorithm that takes standard blood work and correlates it to the proteomic signatures from the Immunomes Project?
Dr. David Furman (27:39): Close, but distinct. We use a comprehensive panel of 33 standard biomarkers — cardiovascular, metabolic, and others — from standard labs. The algorithm is agnostic to textbook organ assignments; we simply took all available biomarkers from half a million people and trained it to predict system-specific mortality across ICD-10 disease chapters: cardiovascular, Alzheimer's and dementia, musculoskeletal, and metabolic.The assumption is that the older a system biologically, the higher its mortality risk. We validated the model in 10,000 individuals from the Health and Retirement cohort. For example, creatinine — typically used for kidney function — turns out to be predictive of metabolic syndrome in our model. Cystatin C similarly crosses traditional organ boundaries. The AI captures these cross-system interactions naturally, telling the clinician not just what's aging, but what to do about it.
Dr. Regina Druz (30:47): What is your view on epigenetic age clocks? I have patients with stellar epigenetic biological ages who nevertheless have significant coronary artery disease, pristine blood work, and extensive plaque burden.
Dr. David Furman (31:47): Epigenetic clocks were the first technology developed for biological age estimation and they remain the best at predicting chronological age — but who needs to predict something they already know? The problems are: (1) they are very difficult to change because we do not know how to intervene on the epigenome; (2) test-retest precision is poor — the same person tested at different labs may see a 10-to-20 year spread in results. In contrast, if inflammatory protein markers are elevated, we know exactly which interventions move those proteins. With standard lab-based organ aging, we have 120 years of clinical research behind the levers to optimize those values.
Dr. Regina Druz (33:38): You've mentioned Holistic Heart Centers is now offering immune system age testing. Can you also tell our listeners about your NASA collaboration and what you discovered with astronauts?
Dr. David Furman (34:25): NASA reached out about five years ago because they observed accelerated aging in astronauts during and after space missions. Using a NASA-developed cell culture system that simulates zero-gravity, we can expose a person's own cells to microgravity conditions and observe how they age — creating what is essentially a digital twin of your future biological state. A recently pre-printed paper shows that this microgravity model can predict, for each hallmark of aging, how an individual will age — compared not against a population, but against themselves. The product is called Beyond Age and is available through concierge medicine and longevity clinics.
Dr. Regina Druz (36:35): At Holistic Heart Centers we are building a longevity suite, including HeartWell.ai — our simulation platform for cardiovascular risk modeling. The trials of the future will likely be pragmatic, n-of-1 investigations at scale. The idea that we could take a simple swab, simulate your cellular future in microgravity, and return a personalized risk profile — that is genuinely transformative preventive medicine.
Dr. David Furman (38:58): The most important message is this: biological aging is malleable. You can change the future of your health. This is not fatalism — it is empowerment. With the right measurements and the right interventions, patients can take meaningful control of how they age.
Dr. Regina Druz (39:17): One hundred percent. Be there for your family and friends. Dr. David, this has been immense. I have learned a tremendous amount, and I am ordering my Beyond Age testing kit as soon as we finish recording. We will revisit this topic once my results come in. Thank you for tuning in to Own Your Heart Health with Dr. Regina Druz. This podcast is powered by Holistic Heart Centers. Please rate and review us on your favorite platform, visit holisticheartcenters.com, and subscribe to our YouTube channel — the link is in the show notes. See you next week.
Inflammatory Age — or iAge — is a biological aging metric developed by Dr. Furman's team at Stanford based on a panel of inflammatory proteins identified in the 1000 Immunomes Project. Unlike standard inflammation markers such as hs-CRP (high-sensitivity C-reactive protein) or IL-6, which primarily reflect acute infection or injury, iAge captures chronic, low-grade systemic inflammation — the kind that silently drives cardiovascular disease, brain aging, and cellular senescence over decades. The key proteins measured include CXCL9 (linked to endothelial damage and arterial stiffening), eotaxin/CCL11 (linked to brain and memory decline), gamma interferon, GRO-alpha, and TRAIL. Standard panels can appear completely normal even when iAge reveals significant underlying inflammation. If you are interested in getting your immune system age measured, ask your physician about iAge testing or visit holisticheartcenters.com.
Dr. Furman recommends starting in the early 30s, because the molecular and cellular changes that precede disease typically begin 15 to 20 years before clinical symptoms appear. By the time a patient develops hypertension, arterial stiffening, or cardiac hypertrophy, the underlying inflammatory processes have often been active for well over a decade. In the research study, 150 individuals who were matched for every conventional cardiovascular risk factor — normal CRP, normal BMI, no known disease — were found to have measurable arterial stiffening detected only through iAge and pulse wave velocity testing. Testing earlier gives patients and clinicians the opportunity to intercept these processes before they become irreversible. Individuals with a family history of heart disease, high polygenic risk scores, or early lipid abnormalities may benefit from starting even sooner.
Dr. Furman describes a layered intervention approach. The essential foundation — what he calls Layer One — applies to everyone and must be in place before anything else: consistent quality sleep, regular physical movement (sedentary behavior is a measurable driver of inflammation), time in natural environments, and a whole-food diet free of refined grains and processed dairy. Berries and small fish are particularly beneficial. Reducing microplastic exposure by switching from plastic to glass food storage also matters. Layer Two is personalized: if eotaxin is elevated, for instance, improving indoor air quality through air purifiers and monitoring outdoor pollution becomes a priority target. The key insight is that chronicity of exposure is the risk factor — an occasional pizza does not undo a strong baseline. Sustainable daily habits are what move the needle on these proteins.
The AI-based organ aging model developed by Dr. Furman's team analyzes 33 standard blood biomarkers — the kind already available from labs like Superpower or Function — and predicts system-specific mortality risk across major organ categories including cardiovascular, neurological, musculoskeletal, and metabolic. Validated in over 500,000 individuals and a separate 10,000-person cohort, the model assigns a biological age to each organ system and identifies which may be aging fastest. This differs significantly from epigenetic age clocks, which estimate chronological age from DNA methylation patterns but have limited actionability and poor test-retest precision (results can vary by 10-20 years across labs). The organ aging model is grounded in biomarkers that clinicians already know how to move — giving both doctor and patient a clear target for intervention.
Beyond Age is a personalized aging prediction tool developed in collaboration with NASA. A sample of a patient's own cells is exposed to a simulated zero-gravity environment using a cell culture system originally designed for space medicine research. Because microgravity accelerates cellular aging processes, this allows scientists to observe how that individual's cells will age across the hallmarks of aging — not compared to a population average, but relative to the patient's own baseline. The result is a form of biological digital twin: a window into your cellular future. The technology is currently available through concierge medicine practices and longevity clinics. Holistic Heart Centers is exploring its incorporation into the longevity suite alongside iAge and HeartWell.ai cardiovascular risk modeling. Please note that this is an emerging technology and has not yet completed full clinical validation as of the recording of this episode.
Immunologist | Data Scientist | Longevity & Aging ResearcherStanford-trained; former researcher, 1000 Immunomes ProjectCreator of iAge (Inflammatory Age) and co-developer of Beyond AgeLocation: San Francisco Bay Area, CA
• iAge Immune System Age Test — available through longevity/concierge medicine clinics including Holistic Heart Centers
• Beyond Age (microgravity digital twin) — beyondage.com (confirm current URL with Dr. Furman's team)
• 1000 Immunomes Project — Stanford University longitudinal study on immune aging biomarkers
• Inflammatory Age (iAge): A biological aging score based on five inflammatory proteins predictive of morbidity and mortality.
• CXCL9 (MIG): A protein that increases with age and drives endothelial senescence, arterial stiffening, and left ventricular hypertrophy.
• Eotaxin (CCL11): A chemokine produced in the lungs in response to air quality exposures; crosses the blood-brain barrier and is associated with cognitive decline.
• TRAIL: A protein that promotes apoptosis (programmed cell death) of senescent cells. Low TRAIL = accumulation of senescent cells throughout the body.
• Cellular Senescence: A state in which damaged cells stop dividing but do not die, instead releasing inflammatory signals that damage surrounding tissue.
• hs-CRP: High-sensitivity C-reactive protein — a common acute-phase inflammation marker with limited utility for predicting chronic cardiovascular aging.
• Proteomics: The large-scale study of proteins in a biological system, including their structure, function, and interactions.
• Epicardial Adipose Tissue (EAT): Fat surrounding the heart that, when excessive, can infiltrate cardiac muscle and contribute to heart failure with preserved ejection fraction (HFpEF).
• Pulse Wave Velocity: A clinical measure of arterial stiffness — higher values indicate stiffer arteries and greater cardiovascular risk.
• ICD-10: International Classification of Diseases, 10th revision — the global standard for disease classification used in clinical and research settings.
• HFpEF: Heart failure with preserved ejection fraction — a form of heart failure where the heart muscle contracts normally but the ventricles are stiff.
holisticheartcenters.com HeartWell.ai — AI-powered cardiovascular risk assessment Address: 55 Bryant Avenue, Suite #6, Roslyn, NY 11576 Phone: 877-511-5166 YouTube: @reginadruzmd Instagram: @dr.reginadruz Podcast: Own Your Heart Health — available on Apple Podcasts, Spotify, and all major platforms
If you enjoyed this episode, please rate and review us on your favorite platform — it helps more people find the show. Apple Podcasts | Spotify | YouTube
The information in this transcript is for educational purposes only and does not constitute medical advice. The discussions about stem cells, exosomes, peptides, and regenerative therapies reflect the clinical experiences and opinions of the physicians involved. These treatments are not FDA-approved for all applications discussed. Individual results vary. Please consult your licensed healthcare practitioner before making any changes to your health regimen.
]]>In this episode, Dr. Regina Druz is joined by Dr. David Furman — Stanford-trained immunologist, data scientist, and creator of the iAge (Inflammatory Age) metric — to explore the biological roots of cardiovascular and brain aging. Dr. Furman explains why standard inflammation markers like hs-CRP miss the chronic inflammatory proteins that most accurately predict disease, and how proteomic testing can reveal silent arterial stiffening and organ aging years before clinical symptoms appear. The conversation covers the 1000 Immunomes Project, a landmark 17-year study at Stanford, and introduces two groundbreaking technologies: an AI-based organ aging model derived from routine blood labs, and a NASA-developed microgravity cell culture platform that functions as a personal digital twin for future aging.
🎬 Watch on YouTube: This episode is now available on the Own Your Heart Health YouTube channel. Subscribe to be notified.
Dr. Regina Druz (00:02): Welcome to Own Your Heart Health. I'm Dr. Regina Druz, your holistic cardiologist. This week, we dive into common heart health concerns, uncovering root causes and unpacking scientific discoveries. Please remember that the information provided does not constitute medical advice — consult your healthcare practitioner before making any changes to your health regimen.Today I am joined by Dr. David Furman, a societal entrepreneur and prolific researcher whose goal is to redefine how we approach biomarkers of longevity. His work centers on testing that allows us to choose actionable steps for extending not just our lifespan, but our health span. Dr. David, welcome to the show.
Dr. David Furman (01:17): Thank you so much for having me, Regina.
Dr. Regina Druz (01:20): I always ask my guests: how did you grow up to become who you are today? Tell us your story.
Dr. David Furman (01:31): I was born in Argentina, moved to Israel when I was young, and by 17 or 18 I was deeply immersed in arts and music. I wanted to create impact in humanity. My father convinced me that studying biology rather than medicine would allow me to affect far more people. So I pursued biology, then immunology, then became a data scientist. Stanford recruited me while I was finishing my PhD. After analyzing data from the 1000 Immunomes Project — which we launched in 2007 — I realized that most of the signal pointed to the biology of aging. That realization shifted my entire focus around 2012.
Dr. Regina Druz (03:47): People may not appreciate that one of the primary systems that ages as we get older is the immune system. Can you explain what is happening with the immune system, and what the 1000 Immunomes Project was designed to discover?
Dr. David Furman (04:31): The immune system is one of the most important determinants of how rapidly other organ systems age, because it senses the environment and reacts to it — producing what we call systemic chronic inflammation. Inflammation is the silent enemy that drives cardiovascular disease, Alzheimer's disease, musculoskeletal conditions, and metabolic disorders. By 2000 we knew very little about which biomarkers were causally linked to this process. Over the past 25 years we have learned that the immune system is truly a hub for aging — hallmarks like cellular senescence and epigenetic changes are largely driven by inflammation.The 1000 Immunomes Project was designed to provide solid science around this. We recruited 1,000 relatively healthy, ambulatory individuals and secured over $70 million from federal agencies. The study ran for 15 to 17 years, allowing us to prospectively identify biomarkers of systemic chronic inflammation that predict morbidity and mortality.
Dr. Regina Druz (06:29): Were these participants volunteers from the general public, or patients from the Stanford healthcare system?
Dr. David Furman (06:41): Completely healthy volunteers who came in for a flu vaccine. People with serious uncontrolled disease were excluded, although those with well-managed conditions — hypertension being very common in individuals over 65, for example — were included. This design allowed us to prospectively predict who developed various conditions as the study progressed.
Dr. Regina Druz (07:25): Most of my patients have had high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) measured. These are the classic inflammation markers. But the immune system aging and chronic inflammation you describe — is that the same thing we see on a standard blood panel?
Dr. David Furman (08:04): The key distinction is acute versus chronic inflammation. For roughly two decades, research has shown that hs-CRP and IL-6 are very poor predictors of non-communicable diseases. Cardiovascular disease can be predicted only marginally better than chance using hs-CRP, and most cardiologists no longer rely on it. These markers do rise dramatically with acute infection — a cut finger, a flu — but systemic chronic inflammation shows up as entirely different proteins in the blood. Because there was a gap in knowledge, we took an unbiased approach: we measured hundreds of thousands of parameters from those thousand individuals to find the most predictive ones.
Dr. Regina Druz (09:43): What did you find? Which biomarkers emerged as the most important predictors of aging?
Dr. David Furman (11:05): Out of all the data we analyzed — gene expression, proteins, cell frequencies, metabolites — proteins were the most predictive of chronological aging and disease risk. The single most predictive protein was not IL-6. It was CXCL9, also called MIG. CXCL9 circulates in the blood, increases with age, and causes damage to the endothelium — the inner lining of blood vessels. Elevated CXCL9 is associated with cellular senescence of the endothelium, left ventricular hypertrophy, and arterial stiffening.The second key protein is eotaxin, also known as CCL11. Eotaxin-1 is produced largely in response to airborne exposures — air pollution, cooking vapors, allergens. Macrophages in the lungs produce it, and it enters the bloodstream where it crosses the blood-brain barrier easily. There it causes cognitive dysfunction and is associated with dementia and memory loss.The other three important proteins are gamma interferon (involved in immune system activation), GRO-alpha, and TRAIL. TRAIL is particularly interesting: it sensitizes senescent cells to undergo apoptosis. Low TRAIL means senescent cells are not being cleared, and they accumulate throughout the body — a core driver of tissue aging.
Dr. Regina Druz (14:23): Fascinating. CXCL9 — is it produced by immune cells, or by the endothelium itself as it ages?
Dr. David Furman (14:39): In the textbook, CXCL9 is produced by immune cells to call lymphocytes to a site of infection. But in aging, what we see is that damaged endothelium itself produces CXCL9 — and then that CXCL9 damages neighboring endothelial cells. You get a propagating senescence signal: more senescence leads to stiffer tissue, higher vascular resistance, elevated pressure on the heart, and eventually hypertrophy — which is very difficult to reverse.
Dr. Regina Druz (15:38): We can measure endothelial dysfunction and plaque progression in clinical practice. Recently, AI tools have been able to detect inflammation in epicardial adipose tissue — the fat surrounding the heart, sometimes abbreviated EAT. When this tissue infiltrates the cardiac muscle it leads to stiffening and a syndrome called heart failure with preserved ejection fraction (HFpEF), strongly linked to obesity. At what age should people begin testing these proteomic markers? Because someone could have a beautiful lipid profile, normal hs-CRP, and no cardiac hypertrophy on ultrasound, and yet already carry these protein signatures of endothelial dysfunction.
Dr. David Furman (17:30): That happens all the time. We conducted a study in 150 people who were matched for CRP, BMI, and every conventional cardiovascular risk factor. Those with elevated Inflammatory Age — our metric — had measurable arterial stiffening on pulse wave velocity testing and increased left ventricular changes, despite having no clinical symptoms and never presenting to a clinic for cardiovascular concerns.The molecular and cellular changes that precede disease begin 15 to 20 years before any clinical presentation. I would say the early 30s is a reasonable starting point for measuring these biomarkers — that is when we can intercept the molecular trajectory of disease before it becomes irreversible.
Dr. Regina Druz (20:00): What are the most powerful interventions? What can actually be changed, and on what timeline?
Dr. David Furman (21:02): There are several layers. Layer one is the foundation — the one-size-fits-all baseline that everyone must establish first. Without it, advanced interventions provide no benefit and may even cause harm. Layer one includes: quality sleep and sleep hygiene; regular movement (sedentary behavior measurably raises inflammation); time in nature (even viewing greenery reduces inflammatory markers in peer-reviewed studies); and a whole-food diet rich in nutrients.From a dietary standpoint, refined wheat products — bread, pasta — are among the strongest drivers of organ aging in our data. Dairy products are also inflammatory. Conversely, berries and small fish are highly beneficial. Microplastics from plastic food storage accumulate in blood and tissues and are now recognized as contributors to inflammation.Layer two is fine-tuning based on your specific protein deviations. For example, if your eotaxin is elevated, we investigate your air quality at home and at work and recommend air purification. Each deviated protein has a corresponding environmental or behavioral trigger.Layer three involves newer technologies — including AI-based organ aging analysis from standard labs, and the microgravity-based digital twin technology.
Dr. Regina Druz (25:47): Resilience is the word I always come back to. The foundation has to come first. Patients often tell me: I exercise, I eat well, I don't smoke, I sleep, I manage stress — why is my blood pressure still elevated? The honest answer is that effort intensity does not always match the cellular processes already in motion. The proteome gives us a window into those processes so we can address them specifically.
Dr. Regina Druz (27:00): Tell me more about the organ aging AI. Is this an algorithm that takes standard blood work and correlates it to the proteomic signatures from the Immunomes Project?
Dr. David Furman (27:39): Close, but distinct. We use a comprehensive panel of 33 standard biomarkers — cardiovascular, metabolic, and others — from standard labs. The algorithm is agnostic to textbook organ assignments; we simply took all available biomarkers from half a million people and trained it to predict system-specific mortality across ICD-10 disease chapters: cardiovascular, Alzheimer's and dementia, musculoskeletal, and metabolic.The assumption is that the older a system biologically, the higher its mortality risk. We validated the model in 10,000 individuals from the Health and Retirement cohort. For example, creatinine — typically used for kidney function — turns out to be predictive of metabolic syndrome in our model. Cystatin C similarly crosses traditional organ boundaries. The AI captures these cross-system interactions naturally, telling the clinician not just what's aging, but what to do about it.
Dr. Regina Druz (30:47): What is your view on epigenetic age clocks? I have patients with stellar epigenetic biological ages who nevertheless have significant coronary artery disease, pristine blood work, and extensive plaque burden.
Dr. David Furman (31:47): Epigenetic clocks were the first technology developed for biological age estimation and they remain the best at predicting chronological age — but who needs to predict something they already know? The problems are: (1) they are very difficult to change because we do not know how to intervene on the epigenome; (2) test-retest precision is poor — the same person tested at different labs may see a 10-to-20 year spread in results. In contrast, if inflammatory protein markers are elevated, we know exactly which interventions move those proteins. With standard lab-based organ aging, we have 120 years of clinical research behind the levers to optimize those values.
Dr. Regina Druz (33:38): You've mentioned Holistic Heart Centers is now offering immune system age testing. Can you also tell our listeners about your NASA collaboration and what you discovered with astronauts?
Dr. David Furman (34:25): NASA reached out about five years ago because they observed accelerated aging in astronauts during and after space missions. Using a NASA-developed cell culture system that simulates zero-gravity, we can expose a person's own cells to microgravity conditions and observe how they age — creating what is essentially a digital twin of your future biological state. A recently pre-printed paper shows that this microgravity model can predict, for each hallmark of aging, how an individual will age — compared not against a population, but against themselves. The product is called Beyond Age and is available through concierge medicine and longevity clinics.
Dr. Regina Druz (36:35): At Holistic Heart Centers we are building a longevity suite, including HeartWell.ai — our simulation platform for cardiovascular risk modeling. The trials of the future will likely be pragmatic, n-of-1 investigations at scale. The idea that we could take a simple swab, simulate your cellular future in microgravity, and return a personalized risk profile — that is genuinely transformative preventive medicine.
Dr. David Furman (38:58): The most important message is this: biological aging is malleable. You can change the future of your health. This is not fatalism — it is empowerment. With the right measurements and the right interventions, patients can take meaningful control of how they age.
Dr. Regina Druz (39:17): One hundred percent. Be there for your family and friends. Dr. David, this has been immense. I have learned a tremendous amount, and I am ordering my Beyond Age testing kit as soon as we finish recording. We will revisit this topic once my results come in. Thank you for tuning in to Own Your Heart Health with Dr. Regina Druz. This podcast is powered by Holistic Heart Centers. Please rate and review us on your favorite platform, visit holisticheartcenters.com, and subscribe to our YouTube channel — the link is in the show notes. See you next week.
Inflammatory Age — or iAge — is a biological aging metric developed by Dr. Furman's team at Stanford based on a panel of inflammatory proteins identified in the 1000 Immunomes Project. Unlike standard inflammation markers such as hs-CRP (high-sensitivity C-reactive protein) or IL-6, which primarily reflect acute infection or injury, iAge captures chronic, low-grade systemic inflammation — the kind that silently drives cardiovascular disease, brain aging, and cellular senescence over decades. The key proteins measured include CXCL9 (linked to endothelial damage and arterial stiffening), eotaxin/CCL11 (linked to brain and memory decline), gamma interferon, GRO-alpha, and TRAIL. Standard panels can appear completely normal even when iAge reveals significant underlying inflammation. If you are interested in getting your immune system age measured, ask your physician about iAge testing or visit holisticheartcenters.com.
Dr. Furman recommends starting in the early 30s, because the molecular and cellular changes that precede disease typically begin 15 to 20 years before clinical symptoms appear. By the time a patient develops hypertension, arterial stiffening, or cardiac hypertrophy, the underlying inflammatory processes have often been active for well over a decade. In the research study, 150 individuals who were matched for every conventional cardiovascular risk factor — normal CRP, normal BMI, no known disease — were found to have measurable arterial stiffening detected only through iAge and pulse wave velocity testing. Testing earlier gives patients and clinicians the opportunity to intercept these processes before they become irreversible. Individuals with a family history of heart disease, high polygenic risk scores, or early lipid abnormalities may benefit from starting even sooner.
Dr. Furman describes a layered intervention approach. The essential foundation — what he calls Layer One — applies to everyone and must be in place before anything else: consistent quality sleep, regular physical movement (sedentary behavior is a measurable driver of inflammation), time in natural environments, and a whole-food diet free of refined grains and processed dairy. Berries and small fish are particularly beneficial. Reducing microplastic exposure by switching from plastic to glass food storage also matters. Layer Two is personalized: if eotaxin is elevated, for instance, improving indoor air quality through air purifiers and monitoring outdoor pollution becomes a priority target. The key insight is that chronicity of exposure is the risk factor — an occasional pizza does not undo a strong baseline. Sustainable daily habits are what move the needle on these proteins.
The AI-based organ aging model developed by Dr. Furman's team analyzes 33 standard blood biomarkers — the kind already available from labs like Superpower or Function — and predicts system-specific mortality risk across major organ categories including cardiovascular, neurological, musculoskeletal, and metabolic. Validated in over 500,000 individuals and a separate 10,000-person cohort, the model assigns a biological age to each organ system and identifies which may be aging fastest. This differs significantly from epigenetic age clocks, which estimate chronological age from DNA methylation patterns but have limited actionability and poor test-retest precision (results can vary by 10-20 years across labs). The organ aging model is grounded in biomarkers that clinicians already know how to move — giving both doctor and patient a clear target for intervention.
Beyond Age is a personalized aging prediction tool developed in collaboration with NASA. A sample of a patient's own cells is exposed to a simulated zero-gravity environment using a cell culture system originally designed for space medicine research. Because microgravity accelerates cellular aging processes, this allows scientists to observe how that individual's cells will age across the hallmarks of aging — not compared to a population average, but relative to the patient's own baseline. The result is a form of biological digital twin: a window into your cellular future. The technology is currently available through concierge medicine practices and longevity clinics. Holistic Heart Centers is exploring its incorporation into the longevity suite alongside iAge and HeartWell.ai cardiovascular risk modeling. Please note that this is an emerging technology and has not yet completed full clinical validation as of the recording of this episode.
Immunologist | Data Scientist | Longevity & Aging ResearcherStanford-trained; former researcher, 1000 Immunomes ProjectCreator of iAge (Inflammatory Age) and co-developer of Beyond AgeLocation: San Francisco Bay Area, CA
• iAge Immune System Age Test — available through longevity/concierge medicine clinics including Holistic Heart Centers
• Beyond Age (microgravity digital twin) — beyondage.com (confirm current URL with Dr. Furman's team)
• 1000 Immunomes Project — Stanford University longitudinal study on immune aging biomarkers
• Inflammatory Age (iAge): A biological aging score based on five inflammatory proteins predictive of morbidity and mortality.
• CXCL9 (MIG): A protein that increases with age and drives endothelial senescence, arterial stiffening, and left ventricular hypertrophy.
• Eotaxin (CCL11): A chemokine produced in the lungs in response to air quality exposures; crosses the blood-brain barrier and is associated with cognitive decline.
• TRAIL: A protein that promotes apoptosis (programmed cell death) of senescent cells. Low TRAIL = accumulation of senescent cells throughout the body.
• Cellular Senescence: A state in which damaged cells stop dividing but do not die, instead releasing inflammatory signals that damage surrounding tissue.
• hs-CRP: High-sensitivity C-reactive protein — a common acute-phase inflammation marker with limited utility for predicting chronic cardiovascular aging.
• Proteomics: The large-scale study of proteins in a biological system, including their structure, function, and interactions.
• Epicardial Adipose Tissue (EAT): Fat surrounding the heart that, when excessive, can infiltrate cardiac muscle and contribute to heart failure with preserved ejection fraction (HFpEF).
• Pulse Wave Velocity: A clinical measure of arterial stiffness — higher values indicate stiffer arteries and greater cardiovascular risk.
• ICD-10: International Classification of Diseases, 10th revision — the global standard for disease classification used in clinical and research settings.
• HFpEF: Heart failure with preserved ejection fraction — a form of heart failure where the heart muscle contracts normally but the ventricles are stiff.
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The information in this transcript is for educational purposes only and does not constitute medical advice. The discussions about stem cells, exosomes, peptides, and regenerative therapies reflect the clinical experiences and opinions of the physicians involved. These treatments are not FDA-approved for all applications discussed. Individual results vary. Please consult your licensed healthcare practitioner before making any changes to your health regimen.
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[00:02] Welcome & Introduction [02:04] From Neurosurgeon to Regenerative Medicine Pioneer [06:54] Stem Cells 101 — What They Are and How They Work [08:50] The Source Question — Whose Stem Cells, and Why It Matters [15:40] From Stem Cells to Exosomes — What's Actually Doing the Work [22:36] Plant Exosomes — Nature's Delivery System for Phytonutrients [25:44] Clinical Results — Cartilage, Inflammation & Systemic Benefits [31:51] Who Should Consider Regenerative Therapy — and When [36:35] The Upstream Question — Starting Early in Cardiovascular Prevention [49:36] Closing — The Future of Integrative and Regenerative Medicine
Dr. Regina Druz (00:02): Welcome to Own Your Heart Health. I'm Dr. Regina Druz, your holistic cardiologist. Each week we uncover root causes of common heart health concerns and unpack the latest scientific discoveries — and controversies. The information provided does not constitute medical advice. Please consult your healthcare practitioner before making any changes that may affect your health.
Today's guest is Dr. Jeffrey Gross — neurosurgeon, spine specialist, and self-described "bio-nerd." About seven to eight years ago, Dr. Gross made a bold pivot away from traditional surgery into longevity-driven regenerative medicine. With longevity becoming one of the most talked-about topics in medicine, I wanted someone who represents what it actually means in practice — a physician who studies the physiology, understands the biochemistry, and can connect the dots for patients. Jeff, let's start with the question I ask every guest: how did you grow up to be who you are today?
Dr. Jeffrey Gross (02:04): I was a spine fellowship-trained neurosurgeon — neck and back, disc problems, the full range. We were always looking for less invasive, more biologic ways to avoid surgery, and I found I didn't quite fit in with conventional colleagues. Spine surgery hasn't changed appreciably in decades. I finally decided to look beyond the standard of care and pursue stem cells, which my patients were already asking about. My background is in biochemistry, and as you said, Dr. Druz, it always comes back to cellular function. Studying stem cells reconnected me to that foundation. From there my entire practice transformed — stem cells, exosomes, peptides, regenerative applications, longevity. I'm more functional in my mindset than I've ever been.
Dr. Regina Druz (03:56): How did your traditional colleagues react? I ask because I've seen this shift in cardiology too. The Journal of the American College of Cardiology recently published research on a Chinese movement practice for blood pressure control. We're seeing papers on microplastics and air pollution. Integrative approaches are moving into the mainstream — but it took time. What was your experience?
Dr. Jeffrey Gross (05:02): Many colleagues still have blinders on. They're focused on volume, driven by what insurers will reimburse. A few open-minded ones are curious and starting to dip their toes in. But most are holding onto the sick-care system because it pays their bills.
Dr. Regina Druz (05:49): It's the security blanket of conventional medicine. Though, as I like to say — the future favors the bold, and not all pioneers take arrows in the back.
Dr. Regina Druz (06:54): Let's give our listeners a foundation. What are stem cells? How are you using them? And what impact do they have on longevity and health span?
Dr. Jeffrey Gross (06:54): When you are a fertilized egg, you are a single omnipotent stem cell — capable of creating an entire person. Those cells divide and differentiate. First pluripotent (can create a limb or organ), then multipotent (can repair and regenerate tissue, but can't create a limb). By adulthood, we rely on multipotent stem cells, but with age, inflammatory stress, poor diet, lack of exercise, seed oils, and poor sleep, those cells become exhausted — fewer in number and diminished in function.
Dr. Regina Druz (08:24): Where do those stem cells actually live in the adult body?
Dr. Jeffrey Gross (08:50): Mostly in bone marrow. Also in fat, and in other tissues surrounding blood vessels. They're distributed throughout the body in all our tissues to some extent.
Dr. Jeffrey Gross (08:50): When we use stem cells therapeutically, you can use your own — but when you take your car for an oil change, you don't put the old oil back in. I prefer donated perinatal sources: amniotic fluid, umbilical cords, and placenta, collected at the time of a scheduled C-section from healthy, screened, consenting mothers. This material would otherwise be discarded. It goes through FDA-registered lab and tissue donation processes. You do not need to travel outside the country — that's a myth international clinics love to perpetuate. The source we use tests for multiple variables, including using only tissue from mothers who were not COVID-vaccinated, because we don't yet fully understand what the spike protein may be doing long-term.
Dr. Regina Druz (10:32): In my practice, we've been navigating the FDA's complex stance on peptides — some were moved to a compound category that created a gray market of unregulated, untested products. With stem cells, you're describing an FDA-regulated pathway. How does that actually work?
Dr. Jeffrey Gross (11:23): The FDA regulates the handling, documenting, and marketing of these biologics — but it does not regulate the practice of medicine. Clinicians can legally offer these treatments under the doctrine of informed consent. IV fluids for dehydration are not FDA-approved — but everyone uses them. A physician can discuss all options, including stem cell or regenerative approaches, and let the patient make an informed decision. What we cannot do is make marketing claims about outcomes. If a doctor presents you with a knee replacement as your only option without discussing regenerative alternatives, that doctor has arguably failed the informed consent standard.
Dr. Jeffrey Gross (15:40): Here's something that surprised us: the stem cells themselves aren't primarily doing the therapeutic work. If you came to my clinic for IV stem cells, within a couple of days those cells are gone from your body. But the benefits — reduced inflammation, increased energy, improved sleep, cognitive clarity — last weeks, months, and some changes appear to be permanent. What's doing the work? The stem cells are delivery trucks. The actual packages are peptides, growth factors, and extracellular vesicles called exosomes. Those exosomes carry cargo into your cells, signal anti-inflammatory pathways, and essentially reactivate your body's own youthful repair mechanisms. This is why we've largely shifted to using exosomes directly. They're about a third of the cost of stem cells, travel through tissue more efficiently, and cross the blood-brain barrier.
Dr. Regina Druz (20:31): Let me translate the biology. Cells communicate by packaging small portions of themselves — including signaling molecules — into tiny membrane-bound vesicles and releasing them. Neighboring cells take those vesicles in through endocytosis (a process that doesn't require a lock-and-key receptor). It's more like mail being dropped in a mailbox — the recipient picks it up and reads the message inside. Is that accurate?
Dr. Jeffrey Gross (21:52): That's exactly right. And importantly, all of our cells produce exosomes. For therapeutic purposes, we focus on stem cell-derived exosomes from amniotic sources — filtered, tested, concentrated, fresh-frozen, and unmanipulated.
Dr. Jeffrey Gross (22:36): Here's something most people don't know: plants deliver their phytonutrients — resveratrol, sulforaphane, quercetin, B vitamins, vitamin C — through exosomes. We've partnered with a lab in Italy that can extract exosomes directly from organic plants. We've developed a longevity supplement — Longev-X — that delivers plant phytonutrients via their natural exosome packaging, getting nutrients directly into the cell. Early data suggests delivery is 700 times more efficient than a liposomal supplement and 4,500 times more effective than a traditional supplement.
Dr. Regina Druz (24:11): How does the plant exosome survive the stomach's acidic pH of around 2?
Dr. Jeffrey Gross (24:22): The plant exosome membrane is significantly more durable than human cell membranes and survives the digestive process intact, reaching the small intestine where absorption occurs with high bioavailability. This is supported by preclinical studies and we are entering clinical trials now.
Dr. Jeffrey Gross (25:44): Structurally, we've seen remarkable results in joints. Patients who were bone-on-bone and facing knee replacement have come in for a single injection and within a year shown measurable cartilage regrowth on MRI — in some cases 25% or more thickening. We're not inventing this; European literature includes 15-year follow-up data on similar protocols. The mechanism: we turn off the inflammatory damage in the cells that produce cartilage, allowing the body to restart the factory that built it in the first place. Systemically, we've seen improvements in HRV (heart rate variability), reductions in C-reactive protein and homocysteine, improvements in lipid profiles, and consistent patient-reported improvements in energy, sleep quality, and cognitive clarity.
Dr. Regina Druz (27:13): A cardiovascular perspective: once joint inflammation subsides, we'd expect systemic inflammatory markers to shift as well — and that matters enormously for cardiovascular and brain health. Joint inflammation is an early sign of total body inflammation.
Dr. Jeffrey Gross (27:24): Exactly. HRV is a sensitive metric for tracking this. I've seen HRV increase by up to 50% in some patients within days of an IV exosome treatment. One high-performance athlete in his thirties went from HRV in the 60s to the 90s — with a slow, gradual decline over months before returning for another treatment.
Dr. Regina Druz (31:51): Let's talk patient selection. I see a lot of mid-40s and mid-50s busy professionals — overweight, hypertensive, some with subclinical coronary disease or a prior cardiac event. We address lifestyle, weight loss, anti-inflammatory protocols, hormones, peptides. Where does regenerative medicine fit in that sequence?
Dr. Jeffrey Gross (31:51): Lifestyle and foundational optimization always comes first. Fix the terrain — diet, exercise, nutrition, sleep — so the person gets the most from any regenerative intervention. Then peptides as a less expensive entry point. Then regenerative biologics like exosomes, unless there's a specific reason to move faster — an autoimmune condition, long COVID, significant systemic inflammation, or a focal structural problem. I cluster patients into three groups: an older population managing energy decline and diffuse osteoarthritis; middle-aged patients becoming aware of suboptimal lifestyle choices; and younger high-performance biohackers wanting faster workout recovery and proactive aging prevention. For frequency: a young biohacker every 6-12 months, I personally do every three months, and an older patient with specific conditions perhaps annually.
Dr. Regina Druz (36:35): I want to raise something I'm seeing at HeartWell.ai, our cardiovascular risk platform. A recent Harvard study looked at patients with low traditional cardiovascular risk scores but high polygenic risk scores. Over a thousand people in their 50s had CT angiography with AI quantitation. Even with a calcium score of zero, 50% had soft plaque — and approximately a third had high-risk plaque features. We are systematically underestimating cardiovascular risk. Should longevity medicine be moving upstream to address this earlier?
Dr. Jeffrey Gross (37:23): Absolutely — early and often. If AI risk assessment identifies elevated genetic and imaging risk, we should be considering proactive interventions: nattokinase, lumbrokinase, endocalytics — tracking those patients and learning what works. We need to move upstream in pattern recognition, and you're doing that in cardiology.
Dr. Regina Druz (37:23): The environmental burden compounds this further. One day of exposure to fine air pollution has been linked to increased cardiac mortality. Microplastics are being found in arterial plaques. The risk calculus is far more complex than traditional scoring systems capture.
Dr. Regina Druz (49:36): Jeff, this has been a fascinating conversation. A few things come through clearly. First, lifestyle optimization remains foundational — no regenerative intervention substitutes for it. Second, once that foundation is in place, there is a real opportunity for optimization through regenerative approaches. And third, we now have the tools — exosomes, AI risk assessment, genetic panels, digital health monitoring — to do this with more precision than ever. I recently had a patient who, through integrative protocols without medications, dropped his LDL cholesterol by 47%. His follow-up note from Cleveland Clinic ended with the phrase "working with your functional medicine cardiologist." That's progress.
Dr. Jeffrey Gross (49:04): The paradigm is shifting. We have the knowledge, the tools, and increasingly the evidence. I've never been more passionate about medicine. Most of our patients aren't in Las Vegas — we consult remotely anywhere and invite you in when you're a candidate.
Dr. Regina Druz (52:08): Thank you for tuning in to Own Your Heart Health. This podcast is powered by Holistic Heart Centers. If you enjoyed the show, please rate and review us on your favorite platform. Visit holisticheartcenters.com to learn more, and subscribe to our YouTube channel — link in the show notes. See you next week.
Stem cells are living cells that act as delivery vehicles, releasing signaling molecules that instruct surrounding tissue to reduce inflammation and begin repair. Exosomes are the extracellular vesicles those stem cells release, containing the actual therapeutic cargo: peptides, growth factors, and genetic signaling molecules. Research has shown that exosomes are primarily responsible for the clinical benefits — the stem cells themselves leave the body within days. Exosomes are now preferred by many regenerative medicine physicians because they are smaller, travel more freely throughout the body, cross the blood-brain barrier, cost significantly less, and can be delivered more precisely.
Yes — though with important nuance. The FDA regulates the handling, processing, testing, and marketing of biologic products, including stem cells and exosomes derived from donated perinatal tissue (amniotic fluid, umbilical cord, placenta). Reputable U.S.-based clinics use FDA-registered labs and follow tissue donation protocols. What the FDA does not regulate is the practice of medicine itself — meaning a licensed physician can legally offer these treatments under the doctrine of informed consent, provided no unauthorized marketing claims are made. Patients do not need to travel outside the United States for legitimate regenerative treatments.
The strongest evidence exists for musculoskeletal applications: osteoarthritis, cartilage degeneration, joint inflammation, and spinal disc conditions. MRI data has shown cartilage thickening of 25% or more in some patients following a single injection, with European literature including 15-year follow-up data. Systemically, IV exosome infusions have been associated with reductions in C-reactive protein, improvements in heart rate variability (HRV), better sleep quality, increased energy, and enhanced cognitive clarity. Emerging applications include neurodegenerative conditions, long COVID, autoimmune-driven inflammation, and proactive longevity optimization. These are clinical observations, not FDA-approved indications.
Plant exosomes are naturally occurring nanoparticles that plants use to package and deliver phytonutrients — including resveratrol, sulforaphane, quercetin, and most B vitamins. Their membranes survive digestion and deliver nutrients directly into cells with dramatically higher bioavailability — estimated at up to 700 times more efficient than liposomal delivery. Injectable human perinatal exosomes are used for direct therapeutic intervention. The two approaches serve different purposes and can complement each other: plant exosomes support daily cellular maintenance, while injectable exosomes address specific inflammatory or structural conditions.
Physicians track both subjective and objective markers. Patients commonly report improved energy, better sleep, reduced joint pain, and enhanced cognitive function within days to weeks. Heart rate variability (HRV), tracked via wearables, has shown increases of up to 50% shortly after IV treatment. Blood markers including high-sensitivity C-reactive protein (hs-CRP), homocysteine, and lipid panels are monitored before and after. Frequency varies: younger patients may do treatments every 6-12 months; middle-aged patients typically every 3-6 months; older patients as needed, sometimes annually. Treatment intervals are ideally individualized based on how long benefits are sustained.
Practice: ReCelebrate Regenerative Medicine | Las Vegas, NV Specialty: Regenerative medicine, stem cells, exosomes, peptides, longevity medicine Supplement: Longev-X plant exosome longevity capsule Remote consultations available — visit is arranged if you are a candidate for treatment
Exosomes — extracellular vesicles containing peptides, growth factors, and genetic signals released by cells to communicate with neighbors Perinatal biologics — stem cells and exosomes sourced from amniotic fluid, umbilical cord, and placenta collected at scheduled C-section HRV (Heart Rate Variability) — a sensitive metric of cardiovascular and autonomic nervous system health, trackable via wearables hs-CRP (high-sensitivity C-reactive protein) — a blood marker of systemic inflammation; goal under 1.0 mg/L Polygenic risk score — a genetic assessment combining multiple variants to estimate cardiovascular disease risk HeartWell.ai — Dr. Druz's AI-powered cardiovascular risk assessment platform
holisticheartcenters.com HeartWell.ai — AI-powered cardiovascular risk assessment Address: 55 Bryant Avenue, Suite #6, Roslyn, NY 11576 Phone: 877-511-5166 YouTube: @reginadruzmd Instagram: @dr.reginadruz Podcast: Own Your Heart Health — available on Apple Podcasts, Spotify, and all major platforms
If you enjoyed this episode, please rate and review us on your favorite platform — it helps more people find the show. Apple Podcasts | Spotify | YouTube
The information in this transcript is for educational purposes only and does not constitute medical advice. The discussions about stem cells, exosomes, peptides, and regenerative therapies reflect the clinical experiences and opinions of the physicians involved. These treatments are not FDA-approved for all applications discussed. Individual results vary. Please consult your licensed healthcare practitioner before making any changes to your health regimen.
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[00:02] Welcome & Introduction [02:04] From Neurosurgeon to Regenerative Medicine Pioneer [06:54] Stem Cells 101 — What They Are and How They Work [08:50] The Source Question — Whose Stem Cells, and Why It Matters [15:40] From Stem Cells to Exosomes — What's Actually Doing the Work [22:36] Plant Exosomes — Nature's Delivery System for Phytonutrients [25:44] Clinical Results — Cartilage, Inflammation & Systemic Benefits [31:51] Who Should Consider Regenerative Therapy — and When [36:35] The Upstream Question — Starting Early in Cardiovascular Prevention [49:36] Closing — The Future of Integrative and Regenerative Medicine
Dr. Regina Druz (00:02): Welcome to Own Your Heart Health. I'm Dr. Regina Druz, your holistic cardiologist. Each week we uncover root causes of common heart health concerns and unpack the latest scientific discoveries — and controversies. The information provided does not constitute medical advice. Please consult your healthcare practitioner before making any changes that may affect your health.
Today's guest is Dr. Jeffrey Gross — neurosurgeon, spine specialist, and self-described "bio-nerd." About seven to eight years ago, Dr. Gross made a bold pivot away from traditional surgery into longevity-driven regenerative medicine. With longevity becoming one of the most talked-about topics in medicine, I wanted someone who represents what it actually means in practice — a physician who studies the physiology, understands the biochemistry, and can connect the dots for patients. Jeff, let's start with the question I ask every guest: how did you grow up to be who you are today?
Dr. Jeffrey Gross (02:04): I was a spine fellowship-trained neurosurgeon — neck and back, disc problems, the full range. We were always looking for less invasive, more biologic ways to avoid surgery, and I found I didn't quite fit in with conventional colleagues. Spine surgery hasn't changed appreciably in decades. I finally decided to look beyond the standard of care and pursue stem cells, which my patients were already asking about. My background is in biochemistry, and as you said, Dr. Druz, it always comes back to cellular function. Studying stem cells reconnected me to that foundation. From there my entire practice transformed — stem cells, exosomes, peptides, regenerative applications, longevity. I'm more functional in my mindset than I've ever been.
Dr. Regina Druz (03:56): How did your traditional colleagues react? I ask because I've seen this shift in cardiology too. The Journal of the American College of Cardiology recently published research on a Chinese movement practice for blood pressure control. We're seeing papers on microplastics and air pollution. Integrative approaches are moving into the mainstream — but it took time. What was your experience?
Dr. Jeffrey Gross (05:02): Many colleagues still have blinders on. They're focused on volume, driven by what insurers will reimburse. A few open-minded ones are curious and starting to dip their toes in. But most are holding onto the sick-care system because it pays their bills.
Dr. Regina Druz (05:49): It's the security blanket of conventional medicine. Though, as I like to say — the future favors the bold, and not all pioneers take arrows in the back.
Dr. Regina Druz (06:54): Let's give our listeners a foundation. What are stem cells? How are you using them? And what impact do they have on longevity and health span?
Dr. Jeffrey Gross (06:54): When you are a fertilized egg, you are a single omnipotent stem cell — capable of creating an entire person. Those cells divide and differentiate. First pluripotent (can create a limb or organ), then multipotent (can repair and regenerate tissue, but can't create a limb). By adulthood, we rely on multipotent stem cells, but with age, inflammatory stress, poor diet, lack of exercise, seed oils, and poor sleep, those cells become exhausted — fewer in number and diminished in function.
Dr. Regina Druz (08:24): Where do those stem cells actually live in the adult body?
Dr. Jeffrey Gross (08:50): Mostly in bone marrow. Also in fat, and in other tissues surrounding blood vessels. They're distributed throughout the body in all our tissues to some extent.
Dr. Jeffrey Gross (08:50): When we use stem cells therapeutically, you can use your own — but when you take your car for an oil change, you don't put the old oil back in. I prefer donated perinatal sources: amniotic fluid, umbilical cords, and placenta, collected at the time of a scheduled C-section from healthy, screened, consenting mothers. This material would otherwise be discarded. It goes through FDA-registered lab and tissue donation processes. You do not need to travel outside the country — that's a myth international clinics love to perpetuate. The source we use tests for multiple variables, including using only tissue from mothers who were not COVID-vaccinated, because we don't yet fully understand what the spike protein may be doing long-term.
Dr. Regina Druz (10:32): In my practice, we've been navigating the FDA's complex stance on peptides — some were moved to a compound category that created a gray market of unregulated, untested products. With stem cells, you're describing an FDA-regulated pathway. How does that actually work?
Dr. Jeffrey Gross (11:23): The FDA regulates the handling, documenting, and marketing of these biologics — but it does not regulate the practice of medicine. Clinicians can legally offer these treatments under the doctrine of informed consent. IV fluids for dehydration are not FDA-approved — but everyone uses them. A physician can discuss all options, including stem cell or regenerative approaches, and let the patient make an informed decision. What we cannot do is make marketing claims about outcomes. If a doctor presents you with a knee replacement as your only option without discussing regenerative alternatives, that doctor has arguably failed the informed consent standard.
Dr. Jeffrey Gross (15:40): Here's something that surprised us: the stem cells themselves aren't primarily doing the therapeutic work. If you came to my clinic for IV stem cells, within a couple of days those cells are gone from your body. But the benefits — reduced inflammation, increased energy, improved sleep, cognitive clarity — last weeks, months, and some changes appear to be permanent. What's doing the work? The stem cells are delivery trucks. The actual packages are peptides, growth factors, and extracellular vesicles called exosomes. Those exosomes carry cargo into your cells, signal anti-inflammatory pathways, and essentially reactivate your body's own youthful repair mechanisms. This is why we've largely shifted to using exosomes directly. They're about a third of the cost of stem cells, travel through tissue more efficiently, and cross the blood-brain barrier.
Dr. Regina Druz (20:31): Let me translate the biology. Cells communicate by packaging small portions of themselves — including signaling molecules — into tiny membrane-bound vesicles and releasing them. Neighboring cells take those vesicles in through endocytosis (a process that doesn't require a lock-and-key receptor). It's more like mail being dropped in a mailbox — the recipient picks it up and reads the message inside. Is that accurate?
Dr. Jeffrey Gross (21:52): That's exactly right. And importantly, all of our cells produce exosomes. For therapeutic purposes, we focus on stem cell-derived exosomes from amniotic sources — filtered, tested, concentrated, fresh-frozen, and unmanipulated.
Dr. Jeffrey Gross (22:36): Here's something most people don't know: plants deliver their phytonutrients — resveratrol, sulforaphane, quercetin, B vitamins, vitamin C — through exosomes. We've partnered with a lab in Italy that can extract exosomes directly from organic plants. We've developed a longevity supplement — Longev-X — that delivers plant phytonutrients via their natural exosome packaging, getting nutrients directly into the cell. Early data suggests delivery is 700 times more efficient than a liposomal supplement and 4,500 times more effective than a traditional supplement.
Dr. Regina Druz (24:11): How does the plant exosome survive the stomach's acidic pH of around 2?
Dr. Jeffrey Gross (24:22): The plant exosome membrane is significantly more durable than human cell membranes and survives the digestive process intact, reaching the small intestine where absorption occurs with high bioavailability. This is supported by preclinical studies and we are entering clinical trials now.
Dr. Jeffrey Gross (25:44): Structurally, we've seen remarkable results in joints. Patients who were bone-on-bone and facing knee replacement have come in for a single injection and within a year shown measurable cartilage regrowth on MRI — in some cases 25% or more thickening. We're not inventing this; European literature includes 15-year follow-up data on similar protocols. The mechanism: we turn off the inflammatory damage in the cells that produce cartilage, allowing the body to restart the factory that built it in the first place. Systemically, we've seen improvements in HRV (heart rate variability), reductions in C-reactive protein and homocysteine, improvements in lipid profiles, and consistent patient-reported improvements in energy, sleep quality, and cognitive clarity.
Dr. Regina Druz (27:13): A cardiovascular perspective: once joint inflammation subsides, we'd expect systemic inflammatory markers to shift as well — and that matters enormously for cardiovascular and brain health. Joint inflammation is an early sign of total body inflammation.
Dr. Jeffrey Gross (27:24): Exactly. HRV is a sensitive metric for tracking this. I've seen HRV increase by up to 50% in some patients within days of an IV exosome treatment. One high-performance athlete in his thirties went from HRV in the 60s to the 90s — with a slow, gradual decline over months before returning for another treatment.
Dr. Regina Druz (31:51): Let's talk patient selection. I see a lot of mid-40s and mid-50s busy professionals — overweight, hypertensive, some with subclinical coronary disease or a prior cardiac event. We address lifestyle, weight loss, anti-inflammatory protocols, hormones, peptides. Where does regenerative medicine fit in that sequence?
Dr. Jeffrey Gross (31:51): Lifestyle and foundational optimization always comes first. Fix the terrain — diet, exercise, nutrition, sleep — so the person gets the most from any regenerative intervention. Then peptides as a less expensive entry point. Then regenerative biologics like exosomes, unless there's a specific reason to move faster — an autoimmune condition, long COVID, significant systemic inflammation, or a focal structural problem. I cluster patients into three groups: an older population managing energy decline and diffuse osteoarthritis; middle-aged patients becoming aware of suboptimal lifestyle choices; and younger high-performance biohackers wanting faster workout recovery and proactive aging prevention. For frequency: a young biohacker every 6-12 months, I personally do every three months, and an older patient with specific conditions perhaps annually.
Dr. Regina Druz (36:35): I want to raise something I'm seeing at HeartWell.ai, our cardiovascular risk platform. A recent Harvard study looked at patients with low traditional cardiovascular risk scores but high polygenic risk scores. Over a thousand people in their 50s had CT angiography with AI quantitation. Even with a calcium score of zero, 50% had soft plaque — and approximately a third had high-risk plaque features. We are systematically underestimating cardiovascular risk. Should longevity medicine be moving upstream to address this earlier?
Dr. Jeffrey Gross (37:23): Absolutely — early and often. If AI risk assessment identifies elevated genetic and imaging risk, we should be considering proactive interventions: nattokinase, lumbrokinase, endocalytics — tracking those patients and learning what works. We need to move upstream in pattern recognition, and you're doing that in cardiology.
Dr. Regina Druz (37:23): The environmental burden compounds this further. One day of exposure to fine air pollution has been linked to increased cardiac mortality. Microplastics are being found in arterial plaques. The risk calculus is far more complex than traditional scoring systems capture.
Dr. Regina Druz (49:36): Jeff, this has been a fascinating conversation. A few things come through clearly. First, lifestyle optimization remains foundational — no regenerative intervention substitutes for it. Second, once that foundation is in place, there is a real opportunity for optimization through regenerative approaches. And third, we now have the tools — exosomes, AI risk assessment, genetic panels, digital health monitoring — to do this with more precision than ever. I recently had a patient who, through integrative protocols without medications, dropped his LDL cholesterol by 47%. His follow-up note from Cleveland Clinic ended with the phrase "working with your functional medicine cardiologist." That's progress.
Dr. Jeffrey Gross (49:04): The paradigm is shifting. We have the knowledge, the tools, and increasingly the evidence. I've never been more passionate about medicine. Most of our patients aren't in Las Vegas — we consult remotely anywhere and invite you in when you're a candidate.
Dr. Regina Druz (52:08): Thank you for tuning in to Own Your Heart Health. This podcast is powered by Holistic Heart Centers. If you enjoyed the show, please rate and review us on your favorite platform. Visit holisticheartcenters.com to learn more, and subscribe to our YouTube channel — link in the show notes. See you next week.
Stem cells are living cells that act as delivery vehicles, releasing signaling molecules that instruct surrounding tissue to reduce inflammation and begin repair. Exosomes are the extracellular vesicles those stem cells release, containing the actual therapeutic cargo: peptides, growth factors, and genetic signaling molecules. Research has shown that exosomes are primarily responsible for the clinical benefits — the stem cells themselves leave the body within days. Exosomes are now preferred by many regenerative medicine physicians because they are smaller, travel more freely throughout the body, cross the blood-brain barrier, cost significantly less, and can be delivered more precisely.
Yes — though with important nuance. The FDA regulates the handling, processing, testing, and marketing of biologic products, including stem cells and exosomes derived from donated perinatal tissue (amniotic fluid, umbilical cord, placenta). Reputable U.S.-based clinics use FDA-registered labs and follow tissue donation protocols. What the FDA does not regulate is the practice of medicine itself — meaning a licensed physician can legally offer these treatments under the doctrine of informed consent, provided no unauthorized marketing claims are made. Patients do not need to travel outside the United States for legitimate regenerative treatments.
The strongest evidence exists for musculoskeletal applications: osteoarthritis, cartilage degeneration, joint inflammation, and spinal disc conditions. MRI data has shown cartilage thickening of 25% or more in some patients following a single injection, with European literature including 15-year follow-up data. Systemically, IV exosome infusions have been associated with reductions in C-reactive protein, improvements in heart rate variability (HRV), better sleep quality, increased energy, and enhanced cognitive clarity. Emerging applications include neurodegenerative conditions, long COVID, autoimmune-driven inflammation, and proactive longevity optimization. These are clinical observations, not FDA-approved indications.
Plant exosomes are naturally occurring nanoparticles that plants use to package and deliver phytonutrients — including resveratrol, sulforaphane, quercetin, and most B vitamins. Their membranes survive digestion and deliver nutrients directly into cells with dramatically higher bioavailability — estimated at up to 700 times more efficient than liposomal delivery. Injectable human perinatal exosomes are used for direct therapeutic intervention. The two approaches serve different purposes and can complement each other: plant exosomes support daily cellular maintenance, while injectable exosomes address specific inflammatory or structural conditions.
Physicians track both subjective and objective markers. Patients commonly report improved energy, better sleep, reduced joint pain, and enhanced cognitive function within days to weeks. Heart rate variability (HRV), tracked via wearables, has shown increases of up to 50% shortly after IV treatment. Blood markers including high-sensitivity C-reactive protein (hs-CRP), homocysteine, and lipid panels are monitored before and after. Frequency varies: younger patients may do treatments every 6-12 months; middle-aged patients typically every 3-6 months; older patients as needed, sometimes annually. Treatment intervals are ideally individualized based on how long benefits are sustained.
Practice: ReCelebrate Regenerative Medicine | Las Vegas, NV Specialty: Regenerative medicine, stem cells, exosomes, peptides, longevity medicine Supplement: Longev-X plant exosome longevity capsule Remote consultations available — visit is arranged if you are a candidate for treatment
Exosomes — extracellular vesicles containing peptides, growth factors, and genetic signals released by cells to communicate with neighbors Perinatal biologics — stem cells and exosomes sourced from amniotic fluid, umbilical cord, and placenta collected at scheduled C-section HRV (Heart Rate Variability) — a sensitive metric of cardiovascular and autonomic nervous system health, trackable via wearables hs-CRP (high-sensitivity C-reactive protein) — a blood marker of systemic inflammation; goal under 1.0 mg/L Polygenic risk score — a genetic assessment combining multiple variants to estimate cardiovascular disease risk HeartWell.ai — Dr. Druz's AI-powered cardiovascular risk assessment platform
holisticheartcenters.com HeartWell.ai — AI-powered cardiovascular risk assessment Address: 55 Bryant Avenue, Suite #6, Roslyn, NY 11576 Phone: 877-511-5166 YouTube: @reginadruzmd Instagram: @dr.reginadruz Podcast: Own Your Heart Health — available on Apple Podcasts, Spotify, and all major platforms
If you enjoyed this episode, please rate and review us on your favorite platform — it helps more people find the show. Apple Podcasts | Spotify | YouTube
The information in this transcript is for educational purposes only and does not constitute medical advice. The discussions about stem cells, exosomes, peptides, and regenerative therapies reflect the clinical experiences and opinions of the physicians involved. These treatments are not FDA-approved for all applications discussed. Individual results vary. Please consult your licensed healthcare practitioner before making any changes to your health regimen.
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