The Connection Between Sexual Health, Longevity, and Regenerative Medicine with Dr. Amy B. Killen

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1 year ago

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Katie: Hello and welcome to the Wellness Mama Podcast. I’m Katie from wellnessmama.com. And I’m here today with Dr. Amy B. Killen, who is considered one of the leading longevity and regenerative physicians in the country, specializing in sex and skin. In her Utah-based practices, she combines things like stem cell injections with photobiomodulation, shockwave therapy, bioidentical hormones, peptides, and old-fashioned healthy diet and lifestyle to give patients unparalleled synergistic regenerative effects on their skin, their hair, and their sexual function.

She’s also an international speaker, entrepreneur, educator, and Co-Founder of the Human Optimization Project, or HOP. And in this episode, we go deep on the connection between sexual health, longevity, and regenerative medicine, including a lot of the foundational and more advanced biohacking practices she uses with her patients, her take on more controversial things like Ozempic use recently for many people, recommended peptide supplements, and diet and lifestyle tips. So very far ranging conversation, and let’s join Dr. Killen. Dr. Amy, welcome. Thanks so much for being here.

Amy: Thank you for having me.

Katie: Well, we’ve known each other in real life for years now, so i’m glad we’re finally getting to have a conversation and record it. And there’s going to be so many different directions we get to go in this conversation. But before we jump in, I had a funny note from your bio that you, with the popularity of the Barbie movie right now, you did not play with Barbie as kids, but you had a very unique toy experience instead. So I would love for you to explain that.

Amy: Yes. Yeah, I wasn’t a big doll person, but I did have a rubber fishing worm collection, and I had a big box of rubber fishing worms, and I had names for all of them, and I’d get them out and like play with them and throw them against the wall, and I had a whole, like it was a whole thing. I don’t know where, where it came from.

Katie: That is so funny. I don’t think I’ve ever met someone else that played with fishing worms as a kid and I kind of love that. Now in the work that you do, you’re well known for your work in Regenerative Medicine, and I know many people who work with you and have had fabulous results, but I know this wasn’t actually how you started out. So can you walk us through your background and how you got into the work you do now?

Amy: Yeah, absolutely. So I was an emergency medicine physician for the first 10 years of my career. I went to ER residency, trained in that, and then I lived in Austin and worked in a really busy emergency department there. And that was 10 years. And then towards the end of that, I had my three kids within two years. I had twins and then one more. And just craziness of the schedule, the getting up at three in the morning, the sleeping two or three hours a night, plus all the extra stress at work and just the bad lifestyle kind of choices and things that I was putting myself up to started to kind of weigh on me over time.

And I started seeing all these effects of just the chronic stuff on me. And then I looked out at the people who were coming into the ER. And I realized that probably like 70% of the people that were coming into the emergency department were there because of things that could have been prevented with just healthy lifestyle, education, and some empowering of those people. So I just realized that I needed to learn a lot of new stuff for myself and then take that information and transfer it to other people.

Katie: And you have somewhat of a focus on sexual health in your practice. I’m curious what sparked that particular interest. And I know that that also has crossover into many other areas of health. It doesn’t of course exist in isolation, but what brought that interest?

Amy: So I had a practice in Portland, Oregon, after I left the ER. I was doing bioidentical hormones, lifestyle medicine hormones. And I would see these people who would come in with like, kind of at the end of their rope, like they were really struggling, gaining weight, no energy, just kind of frazzled. And it was really problematic. And we put them on some hormones and some lifestyle changes. And then they’d come back like two or three months later. And they would say, hey, i’m actually starting to feel better. I have more motivation. My depression is getting better. Now, can you help me with either my skin, make it look better, or my sex life? And so over and over again, I got these two requests. They seemed different. But when I started looking into it, I realized that skin health and sexual health they’re actually closely linked. And they’re both these kind of next levels of health that people don’t really think about too much until they start having problems in those areas or until they can get over all the major health struggles that they’re having. So I started diving into those two fields. And then just became really fascinated with how sexual health is intimately tied, intimately tied to overall health, to longevity, to happiness, to emotional health, all of those things.

Katie: Well, and much like the body, these people seem to be having this sort of experience of triage that we hear about in the body where if you’re in survival mode or you have a big kind of pressing health crisis, your body’s not as concerned with like fertility, for instance, or how your skin looks because it’s trying to survive. And so it seems like the mental experience of these patients was mirroring what their body was feeling in those times as well.

Amy: I mean, it makes total sense, right? Your body does not want to be sexually active or be produced if you are in a state of crisis. If you’re having a hard time even getting through your day because you’re too tired, then your body is just like, well, we don’t need to be doing these other things right now. And so it makes total sense. But what’s interesting is that I find that if people who are interested in being sexually active and sexually healthy, if they even just prioritize that, it ends up creating overall health. So you can prioritize sex. And by doing that, it’s its ripple effect where all of a sudden, oh, your cardiovascular health is better, your hormone health is better, your brain health is better. Like it’s this interesting kind of ripple effect. So I think it’s kind of a hack to be able to help some people become more motivated to get healthy that maybe otherwise they wouldn’t be.

Katie: That makes sense. What’s your take on, I know we keep seeing pretty dire statistics about infertility is on the rise, sperm count is, I’ve seen lots of different estimates, but drastically lower than it was even a couple of generations ago. And I’ve seen even dire predictions of by 2050, we might be facing sort of like almost total infertility. What is your take on those numbers that we’re seeing and if those are accurate where they’re coming from?

Amy: I mean, I don’t know for sure. I mean, I’ve definitely seen the same numbers 40, you know, 40 to 50% drop in sperm count. Although sperm motility is still pretty high, which is really a oftentimes a better marker. But yeah. Is down by 30 to 40% in just the last 50 years in men and fertility in women seems to be down as well.

I think that they’re definitely scary trends, whether those numbers are exactly right or not, but I do think that there’s a lot of concerns that we maybe aren’t taking as seriously as we should. Just part of it’s probably how healthy we’re living our lives. Like for instance, with sperm and testosterone, I think that men just aren’t, they aren’t lifting as many heavy things, they’re not out in the sun as much, they’re not eating as healthy, they’re overstressed, they’re not sleeping as much. And all of these things affect your ability to make testosterone, which has been reflected at least to some degree in your ability to make sperm. And then we also have all the different endocrine disruptors and things that are out in the environment, which I think we still don’t, haven’t really wrapped our head around the significance of a lot of these chemicals and how they’re affecting our endocrine systems.

Katie: That makes sense. And I know from reading some of your work, there’s also a connection between sexual health and longevity. So I’d love to establish some of that connection for context before we start delving into solutions and things that can help.

Amy: Yeah, there’s a couple of interesting studies. Now, they’re correlation studies, so they’re not showing causation. But in 2020, The Journal of Sexual Medicine published a large study with over 13,000, I think, men and women in the US. And they followed them for like six or seven years. And they found that those people who were sexually active, especially more than like about 52 times a year, about once a week, had a 50% lower all-cause mortality rate compared to people who were not sexually active or didn’t have very much sex. And that was actually similar. Similar results were seen in a large study in Wales. And men, again, 50% lower mortality if people were having sex one to two times a week.

And so there’s all of this data that shows that there’s a strong correlation between being sexually active in a healthy way, whether that’s in a relationship or not, we don’t know, and lower all-cause mortality. And it’s probably a reflection of a lot of things. Having a healthy relationship, obviously, social relationships are important for longevity. It’s tied to emotional health and mental health. It’s tied to physical health, because if you can still have sex, it means you have good blood flow and nervous system and all that, hormones. So there’s a lot of pieces of the puzzle, but I do think it’s something that was not talked about enough in the longevity field.

Katie: And what are some of the big things that people come to, maybe male and female specific, when it comes to different ages and a decline in that, whether it’s a decline in sexual activity or libido, what are some of the things you see when they come in with those specific questions?

Amy: In men, it’s mostly erectile dysfunction, and we’re seeing that in younger and younger men. Some of it is probably just because of porn and the easiness of getting that and some of the things that are happening in the brain with that. But then I think a lot of it is also just some of the other things we talked about with low testosterone and blood flow and endocrine disruptors and such.

In women, it’s a range of things. Low libido certainly can be a problem, lack of sensation. Orgasm problems. Those are the most common things I see with women. The most common one is just lack of libido. I’m just not really interested. And we don’t call it sexual dysfunction unless it bothers you. So if you don’t have a libido and you’re totally fine with it and you’re going about your life and everything is great, we don’t talk about it as being dysfunction. We just talk about that as being a personal choice. So it’s only when it bothers you that you can have a libido. You that we start to talk about a dysfunction. And we thought about 40% of women admit to having some kind of sexual dysfunction, which is just ridiculous numbers.

Katie: Wow, that is a higher number than I expected for sure. What are some of the things women can do? And I would guess, does this vary by age? Like, is there a higher concentration of that as people get older, like with each decade, sort of?

Amy: Yeah, it’s definitely higher as you get in the perimenopause, menopause age group. And perimenopause can start as early, I mean, it can start early, but especially 35 or 40 is about where it tends to start. But it’s about those 10 years before menopause when you have a lot of changes happening. So because of lower levels of testosterone as well as progesterone and eventually estrogen in women, we start to see less libido in that population, as well as some of the other problems, problems with arousal, problems with orgasm. And then later problems with pain, because if you lose estrogen, then you may start to have pain as well.

So I think certainly looking at your lifestyle is always key first thing. Are you exercising? Are you eating well? Are you getting sunlight? You know, stress levels. If you’re not sleeping well, you’re not making a lot of these hormones as well. So you’re not making, because you make testosterone as well as growth hormone, primarily while you’re sleeping, if you’re not sleeping or you’re not sleeping well, then you’re not making these hormones. So something as easy as just prioritizing your sleep. And making sure that you have a good sleep hygiene regimen and getting to bed on time and those kinds of things can actually make a big difference and they’re pretty easy to do.

And then the next step is going in and seeing a doctor, you know, getting hormones checked, getting blood tests checked, seeing if there’s any areas of inflammation or things like that that you can target to try to improve whatever’s going on, the health or the blood flow or whatever.

Katie: Okay, so those foundational things would be sort of preventative at any age and probably great lifestyle habits to integrate earlier before you start seeing those problems. But sleep, exercise, and sunlight would top that list for preventative.

Amy: Yeah, absolutely. Diet, of course, eating all the good things, all the antioxidants, getting enough protein. It all kind of goes together, right? I feel like this is stuff that people talk about over and over again. But in the world of sexual health, because you’re talking about healthy hormones, you’re talking about healthy blood flow and a healthy nervous system, all of those things play into whether you are sexually healthy.

The other piece that I think is really important and fairly easy to at least understand is that you want to be able to activate your Parasympathetic Nervous System. And so a lot of people, we live in this high stress, fight or flight world, and we’re in that sort of stress, go, do, give, state all the time.

But we really want to be able to transition at will into what I call the rest and receive state, or the parasympathetic rest and relax, where you’re calming down your nervous system. Because you actually have to be in that state in order to go through all the part of the sexual response curve. You actually have to have input from that parasympathetic system. So if you can’t relax, if you can’t just learn to be and to breathe and to receive, then for men and women, then that is, it’s very difficult to have satisfying sexual relationship.

Katie: That makes sense. And at what age would you recommend getting, starting lab testing just to get a hormone baseline and then kind of frequency beyond that? And what hormones do you recommend people look at and look for? Because I know there’s a lot of variation in what’s recommended here.

Amy: Yeah, you know, there’s some controversy on whether you should be checking hormones in young women who are pretty healthy because your hormones are changing so much during the month, you know, getting a single lab test may not be all that useful. I do think that by the time you’re 40ish, 35, 40, it’s good to get a like a 21 day. So 21 days into your cycle from your when your period starts to get a blood test then and just look at estrogen. So estradiol, progesterone, testosterone, as well as like sex hormone binding globulin, FSH and LH, which are pituitary hormones.

I also think looking at your anti-Mullerian Hormone, AMH hormone, which is going to give you an idea of your ovarian egg reserve could be useful, especially if you’re thinking about, you want to kind of maintain some fertility, but even not, even if you’re just trying to look and see how far out am I from menopause, that sometimes can be helpful as well. And then, yeah, testosterone, those are the main ones. Certainly you can do cortisol testing and things like that, but those are better as saliva tests or as urine tests, and you usually want to do several of them instead of just one. And then repeat those, of course, certainly as you get older. Later, perimenopause, menopause, make sure, see where you are, and then do what needs to be done.

Katie: Got it. So to have sort of that baseline of when you felt really good, know what those numbers look like for your individual body. And then what do you think about as people get older, hormone testing, yes or no? I mean, hormone replacement, sorry, yes or no?

Amy: Yes. I’m very largely pro-hormone replacement. And I think that there’s so much misinformation out there, especially for women about that. I feel like a lot of, I have a lot of friends who are kind of early menopause. And they’re very smart women who are well-informed doctors. And yet they still have this idea that they should just be powering through, you know, perimenopause, powering through menopause. And that if they accept help and get hormones, that it’s some sort of sign of weakness. It’s like, you know, you weren’t tough enough to do this on your own.

And I think that that is just completely garbage. And it discounts the fact that taking hormones is actually very preventative in a way preventing a lot of the degradation that happens, unfortunately, when we lose our estrogen levels as women. So i’m pro-hormones. Obviously, there’s some cases where you can’t take them, but for the most part, I think that they should be looked at for most people.

Katie: And what age do you see women typically come in for that? And do you recommend it for guys as well, especially in light of the declining testosterone?

Amy: So for women, it’s going to be usually it’s like mid perimenopause, which again can start at 35 or 40 and it can go up to 45 or 50. And usually in the beginning in perimenopause, it’s just going to be maybe a little bit of progesterone, two weeks out of the cycle to help kind of even out what’s happening with your estrogen. And then, or maybe it’s adding a little testosterone. Testosterone goes down a lot more slowly in women than it does than the other hormones, it’s still going down every year. And then after menopause, 45, 50, or maybe a little bit older, that’s when you really, really want to make sure you’re replacing. Again, even if you don’t have symptoms, I think it’s worth replacing those hormones.

For men, most guys I see are in the 35 to 40 plus age range. Although I’ve seen younger guys now coming in with legitimately low testosterone. And i’ve seen guys in their 20s who haven’t been on steroids, who don’t really have good reason for it, who have low testosterone. But then unfortunately you look at them and they’re also pre-diabetic or diabetic and they’re overweight and they’re not exercising. And there’s all these other things that we know are risk factors for low testosterone. And vice versa, low-T also increases your risk for obesity and for diabetes and it’s kind of a chicken and egg thing. But 35 or 40, a lot of things tend to change with hormones in men and women.

Katie: And with hormone replacement, are we aiming for the levels we had before they started dropping at all or are there better ranges? Does that change by decade as we get older or are we trying to maintain sort of that pre-baseline?

Amy: In men I try to keep testosterone in the middle to upper end of the normal level of like a 30 year old. So that’s going to be you know somewhere in the 700 to maybe a thousand or so level depending on the lab you’re using.

For women I’m looking at keeping estrogen, the levels won’t be quite what they were when you’re having cycles because during cycles you know you have these very widely fluctuating levels. So the idea with the menopausal especially treatment with hormones is to still keep your levels up but you don’t have those rapid swings. But you do want you know you want estrogen levels to be over maybe 80 or so for help for a minute for protection of your brain and your blood vessels and your bones and your pelvic floor and your skin. Like people talk about that your skin ages very fast as soon as you hit menopause and you lose estrogen because estrogen is helping to support the scaffolding of your skin, the collagen in your skin. And so if you don’t replace that you know pretty quickly you start to see rapid skin aging which is a big complaint you know a lot of my friends and patients have at that age.

Katie: And I feel like this has been largely debunked by now, but I know some people still have concerns about hormone replacement based on a lot of news articles that came out after it became popular, I think decades ago now. But I would love for any dispelling or cautions to be aware of in that area, just because I feel like there are some lingering concerns with the safety of hormone replacement.

Amy: Yeah, great question. So in 2002, the Women’s Health Initiative published the big study, and this is the one that got that made the headlines and that said, you know, hormone replacement therapy causes breast cancer, dementia, stroke, you know. Heart attacks, like it basically causes all bad things. And that was in that moment was when everyone got off hormone therapy. So you had a generation of women who at that time stopped hormones or never got on them because of worries of these things.

Well, it turns out in looking at that data more closely, the group that just got… That just got estrogen actually had a significantly decreased, I think it was like a 25 or 30% decreased rate of cancer. And it was only in the progestin group, the one that was getting the progestin plus estrogen, that had a slight increased risk of breast cancer. Even that wasn’t huge. We’ve since learned that those synthetic progestin, which are not the same as progesterone, which your body makes, they do tend to be a little bit more inflammatory. And we think that those increased risks of just other things like dementia or cancers because of that inflammation.

But there’s not any evidence that just that bioidentical or body identical progesterone increases breast cancer risk at all. There’s some kind of potential increase in breast cancer risk if you’re on hormones for more than 10 years. But even that is a pretty low risk for most people. And if you think about the benefits of the hormones, like just on bone health, for instance, osteoporosis prevention is huge. And not to mention dementia prevention and cardiovascular disease and all of that, but there’s no debate about whether hormones like estrogen help prevent osteoporosis. There is some debate whether it helps to prevent some of these other things.

But if you look at just fracture risk. For adult women, postmenopausal women, it’s enormous. And then you have the, you know, all of the things that go with it. If you break your hip, you have a 25% mortality rate in the first year of a hip fracture. And so these are not insignificant things. So you do have to weigh the risks and the benefits, but for the most part, hormone therapy does not seem to increase breast cancer risk. And if it does, it’s very slight and it’s only after, you know, using it for 10 years or so.

Katie: Got it. That’s good to know. And it seems like just for people who don’t have the context for these, the different hormones probably are going to have different effects obviously within the body. And it sounds like it might get implemented at different ages. So maybe progesterone is the first one that comes online for women and then estrogen later on or testosterone later on when they’re needed. And for guys, is it just testosterone that we’re talking about typically with hormone replacement?

Amy: Yeah, it’s usually just testosterone with men. I mean, you can do other things before you give testosterone. Like for instance, you could do Clomid or Clomiphene, which is actually a medication that’s used for women to improve fertility, but we use it at lower doses in men to increase testosterone production by themselves. So if you have a guy who’s pretty young, like if you have like a 40 year old guy who has some low testosterone, we may try a trial of like Clomid or Clomiphene to help him produce his own testosterone. Because once you get on testosterone, you’re kind of shutting down your own production and you don’t want to do that if you don’t have to.

Katie: Got it. Makes sense. And I’ve heard from friends my age that even just like a progesterone, like a topical progesterone, greatly improved their sleep and perimenopause. Is there a difference as far as I know there’s oral, injectable, topical? Can people start with just like a simple topical one to test that?

Amy: You can. I caution you a little bit about using just like over-the-counter progesterone. Like if you go to the health food store and you buy like yam cream or something. And the truth is that yams, although there is a component in yams that’s made into progesterone in a lab, and that requires lab equipment. It doesn’t happen in your body. So just applying yam cream, if it hasn’t been chemically converted to progesterone to your skin, doesn’t actually do anything. It just makes you, you’re just lathering yam cream on.

Progesterone creams that are prescribed by your doctor can be helpful in perimenopause. I think they’re fine. I don’t like them in menopause because there’s pretty variable absorption and they don’t show up well in the blood tests. And because i’m using blood tests primarily to make sure that your uterus is being protected by the progesterone, then I think that it’s better just to take oral progesterone if you’re menopausal and really need that uterine protection. But if you’re perimenopausal and doing it just to kind of see if it can help with sleep or help with your cycles not be as painful or things like that, then I think creams are fine.

Katie: Okay, got it. That’s an important distinction. And I know that you also specialize in a lot of areas related to longevity. And of course, we’ve made a strong case that sexual health is a big key of that. But I would love to go deeper on maybe some of the foundational, universally positive things people can do as foundational pieces for longevity in general and anti-aging. And then also build on to that.

I know you’re also a biohacker and have tried some of the other things as well. So I would love to start with like foundational and then transition into what are some of the new advanced things that are coming out that you think are promising?

Amy: Funny in the longevity world, which is like researchers, it’s biohackers, it’s always from people, there’s a lot of debate about what really works, except a few things. We know for sure that exercise works. So that’s both aerobic, get your heart rate up, as well as resistance training. We know that people who have more muscle do better long-term. And so building muscle, especially when you’re younger, is very important because you will start to lose the ability to build muscle as easily as you get 50, 60 years old. So starting that early, I think, is very important. There’s no debate about that.

We know sleep is important. We know that a healthy diet is important, but there’s a lot of debate about what that means, as you might imagine. Some people in the longevity space do completely vegetarian, vegan, lower protein, because there’s some evidence in some papers that you don’t want too much protein because of mTOR activations and different things. Whereas other people, like Peter Attia, for instance, advocates for a pretty high protein, like one gram per pound of ideal body weight per day protein intake. And so you actually have divergence even among these experts in what’s the best diet. So I personally, I think the best diet is the one that you will actually stick with. I do think fruits and vegetables are healthy for you. I do think you would need at least moderate protein, so at least a half a gram of protein per pound of body weight a day, but more if you’re physically active, which you should be.

And then after that, I think getting a little sun is actually very important. And i’m very into skin health, and so I do think the sun ages your skin. And I also have seen, there’s some big studies that show that the sun is so beneficial to us, including the big study out of Sweden, where they looked at a bunch of women over decades, and they basically found that the ones who had the lowest sun exposure were the ones who had the highest mortality rates, and that lack of sun exposure was a risk factor for dying that was on par with smoking a pack a day of cigarettes. And so there’s probably a lot of reasons for this, but I do think that getting some sun, 10, 15, 20 minutes outside in the daytime, don’t burn, is a longevity hack that’s not being talked about enough as well.

Katie: I’m really glad you brought that up because I’ve also talked about this in the past and taken some heat from it and I don’t typically use sunscreen for that particular reason. I just moderate my sun exposure based on how much my skin needs. I’ve definitely seen an energy difference when I get regular sunshine. I personally like to do morning sunshine for the light exposure and getting it on my eyes and then midday sun exposure for skin and for Vitamin D. I sort of view those as like separate beneficial categories, but I feel like we did ourselves a tremendous disservice when we all started being afraid of the sun and overusing sunscreen and that we definitely in that case I think threw the baby out with the bathwater.

Amy: And I think that, you know, I do use sun, I use a mineral sunblock, like a zinc oxide, titanium dioxide on my face and neck, because I, you know, I do know, i’m 47 years old and I know how bad the sun is for skin aging. But I also do think that it is important to get sun. And I think that, you know, you can do it in a smart way, whether you just don’t get a lot of sun or you wear protective clothing or you wear sunblock sometimes. But, you know, it’s funny that back, you know, back in the old days, they had, they had all these sanitariums where they would treat tuberculosis patients by putting them out in the sun. And, you know, even Florence Nightingale, the big, like the nurse who like, you know, discovered like a lot of things with germs, you know, she’s a big quote talking about the importance of sun exposure and healing patients.

And I think that, I think you’re right. I think that it’s more than just Vitamin D. Like we know that supplementing with Vitamin D is beneficial probably, but we, but there are other things as too. It’s serotonin, it’s melatonin, it’s circadian rhythm, you know, working on keeping those in sync. It’s, there’s all kinds of mood enhancement, nitric oxide, all of those things are benefited from getting some sun exposure.

Katie: What about on the supplement front? Because I know there’s also as many opinions here as there are maybe more so than different opinions on diet. But it seems like there are definitely some things that can be helpful, especially as we age from a supplemental perspective. So what are some of your most common recommended supplements?

Amy: Well, I actually started a supplement company called HOP Box just because I was getting this question a lot and I was trying to put those things together into my own personal stack and realized that it was kind of hard to do. And so we have a sort of twice daily pack of the 19 ingredients that we think have shown the most promise for slowing of aging. And so it’s things like NAD boosters like either NR or NMN, calcium alpha-ketoglutarate, spermidine, hyaluronic acid, which is great for skin health and you could take it orally as well, as well as some of the Vitamins, B-Vitamins, Vitamin D.

I also really like dihydroberberine or berberine because of its effects on blood sugar. And we know that, you know, that blood sugar, too much blood sugar over time is one of the reasons that you age faster as having higher blood sugar levels. Even if you’re not diabetic, it’s a cause of rapid aging. And so something like berberine or we have dihydroberberine because it’s more available can help blunt the blood sugar effects in your body. And we also have a post-biotic in there. So, yeah, there’s a lot of different things out there. And I think that, you know, we hear and learn about new things every day, but these are some of the ones that we’re hearing about over and over again, as well as antioxidants like Quercetin and Fisetin and some of those kinds of things.

Katie: And you’ve mentioned glucose a couple of times. We now also have the availability of wearable glucose monitors. And I feel like that data is more available. Is that something you recommend for people of having a kind of a snapshot of what’s happening with their glucose and their insulin and modulating that through diet and lifestyle, which also, I guess, leads into the more controversial question about what about the rise in people using Ozempic and your thoughts on that?

Amy: Ah, love all of these questions. So yeah, I think CGMs, continuous blood glucose monitors, can be helpful. I think there are interesting pieces of information. They’re a little problematic in that you could eat something and you could be like, oh my gosh, carrots spiked my blood sugar. I’m not going to have carrots anymore. But you don’t realize that it depends on what time of day you ate the carrots and whether you had been exercising. If your body, like there’s so many other things that go into figuring, deciding what’s going to happen with your blood sugar that’s not just the food you’re eating. What did you eat the carrots with?

And so I think that they’re interesting. And certainly as we start having this more and more of this kind of data and then we’re inputting other pieces to that puzzle, like was it at night where you had to exercise that day? How was your sleep then? All of these pieces and starting to using AI and things like that to really make sense of that data, I think we’ll start to learn a lot more than we can with just those single points of information.

And the second part of your question about, oh, about Ozempic. So, you know, i’ve actually, i’ve been working with Ozempic or Semaglutide or Semaglutide, whatever you want to call it, for several years. And I do think it’s a great medication for a lot of reasons. I do think certainly you should be cautious for some reasons as well. It’s great in that this is the first group of medications. These are the GLP-1 agonists, so it’s glucagon-like peptide. And it works in a few different ways. It decreases your hunger signals from your brain, so you’re just not as hungry. And it does also slow gastric or stomach emptying so that food is staying longer in your stomach. And so you feel full longer because you are full longer. And we know that it has benefits outside, these medications have benefits outside of just causing weight loss. That, you know, decreases your insulin resistance and just some cardio protective benefits.

A big study just came out showing that there was a 20% decrease in cardiac events of people who’ve been taking these medications long-term, which is pretty great. There’s some neuroprotective, there’s all kinds of things that are beneficial.

The downsides of these medications are, I think the biggest downside is that when you lose weight rapidly, you tend to lose more muscle than you would like. Any weight loss is going to cause muscle loss, but especially rapid weight loss will cause more muscle loss. And because you’re not hungry, you’re probably not eating enough protein, and maybe you’re not resistant to the strain like you should be. So that’s all going to help, you’re going to worsen your muscle loss. So I do think that you have to be very, very careful about still getting enough protein every day and still doing your weight training, your heavy lifting, if you’re going to be on these medications. Obviously just only do it with a provider, a doctor, but I think that they can be helpful in the right population.

Katie: And you mentioned the peptide component of that, which is a great springboard into a conversation around peptides in general. And I believe these are things that you use with your patients. But what’s your take on peptides and what would be some of the ones that you would give people as like a starting point for research if they’re interested in either learning about or trying peptides.

Amy: Yeah, I like peptides. There’s hundreds of peptides. Peptides are just short proteins. So it’s basically 20 amino acids are long, short little proteins that have specific receptors that they bind to because they’re not like these big crazy folded proteins. And there’s a bunch of them out there. Some of them are FDA approved. For instance, insulin is a peptide that’s FDA approved, used all the time, obviously. The GLP-1 like Ozempic are peptides. But there are also a lot of them that are kind of in this gray zone, according to the FDA.

But some of my favorites that we know, an easy one to start with is BPC 157. And that’s one, if you ever look at the peptides, that’s probably the first one you’ll hear about. But it’s BPC stands for Body Protective Compound. And this is actually a peptide that’s found in your stomach juice, in your gastric juice, in your body. And it was discovered that it’s really helpful for healing your gut and your stomach. So if you take it orally, like with a pill, I actually have a formulation that I have out there. I’ll give you the link to it. But you take it orally as a pill, it’s really helpful for, with helping with whether it’s stomach ulcers or irritable bowel syndrome or any kind of gut issue it could potentially help. And then you could also inject it. It can be a subcutaneous insulin needle injection and that can help with just improving your ability to heal from especially musculoskeletal injuries.

So I have an Achilles tendonitis right now that i’ve had from over jump roping and i’ve been taking BPC 157 for… So it’s helpful for that, but also skin healing after procedures. There’s a lot of musculoskeletal skin healing for that one. Some of my other favorites, I really like GHK copper as well. That one is usually given as an injectable and you do it for like a cycle, like a month on and a couple of months off. But that one has, you know, it reacts with hundreds of different enzymes in your body. It’s most known for being good for skin and for promoting youth, but it does all kinds of other things as well. So those are two good ones to start with, but there’s, it’s a whole rabbit hole once you start looking into it.

Katie: And I know you have resources for all of this kind of stuff. I’ll put a lot of links in the show notes for you guys listening on the go so you can find and learn more.

But that then I think leads into the conversation for people who have optimized the foundational things. What are some of the more advanced biohacky type things that you think are worth the time and the money to do or that you think are the most impactful?

Amy: I think sauna is very impactful and it does take a little time. I have a sauna and I don’t do it as much as I should because it takes like an hour to heat up and i’m just too lazy. But there is good research for sauna users that decreasing cardiovascular risk, cardiovascular death, dementia, not to mention some of the other potential benefits and things like that. But I do think sauna is a good one.

I am a big fan of cold plunges, although I don’t think there’s as much evidence for that as other things. I do it because it just makes me feel good. I like to do a cold plunge and I feel like i’m unstoppable for several hours afterwards. But there’s the potential benefits to decreasing inflammation and immune system and things like that, which I think that we’ll hear, I think we’ll learn more and more about. But i’m not convinced that we have a lot of evidence yet, but I do still think that it’s fun to do and worth just testing yourself. It’s worth kind of getting uncomfortable sometimes and just saying, i’m okay, i’m uncomfortable and i’m okay. And I feel like that that little bit of teaching is actually one of the best things about doing cold plunges.

I do like red light therapy. So photobiomodulation using red light, that’s going to be light in the light 650 to 1000 nanometer range, whether it’s the panels or a wraparound or the beds or there’s a ton of to do it. But it’s great for skin. It’s great for hair. It’s great for increasing mitochondrial energy production, wound healing, the list of things that red light helps with is actually pretty long and well researched. There’s a lot of there’s a lot of research behind that as well.

Katie: Awesome. Yeah, those are some that I like to use as well. I feel like based on at least the Finnish sauna study that i’ve said before, if sauna was a pill, everybody would take it because they showed some pretty profound results from that. But you’re right, it does take a little bit of a time commitment and the time in there is not always the most comfortable. I think for me, the cold plunge, I’m with you, it’s on the mindset and how I feel after, not necessarily how I feel in the cold, but it does seem to create a measurable increase in dopamine, at least for a short time after the cold. So I feel like it’s a great mental reset.

And one tip I’ve used, even if you don’t have a cold plunge at your house, is just submerging your face in a bowl of ice water can often give you that little bit of a dopamine boost. So if you’re like kind of sluggish in the middle of the day, or just want a little hit of dopamine, that sometimes helps me. And if you feel more alert or focused, just to stick my face even in the cold water.

Amy: Yeah, you know, what I found was, you know, when I do the cold plunge, I have a hard time meditating just in my normal life, because my mind is always doing something. But I do find that when i’m in the cold plunge and i’m just focusing on breathing, that it’s it is kind of this meditative state that I have a hard time getting into otherwise. And I found myself, there’s a couple of times, there was one time recently in the winter, I was driving home with my kids down the mountain, it was super snowy outside, it was just me and them. And it like this huge storm hit, like the roads were icy, it’s from Park City, like really, really dangerous cars going off the side, like, super, super sketchy, I was very stressed out. But I realized I was I had started breathing like I did in the cold plunge, like this like slow kind of rhythmic breathing. And without realizing it, my body had kind of shifted into this, into this like parasympathetic like you got this, you’re uncomfortable, it’s okay, you’re going to survive state. And it got me all the way down the mountain and home. And i’m just so grateful for that. Just in that moment, that’s enough right there for me to do it every day.

Katie: That’s a great point. Yeah, I think the mindset piece can’t be probably overstated and that any chance we have to sort of cultivate that mindset is helpful in so many other areas of life. You’ve also mentioned exercise and movement and weight training specifically a couple of times in relation to both sexual health and to longevity. And this is one anytime I get the chance to talk about, especially in relation to women, I love to go deep on because I feel like for a long time, women were marketed more of like the cardio and the classes and were not really encouraged to do weightlifting as much. And when you look at the data, at least to me, it was extremely compelling. And it’s now what I focus on is like sprinting and weightlifting for the most part. And I thankfully love those things as well. But can you just kind of give us an overview of why, especially for women and especially as we get older, weight training is important to prioritize?

Amy: Yeah, I mean, absolutely. I think, and you know, and i’m a kind of a scrawny person, even though I do lift weights, but I don’t have a lot of muscles, but I still do it all the time. But you know, it becomes harder and harder to gain muscle with age, but lack of muscle, Sarcopenia and Osteoporosis, which are both tied to not lifting weights, are something that in women especially, where you’re goanna start to struggle with, going to start to affect your everyday life and your overall health.

And we know that having more muscle is going to make you metabolically more fit. And you know, having more muscle makes you more resistant to the downfalls of insulin and keeps your blood sugar more regular. Like when you have more muscle, you have less visceral fat. Like there are all of these things that just having more muscle will do that are very positive for you. It helps your brain, it helps, it’s really just everything. And so, you know, certainly there’s benefits, like you said, sprinting, getting your heart rate up for short periods of time, but i’ve definitely shifted my, I used to be the person who would ride on the peloton for 45 minutes, or I would, you know, go for it. I still go for hikes, but I would do hike, do hike, a lot of hiking, and I call that my exercise. But now i’ve shifted where I do, you know, weight training four to five days a week, and then do just try to do short periods of jump roping or hiking or sprinting or, you know, stairs or whatever to get the heart rate up, but in much shorter intervals than I used to do.

Katie: Yeah. And I feel like that was so freeing to me to learn, especially as a busy mom, because a lot of those things, you can get a tremendous benefit without spending hours doing it. So for moms, especially, I feel like those are kind of a cheat code to maintaining muscle and fitness as we get older and they don’t take too much time.

I also am really curious because you as a doctor and working on this kind of longevity space seemingly have access to all of the tools. And I know I also hit this like fatigue point of when there’s so many different things you can do for health, it becomes hard to do them all. And sometimes it can feel overwhelming to even know where to start. So i’m curious for you personally with access to essentially almost everything under the sun, what is your personal 80/20 that you prioritize, whether it be daily or cyclically, for your own health and for anti-aging?

Amy: You know, and I do have access to stem cells and exosomes, and I can do infusions, and I do, and they’re great. But I honestly think that prioritizing sleep is probably my number one. I went for 15 years between training and being an ER doctor and having young kids, which obviously you understand. I just went all these years not sleeping more than a few hours a night. And when I made that switch and started learning how to sleep and prioritizing sleep, it changed everything for me. Like, I lost weight without trying, my mood was better. Like, I was like, what is happening? I don’t even know who I am anymore. It’s just amazing. So that’s my, that’s like a big one. I won’t compromise on that.

And then exercise obviously is a… Well, weight training especially. And then, you know, I think if you want to add in other cool stuff like other, you know, stem cells or light or light therapy or some of these other tools, that’s great. But if you don’t have the foundations, I think that’s one of the mistakes that biohackers kind of make some of them is using all the gadgets but not actually have gotten the foundational stuff really dialed in yet. And to me, if you don’t dial in the foundational stuff, then the gadgets are, they’re nothing. They’re not going to help you that much.

Katie: I fully agree. And if you have those foundational things dialed in, the gadgets or the supplements will all be more effective because your body’s going to be in a better place to receive and process all of that to begin with. And you’re a mom as well. So i’m curious which of these habits you’ve integrated with your kids and at what ages. And I know you probably also have the conversations around these things all the time with them. So it’s probably led partially by their interest, but which things have also made it into your family culture or that your kids now do regularly?

Amy: Well, I have a couple of kids, two of my kids like to do cold plunges. So we’ll do in the yards, certainly in lakes and things around that. So we like to do cold plunges and that’s a lot of fun together. My husband has decided that hot tubs are the equivalent to a sauna. So he just spends a lot of time in the hot tub. I’m not sure if that’s really helping or not. But, but, but I think but maybe, you know, I tried to I think the sleep piece is the probably the thing that they actually listen to. They’re all very good sleepers and it’ll be like nine o’clock at night and my daughter will just get up and walk and go to bed and she’s like, I’ll see you tomorrow. And she just knows that she feels better when she sleeps.

We also have time outdoors and I think getting out and hiking and mountain biking and doing things like that is fun. We enjoy it, but I do think that the activity plus the sunlight plus the getting off of your phones and devices and having your brain have to just entertain itself for a while, I think all of those things are really important as well.

Katie: Agreed. And I know sleep can always be the biggest challenge for moms, especially with little kids, for sure. But I agree with you completely. Anytime we can help make that a priority for our kids in a way they can own it from a young age, I think that’s going to pay dividends for their health from a lifelong perspective as well. And you mentioned, I want to make sure we also make sure people can find and learn from you more. So I know that you have a practice, you also have a website, and you also have a supplement company. So walk us through where people can find you and keep learning from you. And if you’re taking new patients, how people can work with you.

Amy: So yeah, thank you. So my website is dramykillen.com. That has links to a lot of other things on there, if you can’t find me from that. My supplement company is called HOP Box, h-o-p-b-o-x. So it’s hopbox.life. And we have the longevity box there. We also have a starting in a couple of weeks, we’re going to be launching our longevity challenge, which is a 26 day longevity challenge called the beams challenge. And beams stands for belong, eat, activate, moves, stress, sun and sex. And so we’re going to have some very specific, easy things you can sort of implement and add on every day to start moving the needle or whatever in the right direction for longevity and health and how you feel. So that’s also on the HOP Box website.

And then I also have a clinic, I have a stem cell clinic in Park City, Utah. That’s a Dossary Clinics and I am taking new patients there for stem cells. I have a few other clinics as well that I don’t see new patients at, but I can refer you to those clinics if you want to see another provider. But I am sort of involved in those clinics, but i’m not seeing patients there.

Katie: Love it. And a few questions I love to ask at the end of interviews. The first is if there’s a book or number of books that has had a profound impact on you personally and if so, what they are and why.

Amy: So you know books that I read in the last few years that I keep coming back to is Comfort Crisis by Michael Easter. I think that that is it. It’s an amazing book about the importance of kind of being uncomfortable and he has this one bit in there where he talks about how we’re living in a progressively sheltered, sterile, temperature controlled, overfed, under challenged, safety netted lives. And I think that that idea is so true and that it’s the importance of being uncomfortable, the importance of being alone with your thoughts, of being a little hungry sometimes, and being okay with that, I think is powerful and helps me get through some of those times where i’m uncomfortable. I’m like, this is good for me, I should be uncomfortable. So I like that one a lot.

Katie: That’s wonderful. That’s a new recommendation for me. I’m excited to check it out. And lastly, any parting advice for the listeners that could be related to the topics we’ve covered or unrelated life advice that you find helpful.

Amy: One of my favorite quotes that someone told me at one point was, it’s better to be brave than perfect. And I love that quote, because I grew up kind of thinking I had to be perfect, you know, get good grades, look a certain way, act a certain way. But what i’ve learned as i’ve gotten older is that, you know, being brave and just going out and trying new things is way more important. And so I think that it’s, you know, I think that you as a person have so much power over your health, you have so much power over your life. And it does, you know, it does require you being brave and getting out of your comfort zone to go out and try new things, but that it ends up being really worth it if you take a few steps out of your comfort zone.

Katie: I love that. Amy, thanks so much for the time. It’s so fun to get to chat and record and share it. Thanks for all that you’ve shared today.

Amy: Thank you. Bye.

Katie: And thanks to all of you for listening and sharing your most valuable resources, your time, your energy, and your attention with us today. We’re both so grateful that you did. And I hope that you will join me again on the next episode of The Wellness Mama podcast.

If you’re enjoying these interviews, would you please take two minutes to leave a rating or review on iTunes for me? Doing this helps more people to find the podcast, which means even more moms and families could benefit from the information. I really appreciate your time, and thanks as always for listening.

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