Extend Podcast with Darshan Shah, MD

What if your risk of Alzheimer's isn't predetermined by your genes—but influenced by the metabolic health of your brain?
My guest, Dr. David Perlmutter, is a board-certified neurologist, six-time New York Times bestselling author, and one of the world's leading voices on brain health and neurodegenerative disease. His latest work reveals a fascinating shift in how we understand Alzheimer's and Parkinson's: the role of the brain's own immune cells.
At the center of our conversation are microglia—specialized immune cells that can either protect your neurons or contribute to inflammation and neurodegeneration. Dr. Perlmutter explains why their function is closely connected to metabolic health, and how insulin resistance, obesity, poor sleep, gut dysfunction, chronic inflammation, and environmental toxins may influence the way your brain ages.
We also challenge the idea that carrying APOE4 means Alzheimer's is inevitable and examine research showing how lifestyle interventions can influence cognitive function—even later in life.
In this episode, you'll learn:
• How microglia can shift from "brain defenders" to drivers of neuroinflammation
• Why metabolic health and insulin resistance are connected to Alzheimer's risk
• How the gut microbiome, leaky gut, antibiotics, and inflammation can affect the brain
• What emerging research says about GLP-1 drugs for Alzheimer's and Parkinson's
• Why current amyloid-targeting Alzheimer's drugs may not address the underlying problem
• How sleep, exercise, nutrition, and environmental exposures can influence cognitive aging
We also explore emerging approaches to brain health, including 40 Hz light and sound therapy, TREM2, mitochondrial health, and metabolic monitoring.
The biggest takeaway for me is that protecting your brain starts long before memory loss appears. Your genetics matter—but so do your metabolism, sleep, exercise, environment, and the choices you make every day.
You have more influence over how your brain ages than you may think.
Learn more about Dr. Shah:
Website: drshah.com
Clinic: next-health.com
Instagram: @extend_podcast and @darshanshahmd
Learn more about Dr. David Perlmutter: 
Website: drperlmutter.com
Dr. Perlmutter's groundbreaking new book, Brain Defenders, is now available. Discover how to protect your brain and future health - order today at braindefenders.com
Thank You to Our Sponsors: 
Next Health Longevity Summit: Head to next-health.com/summit to secure your spot at the first ever Next Health Longevity Summit in Nashville on September 12th!
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What if the biggest mistake we're making with gut health is treating the microbiome like a list of bacteria instead of a living ecosystem?
Your gut is home to trillions of microorganisms that influence inflammation, metabolism, immune function, hormones, brain health, and longevity. But modern life—from ultra-processed foods and antibiotics to pesticides, chronic stress, and inadequate fiber—may be systematically stripping away the microbial diversity we need to stay healthy.
My guest, Kiran Krishnan, is a research microbiologist and microbiome expert who has spent nearly two decades studying these complex microbial ecosystems. He co-founded Microbiome Labs and has helped develop microbiome testing and clinically studied probiotics.
Kiran introduced me to the concept of the holobiome: the idea that we aren't simply human cells and human DNA, but walking ecosystems containing millions of microbial genes that perform essential functions throughout the body.
We explore what's actually damaging that ecosystem, how poor gut health can contribute to leaky gut, endotoxemia, systemic inflammation, and metabolic dysfunction, and most importantly, what we can do to rebuild it.
Kiran breaks down how much fiber we should actually be eating, the difference between soluble and insoluble fiber, why resistant starch and polyphenols matter, what fermented foods really do, and how to think about probiotics and microbiome testing. We also discuss how fasting, sleep, resistance training, outdoor exposure, and even social connection can influence microbial diversity.
In this episode, you'll learn:
• Why microbial diversity may be one of the most important markers of gut health
• How antibiotics, ultra-processed foods, pesticides, and stress can disrupt the gut microbiome
• How leaky gut, endotoxemia, chronic inflammation, and metabolic health are connected
• How fiber, resistant starch, fermented foods, polyphenols, and probiotics support the gut
• Why sleep, fasting, exercise, outdoor exposure, and social connection can help build a more resilient microbiome
We also explore the future of gut health, including the limitations of current microbiome testing and how Kiran is using AI and machine learning to develop targeted probiotic combinations around specific biological pathways.
My biggest takeaway is that gut health isn't something we fix with one supplement. We are guardians of an incredibly complex ecosystem—and the choices we make every day can either support it or slowly dismantle it.
If we want to improve longevity, metabolic health, inflammation, and chronic disease prevention, taking care of our microbiome may be one of the most powerful places to start.
Learn more about Dr. Shah:
Website: www.drshah.com
Clinic: next-health.com
Instagram: @extend_podcast and @darshanshahmd
Learn more about Kiran Krishnan: 
Website: biomelc.com
Instagram: @kiranbiome
Special offer from Kiran! Join the free Circe community here to get the FREE Leaky Gut Guide and The 5 Pillars to Building a Resilient Gut. 
Thank You To Our Sponsors: 
Next Health Longevity Summit: Head to next-health.com/summit to secure your spot at the first ever Next Health Longevity Summit in Nashville on 9/12! Our speakers include Dr. Shah, LeAnn Rimes, Dr. Jeremy London, Dr. Louisa Nicola, Dr. Vonda Wright and many more! This is one day packed with activities like blood tests, recovery modalities, IV's and brands we love that will completely change the way you think about health. 
Momentous: Head to livemomentous.com and use code DRSHAH for up to 35% off your first order!

What if one of the most important markers for your heart, brain, and longevity is something most people have never measured? AND roughly 90% of Americans aren't in the optimal range for? 
In this episode, I sit down with Dr. William Harris, one of the world's leading experts on Omega-3 fatty acids and the co-inventor of the Omega-3 Index, a test he helped develop more than 20 years ago. Dr. Harris has spent decades researching how omega-3s influence cardiovascular health, inflammation, cognitive health, chronic disease, and longevity. And his message is surprisingly simple: you can't know whether you're getting enough omega-3 just by looking at your diet or supplement routine. You have to measure it.
We break down what omega-3s actually do inside your cells, why Dr. Harris believes an Omega-3 Index of 8–12% is the target, and why measuring EPA and DHA in red blood cell membranes gives you a more stable picture of your status than plasma testing. We also tackle some of the biggest controversies in nutrition today—including seed oils, omega-6s, saturated fat, LDL cholesterol, fish versus supplements, EPA versus DHA, and whether you really need to worry about the omega-6 to omega-3 ratio. Dr. Harris also explains why some of the conventional wisdom circulating online simply doesn't match what decades of research actually show.
In this episode, you'll learn:
Why roughly 90% of Americans may be below the optimal Omega-3 Index
What the Omega-3 Index measures and why the target range is 8–12%
Why red blood cell testing can provide a better picture of omega-3 status than plasma testing
How omega-3s help maintain healthy, flexible cell membranes
What EPA and DHA actually do—and why you need both
What the research really says about omega-6s and the seed oil controversy
Why Dr. Harris doesn't recommend focusing on the omega-6 to omega-3 ratio
How chronically elevated LDL contributes to atherosclerotic cardiovascular disease
Why low omega-3 levels have been associated with earlier mortality, cardiovascular disease, cognitive decline, and other chronic diseases
Why eating "fish" doesn't necessarily mean you're getting enough omega-3
The best food sources of EPA and DHA, including salmon, mackerel, sardines, anchovies, and albacore tuna
What to look for when choosing an omega-3 supplement
Why vegans can still get EPA and DHA through algae-based omega-3s
How often Dr. Harris recommends retesting once you're optimizing your Omega-3 Index
Listen to this episode if you take omega-3s, eat fish, care about your heart and brain health—or simply want to know whether you're actually getting enough of one of the most important nutrients for healthy aging. Because when it comes to omega-3s, taking a supplement isn't the goal. Getting your biology into the optimal range is. 
Learn more about Dr. Darshan Shah: 
Website: www.drshah.com
Clinic: https://www.next-health.com
Instagram: @extend_podcast and @darshanshahmd
Learn more about Dr. William Harris: 
Website: www.faresinst.org
Omega-3 At Home Test Kit: https://omegaquant.com/
Thank You To Our Sponsors: 
Next Health Longevity Summit: Head to next-health.com/summit to secure your spot at the first ever Next Health Longevity Summit in Nashville on 9/12. Our speakers include Dr. Shah, Dr. Jeremy London, Dr. Louisa Nicola, Dr. Vonda Wright and many more! This will be one day packed with activities like blood tests, recovery modalities, IV's and brands we love that will completely change the way you think about health.
Momentous: Head to livemomentous.com and use code DRSHAH for up to 35% off your first order!
IM8: Try IM8 today with a 30-day money back guarantee. Get 10% off your first order with code DRSHAH at im8health.com/drshah

What if aging isn't something you simply accept - but something you can measure, predict, and even reverse? 
Most of us are told our lab work is "normal," yet chronic disease often develops silently for years before symptoms appear. Dr. Florence Comite, one of the world's leading pioneers in precision medicine, is explaining why conventional medicine often misses the earliest signs of diesease- and how personalized data can completely change your health trajectory. 
Drawing from more than three decades of experience at Yale, the National Institutes of Health, and her own precision medicine practice, Dr. Comite shares how treating every patient as an "N-of-1" allows her to identify hidden risks years before they become heart disease, diabetes, osteoporosis, dementia, or hormonal decline. Together, they explore the biomarkers that matter most, the surprising role of insulin resistance in nearly every chronic illness, and why your genes are far less predictive than the choices you make every day. 
If you've ever wondered whether it's possible to stay stronger, sharper, and healthier as you age, this conversation offers a practical roadmap backed by decades of research and real-world clinical results. 
In this episode, you'll learn: 
Why precision medicine is replacing the outdated one-size-fits-all approach
The seven biological patterns of aging-and how to identify your own
The biomarkers that reveal disease years before symptoms appear
Why fasting insulin may be one of the most important tests your doctor isn't ordering
How continuous glucose monitors uncover hidden metabolic dysfunction 
The truth about testosterone and estrogen optimization for both men and women
How to reverse muscle loss and protect your bone density as you age
Why standard thyroid testing often misses underlying dysfunction
The daily habits that create exponential improvements in long-term health
How to build a personalized longevity strategy based on your own biology-not population averages
Your biology is unique - your approach to aging should be too. 
Learn More About Dr. Shah: 
Website: drshah.com
Clinic: next-health.com
Instagram: @extend_podcast and @darshanshahmd
Learn more about Dr. Florence Comite:
Website: florencecomite.com
Instagram: @drflorencecomite
Book: theinvinciblebook.com
Thank You To Our Sponsors:
Next Health Longevity Summit: Head to next-health.com/summit to secure your spot at the first ever Next Health Longevity Summit in Nashville on 9/12. Our speakers include Dr. Shah, Dr. Jeremy London, Dr. Louisa Nicola, Dr. Vonda Wright and many more! This will be one day packed with activities like blood tests, recovery modalities, IV's and brands we love that will completely change the way you think about health. 
Momentous: Head to livemomentous.com and use code DRSHAH for up to 35% off your first order!
IM8: Try IM8 today with a 30-day money back guarantee. Get 10% off your first order with code DRSHAH at im8health.com/drshah

We're living in a culture that celebrates being busy. More coffee. More hours. More hustle. But what if those things are actually making you less productive? 
The truth is, many high performers are stuck in a cycle of chasing energy instead of creating it. We rely on caffeine to wake up, push through stress, and squeeze more into each day - only to end up burned out, distracted, and wondering why success still feels exhausting. 
My guest James Beshara, is an entrepreneur, angel investor, and founder of multiple  Magic Mind, one of the fastest-growing mental performance brands. After experiencing burnout firsthand, he set out to rething what sustainable productivity really looks like. 
Together, we explore why optimizing your energy matters more than optimizing your schedule, the hidden costs of caffeine and stimulant dependence, and how adaptogens, functional mushrooms, intentional routines, and timeless philosophy can help you perform at your highest level - without sacrficing your health. 
In this episode, we discuss: 
Why sustainable productivity beats hustle every time
The "Pin Action" framework for creating outsized results with one simple habit
How a consistent morning routine can transform your energy and focus 
Why process-not goals- is the real key to long - term fulfillment 
The surprising downsides of caffeine and other stimulants 
How adaptogens and functional mushrooms can support cognitio, stress resilience, and performance
Practical strategies to overcome procrastination and reduce chronic stress
Whether you're building a business, leading a team, or simply trying to feel your best every day, this conversation will change the way you think about productivity - and what it actually takes to perform at your highest level. 
Learn more about Dr. Shah:
Website: drshah.com
Clinic: next-health.com
Instagram: @extend_podcast and @darshanshahmd
Learn more about James Beshara
Website: jjbeshara.com
Instagram: @jamesjbeshara
Try Magic Mind for 50% off new subscriptions to enhance your mental performance with clincally backed multivitamins for your mind at www.magicmind.com !
Thank You to Our Sponsors: 
Next Health Longevity Summit: Head to next-health.com/summit to secure your spot at the first ever Next Health Longevity Summit, featuring keynotes by Dr. Shah, Dr. Vonda Wright, Dr. Jeremy London and Dr. Louisa Nicola! September 12th in Nashville, see you there! 
Function Health: Learn more and join using my link - www.functionhealth.com/drshah using gift code DRSHAH25 for $25 credit towards your membership.