systems. serendipity.

Protocols for Longevity, Health, and Productivity - a work in progress.

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  • This is where I’ll be sharing my protocols for health and productivity. I recently fell down the rabbit hole of longevity research, due to which I've slowly added several supplements to my routine and changed my approach to exercise a little bit. It's not like I've unlocked the secret to eternal youth, but it's made me look at exercise, supplements, and food in a whole new light.

    I hope you will find this information helpful or just interesting. If you have questions or find any errors on this site, please connect with me on Instagram!

  • This is a warning against changing too many things at once in your life. In behavior modification, it is usually LESS beneficial to start or change too many habits at once. You want to let a new intervention play out to see if you are experiencing benefits or potential downsides.

    I advise you to consider which of the strategies I am using could be the most helpful to you and start on a fresh week or month instead of changing what you’re doing right now.

    This really plays into respecting your roles as a plane, a pilot, and an engineer (if you don’t know what I’m talking about, please go read this short post by Ali Abdal!) . So when you are deciding what you’re going to do and changing things to optimize your behaviors or systems, you’re acting as an engineer- But that’s not all, your responsibility also lies in NOT disrupting your current plan (if you have one) and letting it finish its course before starting a new plan. Similarly, once you are carrying out your new plan or modification, you want to give it a few weeks (decide beforehand) and then re-evaluate at a predetermined checkpoint. 

    Bottom line: Plan when you’re supposed to plan and do when you’re supposed to do. Don’t mix the two. 

    I hope this makes sense. Let’s dive in! 

  • The content provided on this site, including all text, graphics, images, and other material, is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult with your healthcare provider or a qualified medical professional regarding any medical conditions or concerns you may have.

    While the author of this blog is a licensed medical professional, the information shared here should not be used to diagnose or treat any health problems, illnesses, or diseases. The views and opinions expressed on this blog are personal to the author and do not necessarily represent the views of the medical community or other healthcare professionals.

    Any reliance on the information contained on this blog is solely at your own risk. The author makes no representations or warranties regarding the accuracy, reliability, or completeness of the content. The application of any information provided here is at the sole discretion and risk of the reader.

    If you think you may have a medical emergency, call your doctor or emergency services immediately.

SUPPLEMENTS

  • Optimizing my brain health and longevity has become a key focus recently, and it's sent me diving into research on various compounds and supplements. I have long been interested in optimizing health and longevity but was always working with a superficial understanding of physiology. If I was going to start taking new supplements, I wanted to do a deeper dive with a lens of prevention and work on increasing my *****healthspan not just lifespan***** (this is super important to understand!)

    My choices for most of my supplements are largely driven by a desire to minimize the risk of cancer and metabolic syndrome (given my family history) and (of course) preserve and optimize brain health. Somewhere deep down, there is a little bit of vanity involved too but that’s never a strong enough driving force. 

    At the beginning of May 2023, I did a blood test for essential biomarkers through InsideTracker. The areas that caught my attention are listed below and I’ve made some dietary changes but I'm not rushing to conclusions before the follow-up test I scheduled at the end of September

    • Hba1c (mildly high) - started eating lower carb when not socializing - loosely following guidelines in “Fast like a girl” book by Mindy Pelz.

    • Iron levels (mildly low) - started making salads for lunch with iron-rich foods like spinach, legumes and pumpkin seeds along with vitamin C rich foods like broccoli, cherry tomatoes and bell peppers [https://pubmed.ncbi.nlm.nih.gov/21462105/]. I really don’t want to take an iron supplement when it’s only at the low range of normal and I’m not anemic (iron is a pro-oxidant so too much iron is also bad).

    (btw you can also get your doctor to order basic blood tests that assess lipids, hba1c, and certain essential nutrients like iron, b12 etc but other more specific bloodmarkers may be hard to get approved)

  • MORNING

    • 2 capsules of Cocoavia “cardio health” [1130mg of cocoa extract and 500 mg coco flavanols in 2 capsules] 

    • These help improve endothelial function, lower blood pressure, promote healthy blood lipid concentrations, enhance blood flow to the brain and protect skin against sun damage!

    https://www.foundmyfitness.com/topics/cocoa

    • 2 capsules of athletic greens Omega-3 [1300 total Omega-3s including 672 mg EPA and 448 mg DHA in 2 capsules] 

    • It seems that Omega-3s are beneficial for ALL the things. The BIGGEST thing is that they improve your lipid profile and REDUCE inflammation which affects multiple organ systems (including eye health! Which is super important for me as a Radiologist).


    https://www.foundmyfitness.com/topics/omega-3

    • 2 capsules of MegaResveratrol 99% pure Trans-resveratrol [500 mg in 2 capsules] -  has cardioprotective, anticarcinogenic, antiviral, neuroprotective, anti-inflammatory and antioxidant properties.  

    • Improves cognition and memory, induces longevity genes via xenohormesis, promotes autophagy response

    • Note: Resveratrol inhibits cytochrome p450 enzymes which are involved with the metabolism of many drugs - which can increase risk of toxicity of those drugs.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6317057/ 

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6164842/

    • 1 capsule Qunol Ubiquinol CoQ10 [200 mg in 1 capsule] 

    • Improves mitochondrial health, reduces fatigue, and helps with my migraines. 


    https://examine.com/supplements/coenzyme-q10/#examine-database

    MIDMORNING/NOON depending on my fasting schedule

    • AG1 - 1 scoop [multivitamins and greens blend- taking for general micronutrient balance]

      • *** There is some concern about microcystin toxin content in their powder, which I’ve inquired them directly about - based on what i hear back, I might stop taking it! so hang tight.

    • Vital collagen peptides 1 Tbsp - bovine source so if you can’t consume these, try either the marine collagen or [5 g in 1 Tbsp]

      • LOVE this - idk if its just in my head but my skin and joints have actually been feeling great since i started taking 1-2 TBSP of collagen daily ( I combine the marine and bovine sources 50/50)

    • Great Lakes marine collagen peptides 1 scoop - [6 g in 1 scoop]

    • Ultima Electrolytes (lemon flavored goes best with this combination)

      • you don’t really need electrolytes daily but these help keep my hydrated during long days and provide a nice taste to the whole AG1+collagen drink mix

    I take the combo above to work and mix in cold water and have it before or after the first meal of the day. I used to take AG1 fasted but my view on this has changed because of some compounds that may kick the body out of ketosis (not strictly related to calories).

    https://www.foundmyfitness.com/topics/collagen

    EVENING 

    • 2 capsules of athletic greens Omega-3 [1300 total Omega-3s including 672 mg EPA and 448 mg DHA in 2 capsules]

    • see AM section above for why i take this

    https://www.foundmyfitness.com/topics/omega-3

    • 2 capsules Broq sulforaphane [20 mg sulforaphane from broccoli seed extract] - i take it right after dinner to reduce any gi distress

    • Sulforaphane has been shown in many studies to have potent anticancer effects, it also helps excrete air pollution toxicants

    https://www.foundmyfitness.com/topics/sulforaphane

    • 2 capsules Seed probiotics for gut health

    • Probiotics have diverse benefits - not only for digestion, and glucose regulation but also for skin health and mental health

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5730384/

    https://pubmed.ncbi.nlm.nih.gov/22529959/

    OTHER:

    • Vitamin D +K2 (on the weekends - 1-2 dropper-full which is 40-80k units as each drop is 1k units)

    • important for calcium homeostasis, bone health, blood pressure regulation, immune function, aging, and many other physiological processes

    https://www.foundmyfitness.com/topics/vitamin-d

    • Liposomal vitamin C (2-3 times a week or daily when feeling a bit under the weather)

    https://www.foundmyfitness.com/topics/vitamin-c#liposomal-vitamin-c

    • Liposomal glutathione (have not yet started- should NOT be taken regularly- Dr. Rhonda Patrick takes this for liver detoxification - so presumably would be beneficial to take after toxin or alcohol exposure occasionally)

    • Berberine (have not yet started- my a1c was a bit high on my baseline blood test - which is likely due to lots of guilt-free eating through Japan the month before- but I want to try this nonetheless to improve my glucose metabolism. Will test this first maybe with a continuous glucose monitor to better understand the effects. Also probably a good idea to be testing Liver function tests intermittently when taking this)

    https://www.foundmyfitness.com/topics/berberine

    • PQQ (under consideration - PQQ is a compound found in plants that has been found to decrease inflammation and improve mitochondrial efficacy in humans)

    Study: Omega-3 fatty acids, folic acid, and CoQ10 reduce the risk of cardiovascular disease

  • My approach to supplements is an ongoing exploration, fueled by curiosity and a desire to align my choices with well-researched principles (safely).

    I understand that for many of the supplements, there won’t be any noticeable difference as I am fairly healthy at baseline.

    What I did observe:
    - Increase in energy after adding Ubiquinol (CoQ10)

    - Dramatically improved skin hydration after adding collagen peptides.
    [I also want to say that I think my occasional knee pain has resolved but it’s too soon to tell]

    SO - What you see here is a real-time snapshot of where I am now, guided by my goals and available research (sometimes indirectly through experts I trust).

    If you decide to explore supplements for yourself, always consult healthcare professionals (especially if you are or could be pregnant! Many supplemental molecules have not been deemed safe for pregnancy). Be aware that it's a path filled with ongoing adjustment.

    Feel free to explore further by following the links above if you want to delve into the reasoning and evidence behind each supplement.

DAILY ROUTINES (MOSTLY WEEKDAYS)

Keep in mind that what I’ve outlined below is the ideal version and things happen/life happens.

Weekends & Vacations: More Relaxed

I embrace flexibility, but aim not to stray more than 90 minutes from my usual sleep schedule. Weekends are less structured, and vacations are all about relaxation and spontaneous adventure (with some movement and meditation when I feel like it). 

AM 

  • Wake up between 5 and 5:15, use the bathroom, feed my dog Halo half her breakfast (or she pukes - she has BVS)

  • Meditate (with Red light mask 3-4x week) : ideally 15-20 min - by 530 am

  • Movement: 45 min to an hour (including setup, mini stretch, and warmup) - by 630 am 

  • Cold shower (or shower with cold rinse) + get ready: 30 min - by 7 am

    • Take Halo out, feed her the rest of her breakfast + Coffee and AM review: 20 min - by 720 am

    • Outdoor light exposure + water plants for 10 min if I have time

  • Grab lunch + snacks and leave - by 730 am 

PM

  • Get home between 5:25 and 6 pm depending on the traffic 

  • Walk Halo + quick tidy if I get home early enough

  • PM review and snack- 20 min - by 6:30 pm 

  • Make and eat dinner + tv maybe - by 8:30 pm 

  • Wash dishes/ clean up/ check that I have lunch for tomorrow or decide what I’m going to do - by 8:45 pm

  • Take out workout clothes and work clothes, brush teeth+ skin care, and get in bed - by 9:15 pm 

  • Read with legs up the wall or use the Theragun: by 9:30 pm 

  • Close my eyes and try to fall asleep between 9:30 and 9:45 

Shift work: 

Evening/swing shifts:

My most challenging (and thankfully infrequent) shifts these days are the 1 - 10 pm blocks. For this, I make sure to get at least 7 hours of sleep and then adjust everything else. So because I'm usually working a normal 8 to 5 shift before my 1 to 10 PM, I don't try to wake up at 5 AM the morning of my evening shift so I’m able to stay awake later that day. What I do is wake up at 6:30 AM instead (the idea is to keep wakeup time within 90 min window if possible) and do my AM routine closer to 11 am. This means that I have 6:30 to 11 am to relax and do those chores I normally couldn’t do on weekdays like go see the dentist (which is why I still like having some of these shifts sprinkled into my schedule). 

Caffeine also plays a key role here and as a rule of thumb you dont want to drink coffee within 2 hours of when you wake up (to allow the cortisol spike to normalize and minimize that afternoon slump).

Key Tips:

  • Wakeup Time: Stay within a 90-minute window if possible.

  • Caffeine Strategy: No coffee within the first 2 hours of waking.


Nights:

I no longer work nights since finishing up my fellowship but previously I used to do my AM routine right after waking and PM routine right before going to bed which kept things somewhat consistent. You can also decide if you want to do your AM routine closer to when you start your shift as it will provide more energy during the shift (this applies to scenarios where you wake up several hours before your actual shift - for example, if you get up at 5 pm but don’t start work until 9 pm, you might want to exercise and shower right around 730 pm). Keep in mind also that you can split your wake-up routine into half so that you are meditating right after waking up and doing your more energizing activities like exercise and shower right before work.

Studies have shown that exercise helps mitigate a LOT of negative effects that arise with daytime sleep which messes up the body’s natural circadian rhythm so I would HIGHLY ENCOURAGE you to keep exercising if that is the only thing you do in your routine while working nights. 

Key Tips:

  • Routine Timing: Adjusted AM/PM routines based on wake-up time and work hours.

  • Exercise Focus: Studies highlight the importance of exercise to offset the negative effects of nighttime shifts. Keep moving, even if that's the only routine you maintain.


Insights & Takeaways

Life happens, and it's perfectly okay. Whether it's a weekend, vacation, or shift change, these routines provide a modifiable framework. Your body and your needs might require tweaks to this schedule, and that's ALSO totally fine. The key is to find what works for you, maintaining a balance that promotes health, productivity, and most importantly, happiness.

Further reading on relevant topics on Dr. Rhonda Patrick’s website (she has lots of references in these articles so I don’t have to reinvent the wheel):

https://www.foundmyfitness.com/topics/autophagy

https://www.foundmyfitness.com/topics/cold-exposure-therapy

https://www.foundmyfitness.com/topics/fasting

https://www.foundmyfitness.com/topics/time-restricted-eating

https://www.foundmyfitness.com/topics/sauna

https://www.foundmyfitness.com/topics/aerobic-exercise

Combining aerobic exercise and strength training as the best strategy for improving health span: 

https://www.bmj.com/content/370/bmj.m2031

Zone 2 Training: 1-2 Hours Per Week (Jog, Bike, or Hike)

Zone 2 exercise, focusing on a moderate intensity of 60-70% of your maximum heart rate, is not only beneficial for enhancing aerobic endurance but also a peaceful time to listen to educational material. While I can't cite a specific study about learning during Zone 2, the boost in neurotransmitters and blood flow to the brain is likely the reason behind my enhanced retention.
https://peterattiamd.com/exercising-for-longevity-peter-on-zone-2-and-zone-5-training/

HIIT: 1-2 Sessions a Week (10-30 Minutes Each)

High-Intensity Interval Training (HIIT) takes you to Zone 4 or above, where effort reaches 80-90% of your maximum heart rate.  Aside from the more commonly known benefits of cardiovascular benefits and developing more fast-twitch muscle fibers, these brief but intense workouts are known to stimulate autophagy pathways, a cellular process that removes damaged components and has been associated with anti-aging and enhanced metabolic function.

Resistance Training: Most Days, with Daily Focus on Abs

My resistance training fills the rest of my workout schedule, emphasizing full-body awareness and muscle toning. I try to train my abs daily (except on rest days) as core strength plays a big part in balance and daily function. Research does support targeted daily training for specific muscle growth but my focus is on agility and overall strength. As an added benefit, newer studies have shown increased collagen production and thicker dermis as a result of resistance training (https://www.nature.com/articles/s41598-023-37207-9).

Rest Day: Once a Week

Rest is crucial, as it's the time when your body recovers and grows. The scientific consensus underscores that rest can prevent injuries, boost performance, and promote overall well-being.

Your Own Journey:

What works for me may not be an exact fit for you, so don't hesitate to experiment and consult with fitness professionals. For example, I wish I was more into traditional weight training as I would probably build more muscle and research supports more benefits with increased muscle mass but that just isn’t fun or sustainable for me so I am happy with my approach and I think comparatively speaking my small stabilizing muscles are probably in better shape and have more bulk than the average person who focuses on large muscle groups (though ideally you would be training both equally). 

EXERCISE

General brain training:

Work Skills: 

  • Staying updated on research:

    • I skim through the table of contents of 3 or 4 most prominent journals in my field and save articles to a bookmark folder for later processing.

    • Once a week, I process these articles using the Chrome extension "Save to Notion" and send them to my Notion database with the tag "inbox."

    • Once a month or so, I highlight important points from articles and add a summary to the top of the page in Notion.

www.Notion.so

Notion extension I use - https://chrome.google.com/webstore/detail/save-to-notion/ldmmifpegigmeammaeckplhnjbbpccmm
 

  • Learning from day-to-day cases:

    • I save complex or interesting cases to a folder inside our PACS system with the tag "FU” (follow-up).

    • Though inconsistent, I aim to review these cases at the end of the day. Once a month, I tackle a handful of cases, learning valuable insights or deleting as necessary.

  • Strengthening frameworks of fundamental knowledge:

    • I consume more structured knowledge to keep the frameworks strong, using a high-quality CME website or saved lectures.

    • I aim to watch at least one to two 1-hour lectures/content per week, sometimes in the morning or during monotonous tasks at work.

  • Attending conferences:

    • A valuable way to stay updated and network. Both physical and virtual formats contribute to my ongoing learning.

Productivity Tools: Fine-tuning Focus

  • Pomodoro Technique: Starting with 30-minute focus blocks, I stop when I find myself in the flow state and continue working until I feel like I need a break.  The point is to train our focus past the point of “limbic friction” (see below), minimize interruptions (phone on airplane mode, etc during work intervals), and take a few short breaks to reduce mental fatigue at the beginning when the brain isn’t quite “warmed up”. 

  • Deep Work and reconnecting with concentration: Now that I'm settled in my work schedule, I've reintroduced deep work. A 2-3 hour block per week allows me to dive into substantial projects, like writing this very piece!

Other techniques

  • Get Past the Limbic Friction:

    • “Limbic friction” is a term coined by Dr. Andrew Huberman, a well-known neuroscientist and professor at Stanford University. In simple terms, this is the gap between wanting to do something, and actually doing that thing with ease. It refers to the conflict or tension that arises within the limbic system, which is the part of the brain that regulates emotions and motivations. 

    • Acknowledging that it is NORMAL to have initial resistance or "friction" to starting a significant task is crucial (and this is often the point right before the brain decides to focus- so we just have to get past it). I use strategies like positive affirmations or a quick mental warm-up by breaking down tasks into tiny chunks to push past this barrier. This technique helps me dive into tasks without much delay, keeping the momentum going.

  • Capture Everything:

    • I make it a point to jot down thoughts, ideas, or tasks as they come, regardless of how significant or trivial they might seem. This ensures that nothing slips through the cracks and enables a more organized task and knowledge management system. I’m definitely not perfect at this but the more I am intentional about it, the easier it becomes to achieve >90% compliance. 

  • Digital Detox Weekends:

      • Emphasizing balanced living, I dedicate some weekends to digital detox, focusing on hobbies and relaxation. I used to study A LOT in medical school and residency so my weekends were often just half days to relax and half to study but now I have more time and it definitely sparks joy. The mental reset also aids in long-term happiness.

  • The "Two-Minute Rule":

    • For small tasks that pop up, if it takes less than two minutes to complete, I try to do it right away (unless I’m in a deep work or focus session). It's an instant productivity booster and helps clear the clutter from my to-do list. 

  • Mindful Task Batching:

    • By grouping similar tasks together, I channel my energy efficiently. Pairing this with mindful breaks rather than screen time, such as a quick walk or a breathing exercise, enhances overall productivity.

  • 5-Second Rule:

    • When hesitation strikes, I apply the 5-second rule: counting down from 5 and then launching into the task. It's an instant kick-starter that defeats procrastination and taps into a productive state of mind.

CONCLUDING THOUGHTS: The Journey Never Ends 

Continuous learning is not a destination but a journey. Your brain is a muscle, and like any muscle, it requires regular exercise to stay fit. These protocols are not rigid rules but adaptable strategies to ensure ongoing growth. Whether it's staying on top of the latest research, reflecting on complex cases, or optimizing productivity through tried-and-true techniques, the key is to find what resonates with you. Stay curious, and keep pushing the boundaries of your mind. 

PRODUCTIVITY + LEARNING

COMING SOON

  • NOTION and what i use it for

  • How I organize my notes, resources and other tidbits from consuming content and just daily life

  • My creative workflow

TASK AND KNOWLEDGE MANAGEMENT SYSTEMS