The Optispan Podcast with Matt Kaeberlein

What if you had more control over your brain's future than you think? Dr. Tommy Wood, neuroscientist, Associate Professor of Pediatrics at the University of Washington, and head of science for motorsport at Hintsa Performance, joins Dr. Matt Kaeberlein to discuss his new book, The Stimulated Mind. From the science of neuroplasticity to the real drivers of dementia prevention, this episode is packed with evidence-based, actionable insight.Timestamps:0:00 — Introduction: Brain fog, burnout & why our brains feel under strain1:42 — Age-specific dementia incidence has been declining — why no one talks about it2:05 — Why Dr. Wood wrote The Stimulated Mind4:59 — Dr. Wood's background: Cambridge, Oxford, Oslo, and UW8:30 — How a PhD in neonatal brain injury led to elite athlete performance work11:20 — The Keto CTA Trial: ApoB, LDL, and plaque formation on a ketogenic diet15:50 — Can you still have metabolic dysfunction on a long-term keto diet?17:17 — What the keto trial actually found — and why the original results were retracted23:53 — Working with Formula One drivers: biomarkers, blood panels & performance29:51 — Magnesium: is everyone actually deficient?30:33 — The zinc-copper problem in athletes — and why B6 stacks up in their blood34:03 — Why elite athletes use fewer supplements than you'd expect35:19 — Sleep tracking with wearables: HRV, respiratory rate & what actually predicts performance39:53 — Why Dr. Wood wrote The Stimulated Mind (deeper dive)42:16 — Dementia: confluence of factors, individual trajectories & the Lancet projections44:23 — GLP-1s, metabolic disease & shifting dementia projections49:00 — The adult brain is NOT fixed: neuroplasticity across the lifespan52:44 — Is promoting neuroplasticity always beneficial? TMS and the "sledgehammer" problem57:02 — Exercise as a neuroplasticity tool: the 20–30 minute jog protocol58:26 — Arousal, the Yerkes-Dodson curve & how mistakes drive learning1:01:17 — Cold exposure, bright light & breathwork as arousal tools1:04:11 — Psilocybin and neuroplasticity: therapeutic promise vs. open questions1:06:39 — Can grief induce neuroplasticity? An unexpected connection1:08:03 — The 3S Model: Stimulus, Supply & Support for brain health1:15:26 — Education, cognitively stimulating jobs & making up for early deficits1:17:49 — The ACTIVE Study: the brain training game with 20-year dementia data1:23:31 — Video games, exercise & what's actually building cognitive reserve1:25:03 — Supply: why cardiovascular and metabolic health are critical for the brain1:26:29 — Key nutrients for brain health: omega-3s, B vitamins, vitamin D & iron1:27:14 — The Vitacog study: why omega-3 index and homocysteine must be optimized together1:29:59 — PDE5 inhibitors (Viagra/Cialis) and dementia risk — what the data says1:32:30 — Cognitive supplements: what actually has evidence (and what doesn't)1:35:41 — Rapamycin and cognitive function: cerebral blood flow & immune resilience1:38:43 — The best exercise for your brain: Zone 2, HIIT, resistance training & sport1:44:34 — Nutrition strategy for cognitive aging: whole foods, polyphenols & berries1:47:46 — Support: sleep, trophic factors & hormonal health1:48:31 — Testosterone, estrogen & menopause: what hormone therapy can and can't do for the brain1:52:21 — Air quality, chronic stress & environmental exposures as dementia risk factors1:54:19 — Chronic stress as "overtraining" for the brain

Dr. Matt Kaeberlein and Clinical Director Dr. Nicki Byrne tackle your most pressing supplement questions in this AMA episode, cutting through the hype to give you science-backed answers you can actually use. From CoQ10 and statins to sulforaphane influencer hype, creatine and kidney disease, and why a popular longevity doctor may be losing Matt's trust, this episode covers a lot of ground. If you've ever wondered which supplements are worth your money and which ones belong in the trash, this one's for you.Timestamps:00:00 — Cold open highlights01:18 — Episode intro: AMA focused on supplements01:57 — CoQ10: Does it help with statin-induced muscle pain?04:43 — Is there any reason to take CoQ10 on its own?05:23 — Taurine: Promising or overhyped?07:35 — Astaxanthin: What the evidence actually shows09:45 — Why supplement research is structurally flawed11:05 — Creatine for plant-based dieters12:22 — Creatine and kidney disease: What the data says15:48 — Matt, Nicki & Nick's current creatine doses17:00 — Vitamin D: Reference ranges vs. optimal ranges18:57 — Vitamin K2: Bone density, vascular calcification & dosing caution21:55 — Sulforaphane: Great biology, limited evidence, too much hype27:21 — Resveratrol, hormesis & plant defense chemicals27:58 — Fish oil & the omega index: Why Matt supplements even though he eats fish29:23 — Mark Hyman, sirtuins & the problem with longevity influencers32:08 — Lithium & SGLT2 inhibitors: Matt adjusts his dose live34:15 — Is lithium orotate safe? Addressing the liver carcinogen concern36:26 — Is there an OTC alternative to rapamycin?37:40 — Berberine vs. metformin: More similar than you think38:58 — What do Matt, Nicki & Nick actually take?41:48 — Wrap-up & teaser: Deep dive on magnesium coming soon

The Galleri multi-cancer detection test made headlines when its landmark NHS trial failed to meet its primary endpoint, sending Grail's stock down nearly 50%. But does that mean Galleri is useless? Not exactly.
In this episode, Dr. Matt Kaeberlein breaks down what the NHS Galleri trial actually measured, why missing a primary endpoint doesn't tell the whole story, and what the results mean for three distinct groups: the general population, high-risk individuals, and people considering the test for themselves.Timestamps:0:00 — What is Galleri? Multi-cancer detection explained0:44 — Would Dr. Kaeberlein take the test? ($1,000 question)1:29 — Episode overview: defense, takedown, or something else?2:30 — How Galleri works: circulating tumor DNA and methylation3:23 — The core promise: early detection across 50+ cancer types4:20 — The NHS Galleri trial: 140,000 participants, 3 years5:15 — Trial results, the press release spin, and the stock drop5:59 — How OptiSpan currently uses Galleri in practice6:43 — Pre-trial take: not ready for population screening, but why?7:32 — The real risks: false positives, false negatives, and downstream consequences9:05 — What it takes to justify population-level screening10:48 — Inside the NHS trial design12:40 — Why the trial was set up to be difficult from the start13:29 — What the positive signals in the data actually suggest15:49 — High-risk individuals: does Galleri make sense for them?17:38 — Individual-level decision-making: what you need to consider18:33 — Sensitivity and specificity explained plainly22:07 — Walking through the math: false positives in the real world24:20 — Retesting after a positive signal: an open question25:00 — Sensitivity by cancer stage and aggressiveness25:45 — Final verdict: does Galleri have clinical value?27:25 — Dr. Kaeberlein's personal decision on taking the test

What if menopause is one of the most important longevity events in human biology, and we've been ignoring it?

Dr. Matt Kaeberlein sits down with Dr. Jennifer Pearlman, founder of PearlMD and pioneer in female-centric longevity medicine, to unpack why women's health has been systemically underfunded, undertreated, and misunderstood and what a proactive approach actually looks like.

From the flawed science behind the Women's Health Initiative to the nuts and bolts of hormone optimization, testosterone for women, and the emerging field of ovarian tissue cryopreservation, Dr. Pearlman brings 20+ years of clinical expertise and a framework she calls FemSpan: harnessing the unique biology of female longevity while mitigating the risks most medicine ignores.

Timestamps:
00:00 — Cold open
00:47 — Welcome & Dr. Pearlman's origin story
02:33 — Why the medical system fails women
08:37 — How the women's health landscape has shifted over 20 years
09:26 — The Women's Health Initiative: what went wrong
13:07 — What drove the reemergence of menopause medicine
14:38 — Big Pharma, funding, and the micronized progesterone question
17:13 — "Medicine progresses one funeral at a time"
18:01 — From functional medicine to precision medicine
20:35 — Rebranding aging: from anti-aging to longevity
23:50 — Navigating the gray zone between frontier and fringe
27:46 — How to identify credible practitioners
33:32 — What every woman should know about the menopause transition
36:41 — Why take a proactive approach? Symptoms, disease risk, and aging
38:19 — The two simultaneous biology processes of menopause
41:46 — The role of FSH and hormone optimization
43:28 — Estradiol as the body's regenerative signal
47:24 — What to test and when
50:38 — The metabolic theory of menopause
55:08 — Visceral fat as an evolutionary adaptation
57:26 — How to navigate hormone therapy
01:00:24 — Bioidentical hormones: reclaiming the term
01:06:45 — Why route of administration matters
01:11:35 — Progesterone: the unsung hero of menopause management
01:23:19 — Testosterone for women: what the science actually says
01:34:25 — Introducing FemSpan: the female longevity framework
01:37:55 — The biological aging advantages women carry
01:46:46 — Can we close the healthspan gap?
01:53:05 — Could reversing menopause extend female lifespan?
02:00:29 — Regenerative medicine and the future of female longevity
02:03:10 — Ovarian tissue cryopreservation explained
02:10:39 — AI in women's precision medicine
02:15:50 — Medicine at scale: opportunity and risk
02:21:41 — Advanced cardiovascular diagnostics and the female gap
02:24:22 — Closing thoughts: your aging trajectory is more in your control than you think

Dr. Kim Brockenbrough: https://www.cardiavision.com/https://www.linkedin.com/in/kimberly-brockenbrough-md-1b321a123/https://www.instagram.com/kimbromd?ighsh=YjVpcDcwdHA3ejVvYour calcium score came back zero. You're in the clear, right? Not so fast.In this episode, Optispan Clinical Director Dr. Nicki Byrne sits down with Dr. Kim Brockenbrough, board-certified cardiovascular radiologist, 25-year veteran of vascular imaging, and CEO of CardiaVision, for a conversation that challenges one of the most common assumptions in preventive cardiology.If you care about cardiovascular longevity, and you should, because heart disease remains the leading killer, this is the imaging conversation you didn't know you needed.Timestamps:00:00 — Cold open: The 48-year-old runner with an 80% blockage and a zero calcium score00:54 — Dr. Nicki Byrne introduces Dr. Kim Brockenbrough & CardiaVision01:45 — Dr. Brockenbrough's background: 25 years of vascular imaging02:35 — Cardiovascular disease through a longevity lens: imaging vs. labs vs. functional testing03:24 — The lifecycle of plaque: from fatty deposits to rupture and heart attack04:21 — Why soft plaque is more dangerous than calcified plaque (SCOT-HEART 2020)05:14 — How calcium scores are used in clinical practice — and where they fall short06:18 — The only way to see soft plaque non-invasively: coronary CT angiography (CCTA)07:08 — Which populations are most at risk of a false sense of security from calcium scoring08:03 — What a CCTA can tell you that a calcium score can't09:43 — How often should patients follow up with repeat scans?10:28 — Higher vs. lower dose radiation protocols — and why Dr. Brockenbrough chooses higher dose11:17 — Risks of CCTA: contrast reactions, kidney considerations12:15 — Stress tests vs. CCTA: why a negative stress test is a very low bar13:21 — Soft plaque that isn't flow-limiting: small emboli, dementia, and congestive heart failure15:36 — Medications that reverse plaque: statins, PCSK9 inhibitors, and the LOCATE trial16:23 — LDL reduction and plaque regression: what the data shows17:08 — High-intensity statins vs. Repatha — tolerability, efficacy, and the price drop18:27 — When OptiSpan reaches for PCSK9 inhibitors: ApoB, LDL, Lp(a), ApoE4, and significant disease19:22 — Why a rising calcium score on a statin is exactly what you want to see20:25 — AI plaque quantification tools: promise, limitations, and validation concerns22:54 — Has AI ever changed Dr. Brockenbrough's read? A real-world case23:40 — FFR-CT, the ISCHEMIA trial, and why stenting asymptomatic patients is no longer standard of care25:25 — The future of cardiac imaging and the case for universal CCTA screening26:52 — The patient experience: what to expect at a CardiaVision CCTA appointment28:18 — Why seeing soft plaque changes patient behavior — the power of treating disease, not numbers29:49 — Bridging the gap between longevity medicine and traditional cardiology33:11 — Testosterone, the TRAVERSE trial, and what you should know about your coronaries first35:41 — What causes coronary artery disease beyond cholesterol: sugar, inflammation, gum disease37:07 — Image walkthrough: soft plaque vs. calcified plaque on a real CCTA41:36 — Where to find Dr. Brockenbrough and CardiaVision