The Prescription Strength Podcast

In this episode, I'm joined by Dr Fraser Gordon, consultant physician in the NHS and founder of Xvera Medical, a consultant-led online clinic offering testosterone replacement, perimenopause and menopause care, and weight management.

Fraser started out in pharmacology and research into adverse drug reactions before moving into medicine, and has spent twenty years working at the acute end of the NHS. What finally pushed him into private practice was watching medicine become more commercial: people confidently presenting opinions as established facts, and forgetting the basic scientific and statistical principles that need to sit behind them.

We talk about why simple explanations are so easy to believe, from rhyming sayings to adrenal fatigue, a claim he found convincing at first and says has no real scientific basis. We talk about finding a patient to fit a treatment rather than a treatment to fit the patient, and why a test needs a question before it is done, explained with a police officer, New Year's Eve and a woman in a pink unicorn hat.

We also get into the commercial pressure that comes with owning a private clinic. When his marketing team asked for a target conversion rate of 95%, his answer was that converting nearly everyone would mean the clinic was not doing the right job. Not prescribing, he argues, isn't a failure. We talk about a young stroke patient who would not take a statin but was using anabolic steroids and recreational drugs, and what that says about risk perception and marginal gains. And we talk about menopause care, why he was adamant the clinic had to offer it, and the gaps in what doctors are taught.

In this episode:
From pharmacology to medicine, and why the clinic exists
A finite NHS and an almost infinite demand
Adrenal fatigue, and why simple explanations are so believable
Finding a patient for a treatment, and pretest probability
Home testing kits and scans without a clinical question
GLP-1s, and what happens when the treatment stops
Conversion rates, and why a no can be good care
Treating the person, not just the disease
A young stroke, statins and risk perception
Menopause care, HRT and the gaps in medical training
Checking that the person you see is registered and regulated
The one thing you would fix with a magic wand

As Fraser puts it: it's better medicine, done properly.

Find out more about Xvera Medical: https://xveramedical.com

If you enjoyed this, listen back to my conversation with Roxanne Stevenson Brown, founder of Find Care Compare, about finding your way between NHS and private care: "Who Should I See? Navigating NHS and Private Healthcare": https://pod.link/1762298788/episode/OTM4MjdlYjItMTQyYy00ZjhhLWI3N2YtZDU4NTIzNmY3OGIy

In this episode, I'm joined by Sir Muir Gray, public health doctor and one of the people behind the NHS programme Live Longer Better.

Anti-ageing is booming, and with it the idea that if you optimise yourself enough, you can add years to your life. Muir's take is that ageing itself, the normal biological process, is not the cause of major problems until our late nineties. What causes most of the problems we put down to age is three other things: loss of fitness, disease, and the world we live in.

We talk about why your genes matter much less than was once thought, and why what he calls your exposome, everything you have been exposed to since birth, matters far more. Muir explains why he never uses the word lifestyle, why he wants chairs recognised as an occupational hazard, and why he stands up from his chair 82 times a day.

We also talk about the risk of caring too much. Thirty years ago Muir wrote an article in The Lancet asking whether we care too much for our elders, and he would still like to change the word carer to enabler. And he sets out what actually matters if you are 50 or 60 and want to make a difference to the years ahead: a Mediterranean diet, thirty minutes a day of brisk walking, ten minutes for strength, suppleness and skill, and keeping your brain and your social life busy.

In this episode:
Why ageing itself is not the problem until your late nineties
Genes, the exposome, and what your parents died of
Loss of fitness, and the five S's
Why the NHS is a national disease service
Clubs, communities, and moving a little money out of the NHS
Do we care too much for our elders?
Retirement as a renaissance, and retirement regret
What matters at 50 or 60: diet, activity and staying engaged
Creative health, and staying connected when you can't get out
What a clinician can do in nine seconds

As Muir puts it: it's never too late.

Find out more about Live Longer Better: https://www.livelongerbetter.uk

If you enjoyed this, listen back to my conversation with Christine Hobson, who ran her first marathon in her 60s: "At 50 She Was Struggling. At 73, She's Fitter Than Ever": https://pod.link/1762298788/episode/ZTkyNGE1YTYtZDM3ZC00NzY5LWI0ZTMtNWU3NDlmZDU4ZmRk

In this episode, I'm joined by Mick Wadge, the 88-year-old weightlifting grandad who has taken TikTok by storm, and his coach, Ross Starkie.

Mick spent years caring for his wife Margaret, who had rheumatoid arthritis and osteoporosis. When she died, he found himself at a loss, and carrying far more weight than he wanted to. So he took an old broom handle, hung two milk bottles full of water on it, and started training on his patio.

When he turned 85, his grandson booked him four sessions with Ross, a strength and conditioning coach who works with professional athletes. Three years on, Mick has deadlifted 100kg, come off his metformin, had a letter from Arnold Schwarzenegger and lifted on national television.

We talk about why so many people, health and fitness professionals included, are frightened of older people lifting weights, and why Ross thinks doing nothing is the bigger risk. Ross explains how he coached Mick up from an empty bar with nothing more complicated than adding a little weight over time, and why the things Mick already did every day were a squat, a hinge and a deadlift by another name.

We also talk about getting up off the floor, a skill that can matter far more than any personal best, and the technique Ross taught Mick that local firefighters have since asked to share.

In this episode:
Caring for a partner, and putting your own health last
Starting with a broom handle and two milk bottles
Why a council gym can be a great place to start
What structured coaching adds as you get older
Why coaches are nervous of training older clients
Angina, prediabetes, and why Ross says keep the coffee and cake
Getting up off the floor, and why it matters
Arnold Schwarzenegger, This Morning, and saying no to Britain's Got Talent
What to look for in a gym and a coach
Why it is never too late to start

As Ross puts it: it's scarier not to do anything at all.

Follow Mick on TikTok: @old.man.mick2

If you enjoyed this, listen back to my conversation with Christine Hobson, who ran her first marathon in her 60s: "At 50 She Was Struggling. At 73, She's Fitter Than Ever": https://pod.link/1762298788/episode/ZTkyNGE1YTYtZDM3ZC00NzY5LWI0ZTMtNWU3NDlmZDU4ZmRk

Women’s health is about far more than hormones and HRT. In this episode, I’m joined by scientist and researcher Dr Gayathri Delanerolle, whose experience of endometriosis, pregnancy loss and medically induced menopause helped shape the questions she now asks in her research.
Gayathri shares what it was like to live with severe symptoms for years, why finally seeing the extent of her endometriosis brought both relief and difficult questions about fertility, and how those experiences led her to develop the Marie Project.
We talk about gaps in women’s health research, the experiences that conventional menopause discussions can miss, and what Gayathri is learning by listening to women across different countries and cultures. It’s a conversation about asking better questions—and making room for the answers women actually give.

In this episode, I’m joined by Dr Andy Ward, a GP working with people experiencing homelessness in Leicester, and Kyra Biddle from Dear Albert’s Stairway Project, who brings her own lived experience of homelessness, addiction and recovery.
Kyra shares what happened when her family lost their home when she was just 14, how alcohol became a way of coping, and what it really means to live in survival mode.
We talk about the barriers people experiencing homelessness can face when trying to access healthcare, why appointments, medication and even apparently simple health advice can become almost impossible to navigate when you don’t have somewhere safe to live, and how stigma can destroy trust.
Andy explains how working in homeless healthcare changed the way he practises medicine, and why behaviour that can look “difficult” makes much more sense when you understand what someone may be living through.
But this is also a conversation about recovery. Kyra is now more than four years into her own recovery and uses her experience to support others. We talk about what helped her, why being listened to and treated as a human being matters, and how sometimes the beginning of recovery can be as simple as a cup of tea, a Hobnob and somewhere you feel welcome.
A conversation about homelessness, addiction, healthcare, recovery — and the importance of seeing the person in front of you.

You can contact Dear Albert here: https://www.dearalbert.co.uk

See the fantastic work of Inclusion Healthcare here: https://www.inclusionhealthcare.co.uk