Episode 48: Peptides, Hormone Balance, and Muscle for Anti-Aging with Mary Ann Coffey, R.Ph, CCN

Show Summary:

In the world of anti-aging, there are many products and approaches that claim to be the pot of gold to help you look and feel young forever. To help us better understand the world of anti-aging and regenerative wellness is today’s guest, Mary Coffey.

Mary is the founder and Clinical Pharmacist at Boutique Wellness in Winston Salem, NC. She holds double board certifications in Clinical Nutrition and from the American Academy of Anti-Aging and Regenerative Medicine. She is also a member of the American Society of Consultant Pharmacists and Board Member of the North Carolina Integrative Medical Society.

Don’t miss this enlightening conversation about the approaches Mary takes with her clients to support the body in regenerative medicine and anti-aging.

Timestamps:

0:00 - Introduction

2:05 - Why Mary became a pharmacist and nutritionist

3:30 - What is anti-aging medicine?

5:02 - Zombie cells & intermittent fasting

7:42 - How are hormones related to aging?

10:46 - What are peptides and their benefits?

16:18 - Side effects of peptides

18:18 - Anti-aging for skin

26:36 - Nutrition recommendations

33:09 - Mary’s morning routine

36:49: Learn more and contact Mary

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Full Episode Transcript:

SPEAKERS: Dr. Andrew Wong, Mary Ann Coffey, R.Ph, CCN

“A lot of people ask me this question like, well if I start testosterone am I going to have to be on it forever? I'm like why not replenish and feel like you did when you were in your 20s you know. So when I talk to my patients it's not just about hormone levels, a lot of times I'm looking at you know lifestyle, you know management but I'm also looking at their free testosterone their bioavailable testosterone their sex hormone binding globulin their FSH and LH right. So there's the thermostat and there's the furnace there's two ways that I look at things and why does it expedite aging because they feel fatigued they lack that motivation they can't build muscle right and I think the key to longevity is resistance training it's the ability to continue to build muscle.”- Mary Ann Coffey

In the world of anti-aging, there are many products and approaches that claim to be the pot of gold to help you look and feel young forever. To help us better understand the world of anti-aging and regenerative wellness is today's guest Mary Ann Coffey. Mary is the founder and clinical pharmacist at Boutique wellness in Winston-Salem North Carolina. She held double board certifications in clinical nutrition and from the American academy of anti-aging and regenerative medicine. She is also a member of the American Society of Consultant Pharmacists and board member of the North Carolina Integrative Medical Society. I am Dr. Andrew Wong, co-founder of Capital Integrative Health. This is a podcast dedicated to transforming the consciousness around what it means to be healthy and understanding the root causes of both disease and wellness. Don't miss this enlightening conversation about the approaches Mary takes with her clients to support the body in regenerative medicine and to promote a healthy body at all stages of life.

Dr. Wong

Thank you so much Mary for coming on today and great to see you again.

Mary Ann

Great to be here, thank you for having me.

Dr. Wong

First, some background. So you're both the clinical pharmacist and nutritionist. What motivated you to become both a pharmacist and nutritionist?

Mary Ann

Well, actually I was using pharmacy as pre-med and just decided after graduating just to stay and keep, keep pharmacy for a while and after practicing for pharmacy for about 15 years I did long-term care, some retail, it was really in the long-term care sector where I realized that I didn't want to do this anymore. It was after filling 22 scripts for one patient and I said you know what, there's something different here. So I went back to school and got my certification in clinical nutrition and also got my fellowship in, from A4M which is the American Academy of Anti-aging Regenerative Medicine, that's when everything just took off it's just been a domino effect since then. Opened my practice back in 2018, started with just clinical nutrition, and then morphed into hormones and now doing regenerative medicine and now aesthetics. So we're growing and I'm happy to see and happy to be here.

Dr. Wong

That's so awesome. So you've really started with like you said nutrition but aesthetics regenerative medicine anti-aging medicine yeah it sounds like you're doing well and we can talk about this at the end too. But your clinic is in North Carolina, correct?

Mary Ann

Yes next to Wake Forest, Winston-Salem North Carolina.

Dr. Wong

Okay. All right. Go demon deacons yeah.

Mary Ann

Yeah. That's right, that's right.

Dr. Wong

Let's talk about anti-aging for a second in general for the listener. So, what is anti-aging medicine? What kind of symptoms does anti-aging address you know how can that help people?

Mary Ann

Sure. So a lot of times people come to me for hormones to balance them, low libido fatigue, low, just flat liners, and a lot of times it happens after having some virus you know whatever it is it could be that or it could just be something that they've experienced for the past eight years and just thought it was normal until they realize you know what my partner deserves more how do I get my libido back? So, I would say it starts with you know balancing hormones but then if you do that you don't address the adrenals it's pointless, right? So I do, I do address the adrenals the thyroid the pancreas. I look at the whole body and as well as assessing hormones. Now when I look at aging what I think about our inflammation right I think about inflammatory cells. What we call them are actually zombie cells or senescent cells and that is something that we accumulate over time and the key to that is removing them right and how the best way is fasting. I talked to all my patients about fasting over 24 hours but I also talk about different supplements like resveratrol, quercetin, fisetin you know, and how to dose that and then I do some biologics you know afterwards to help, I'll continue that removal and help with that restoring and regenerative process.

Dr. Wong

So the zombie cells I think that's just a fascinating term, I don't know who coined the senescent you know zombie cells. Is the body always trying to get rid of them in general or without fasting like, if we don't fast will they still, will the body still get rid of the zombie cells?

Mary Ann

No they won't, they won't actually if we not, if we don't actively try to remove them they multiply or they stay dormant or they just stay there and so the key is to promote that you know excretion or removal of the zombie cells and that's through a combination of different things. Not just fasting. It's lifestyle, it's exercise it's a, you know increasing as you know, apoptosis the ability to remove those cells but also you know a series of certain supplements, green tea extract you know how do we look at the cell and this is something that my medical director taught me three years and when I look at him you know and most people think he's in his early 50s he's in this he's hitting 70 and that's what shocked me. It's like you know he looks and I was like well what did you do and it's a lifelong process of really you know exercise, diet, lifestyle, and how do we slow it down. So now I'm looking at you know glutathione processes, mitochondrial processes you know it's all you know, it's all combined. So it's not just about you know fasting. No, it's not but it's a combination of that.

Dr. Wong

Would AMPK help? AMPK activators like berberine and things like that?

Mary Ann

Oh yeah, of course. I actually like you know I do a lot of Semagluetide in the practice or Ozempic. So a lot of people also come to me for weight loss. So I do a three-month weight loss program when I balance their hormones like well a lot of times its weight loss. I have such difficult you know difficulty losing that weight. So I do a GLP-1 agonist which helps decrease gastric emptying but it also regulates the blood sugar and decreases insulin resistance you know so that's you know I think it's great for longevity being on a GLP-1 it's great for fertility too and it's FDA approved so people will know it it's they're doing great advertising on tv on Ozempic you know so you know we do that and people look for it and it works you know but it doesn't work for everybody like for those that have SIBO or gastric issues. I don't give it to them or even those that have a history of depression that is contraindicated. People don't realize that they're like oh it's okay I'm like no not really you know because it does have it does tend to make them a little bit more flat-lined.

Dr. Wong

More flat okay got it that's good, that's good to know and just going back to hormones. I know that's a big part of your practice. What is it about hormone imbalances let's say whether it's deficiency or just rank imbalances that lead to accelerated aging? and how do you, how do you typically use hormones to balance that out? and I know it's a broad question but you know how I guess how are hormones related to aging?

Mary Ann

Sure. So it's like a car you know if we were lacking in you know we need to change the oil or something's you know off, why not fill it? So, a lot of people ask me this question like well if I start testosterone am I gonna have to be on it forever? I'm like why not replenish and feel like you did when you were in your 20s you know? So when I, when I talk to my patients it's not just about hormone levels a lot of times I'm looking at you know lifestyle, you know management but I'm also looking at their free testosterone, the bioavailable testosterone, their sex hormone binding globulin, their FSH and LH right. So there's the thermostat and there's the furnace. There's two ways that I look at things and why does it expedite aging? Because they feel fatigued, they lack that motivation they can't build muscle right and I think the key to longevity is resistance training. It's the ability to continue to build muscle right and keep that waist circumference you know. So when you balance those hormones and not everyone needs that you can do it with herbs you can do with lifestyle depends on how their environment has been, how toxic maybe, or that or their lack thereof toxicities are present in the body but I find that just doing basic testosterone especially I'm talking about a male patient and an estrogen blocker you can do that naturally but I find that giving an aromatase inhibitor is a little bit more effective and then something to help stimulate the brain because 93% of the time if you've suffered a concussion or any type of head trauma you have secondary hypogonadism so what is that causing you can't, your pituitary is not telling you luteinizing hormone to tell your testes to make testosterone right so you know you need to stimulate that but we can't just give you testosterone because what happens is your testis will shrink right no one wants that.

Dr. Wong

Right.

Mary Ann

Okay you know so that's why we always want to work on both angles stimulating and continuing that production endogenously through that LH production right there's different products we can give like clomiphene, HCG, kisspeptin, gonadorelin depends and it's a symphony you know there's a little dance that we play here as well because not everyone responds the same way so I put people usually on like a retainer and it just, it continues and I follow them every seven weeks and just really just help them get to their desired state and a lot of times they might, they start feeling better. I hope that answers your question.

Dr. Wong

Yeah. It does, that I don't know, if you know this podcast high-intensity health by Mike Mutzel he talks a lot about better living through chemistry and he's, has a nutritional background too I think and you know he talks about you know kind of anti-aging in a way through diet and lifestyle but I think adding some of the meds or different things can be very helpful herbs like you said supporting like all angles. Curious about your, your experience with peptides and they've kind of gotten to the peptide space, and how that and how that helps anti-aging. So first of all, what are peptides just for the listener and then what are, what are some of the benefits that you can see with peptides for our health and wellness?

Mary Ann

Sure. Well I think peptides are definitely gaining more and more popularity right and the key is that we send out the right information out there so it's used appropriately. So peptides are small chained amino acids that are naturally occurring in the body for insulin. Insulin is a peptide, right? Humalog, Lantus, Levemir. They're all peptides, they're longer chain I think 54 amino acid genes, we have the shorter ones which are like BPC, TB4, TA1, those are careful about saying those because they're not FDA approved and I can't make medical claims right so we're very careful about that. However, what I have seen and there are studies that support this is that they help with gut issues like common ones that we use that you can also find over the counter is called BPC “body protection compound” they're available in capsule, sublingual and injectable form. I find that the injectable form works the best, however, the sub the intranasal there's also intranasal helps with neural inflammation. So a lot of times you have patients coming in with what anxiety, depression, you know. So not only does it help with anxiety and depression by lessening that neural inflammation a lot of times their brain has just been inflamed, but why is it inflamed? So you always think toxins for me anyway right so restore the gut so peptides just help but they're not cure all. You need to follow it with nutrition, diet and lifestyle. If you don't have that it's pointless doing any peptides and balancing hormones. So they're, so to answer your question they're naturally occurring in the body and they just help heal and regenerate the body. They're usually given in small doses you can give it in different doses from capsules to injectables to nasal spray and then you would administer it usually takes sometimes it takes three months sometimes it takes two days. But what I found with like common peptides that I've recommended is that it helps with tissue repair it helps with inflammation. So before I do any weight loss program, I got to look at their homocysteine, their CRP, what's inflamed and if they're inflamed it's pointless putting them on a weight loss program because they're just they're not going to do well.

So that's why I find that doing a low inflammatory diet with intermittent fasting or ketogenic diet with intermittent fasting with a combination of supplements and then add the anti-inflammatory peptides that just specific target but they're pleiotropic meaning there's a lot of different mechanisms so it may be causing anti-inflammation but it's also repairing the gut it's also helping with ligament repair like a lot of shoulder issues or knee issues what I'm dealing with, you can inject it even in that area too the closer to the site of action, of course, the better it is. So as I mentioned, I'm sorry, I'm going all over, it's hard to do, only talk on peptides.

Dr. Wong

Oh this is great, that’s good.

Mary Ann

But that's what I'm seeing you know and that's how I use them. I use them first as anti-inflammation and then I use it as a weight loss program. So I do a lot of growth hormone precursors along with the appetite suppressant or not the appetite suppressant what we call GLP-1 agonist.

Dr. Wong

GLP-1 yeah agonist.

Mary Ann

Yeah. Semaglutide works great when given in conjunction to a growth hormone precursor. So I measure IGF-1 on all my patients. I like those numbers between 250 and 270. Kids like teenagers have optimal IGF-1 normally right although I'm seeing younger and younger having lower IGF-1 and what is that that's your insulin growth factor that measures your growth hormone it's your rate of recovery when that's optimized you're finding that you're recovering faster, you're sleeping better, you know, you're, you can go like that's the teenagers that go out drink all night right sleep two hours the next day they're fine right they have like like they react like nothing whereas for us in our late in our early 40s we're tired all the time so that's where I optimized their growth hormone as well through precursors.

Dr. Wong

So, I have a lot of questions now from that comment and we're going to go down different rabbit holes now. When you have someone on bioidentical hormone replacement therapy are you always considering a growth hormone agonist as well in those situations or how can you when do you decide to do growth hormone?

Mary Ann

Oh that's a good question. No. We're careful about that. In some states, it's illegal in some states that it's approved and it's very expensive to do growth hormone agonist.

Dr. Wong

But I think, I thought you mentioned…

Mary Ann

Talking about Genotropin, Norditropin is that what you're referring to?

Dr. Wong

I'm not sure, I just, I just thought you had mentioned about, like you, have someone on a GLP-1 agonist and then you're going to give them something else to boost.

Mary Ann

Oh! to help, a precursor yeah.

Dr. Wong

A precursor, sorry, a precursor for GH yeah.

Mary Ann

Yeah for GH so when do I start it? I would start it as long as there's no inflammation. So I would start, I would, I usually do an anti-inflammatory if they have no issues with that and they just want to lose weight or sometimes after being on a GLP-1 agonist like Semaglutide or Liraglutide they plateau and they stop losing weight and that's when I add it like okay let's add this adjunct to it but you always want to separate it from food by 30 minutes and exercise, post exercises when it works best it's great for inflammation too.

Dr. Wong

Post exercise. Oh, nice, nice yeah, that that's…

Mary Ann

CJC is what I use, CJC IPM 2 2 is the unit they use about 5 units yeah I'm careful…

Dr. Wong

We'll have to talk more offline on that.

Mary Ann

On that protocol, yeah.

Dr. Wong

Awesome, thank you. And I guess for the peptides too just up for listeners are there any, are there any known sort of like other biological effects that would be considered side effects? or those types of things for these, what's this…

Mary Ann

Well I've mentioned before you know there are certain things that I wouldn't use like there's MOTS-c that help boost the mitochondria but you always want to measure homocysteine, check folate levels, so there's a lot of different things and that's why we do education with providers in fact what we do is I, we provide I have this educational course coming up in August in Sonoma, California. My partner Dr Joe Cleaver and I are putting this together and we, our aim is to bring experts together and educate on protocols proper dosing not just the science not just the chemistry about it behind it but the science you know how it works why it works and what has worked and then we bring our case studies with us or difficult case studies and people can bring them with them and then we also have an app. So, so the proper use is really you know it's education with our providers for sure.

Dr. Wong

Thank you. For the peptides would you say that people could be on them long term is there some short course that they're on or how does that work?

Mary Ann

You know, my favorite patient is the one that knows their body the best and knows what does what you know. So, some people would say you know what I think I need to take a break on my BPC I want to start on and that's when their gut is great you know like they have bowel movements every day they're sleeping great they can tolerate any food and and excrete it really quickly. that's when you know they don't need it anymore and they take a break. Does that make sense? So that's how.

Dr. Wong

It all comes back to the gut, yeah it all comes back to the gut.

Mary Ann

Yes microbiome yeah it all does every single thing.

Dr. Wong

Right. Gut lining, microbiome, motility, absorption and you said there's different ways to take peptides. Let's, let's talk about let's pivot a bit towards aging skin and wrinkles because I know that everyone at the end of the day is into healthy skin.

Mary Ann

Sure.

Dr. Wong

Are there any topicals? Now, this is a more broad question but not necessarily for peptides it could be, but what do you kind of recommend to address aging skin or you know I guess to optimize healthy skin is probably a better way to say it?

Mary Ann

Well, there are a couple of things obviously you want to make sure you're taking good multivitamin, good vitamin A you know if you're prone to acne I like fish oil a good quality fish oil at least four grams a day it's also great for inflammation too especially if you're an athlete but I find if you're really interested to get a little bit more elegant is a peptide called GHK copper and or GHK right and that is actually it's very cancer protective for anyone that has cancer but it also increases collagen and elasticity in the skin so does CJC you know so those are some certain secret peptides that I like and I've noticed a difference in myself you know just use it I just ordered some and it's great for scars too so you can micro needle add a little bit on the scars and you'll find that it actually lessens the the appearance of your scar just doing a little bit of…

Dr. Wong

What about just collagen itself would you just?...

Mary Ann

Collagen yeah and then red light therapy you know. We do a lot of PDO threads at the clinic you know but it's really you know it's inside out if you're out if your skin is looking the way it is then it is also and I usually do a skin elasticity test just under the eyes or on the hand a lot of times it's hydration you know just drink plenty of water it's how you're excreting it right.

Dr. Wong

We're seeing a lot of people actually right now in our clinic with hypermobile eds with the connective tissue Ehlers-Danlos Syndrome with that genetics you know for connective tissue is there anything in the anti-aging world that could be helpful for promoting like healthier connective tissue if someone has a genetic issue like that..

Mary Ann

Yeah i'll have to do some research I know that there is, I mean there are some peptides like it's not fda approved here though it's like cerebrolysin but there is a integrated peptides that you can get cerebro pep that's more for neuro, nerves but I would think that you know biologics you know I would be careful with that but I would, I would even think even just regenerating that with decellularized growth factors is what we call that's where they remove the dna and they add just the growth factors I would think something like that.

Dr. Wong

Okay, yeah more research that's another area for sure. So you said that body protective compound BPC is one of your favorites one of the most ones to use the most commonly you would say for peptides.

Mary Ann

Yes.

Dr. Wong

I know about TA1 as well. Can you talk a little bit about that and how that can impact the immune system?

Mary Ann

It's not fda approved in this country.

Dr. Wong

Okay.

Mary Ann

So it's one of those ones that fda really did try to remove it from all compounding pharmacies so it's very difficult to get but it is fda approved it's I think it's called Zadaxin and it's great for viruses and it's great for boosting modulating the immune system that and I also like TB4 Thymosin Beta 4 so if i'm going to use any anti-inflammatory I usually use those three, would be BPC, TB4 and KPV. KPV is a very potent anti-inflammatory as well and I find that doing those three combinations what I'm careful about because fda really doesn't like you and they've shut down a lot of these pharmacies because of claims so we can't make any that says it does this you know so it's unfortunate because it's a great peptide and I use it for a lot of my autoimmune disorders to help modulate right stimulate other parts of the immune system to help them get out of that innate immune system and get them more into the adaptive or just to balance it right just to so it's a great immune modulator for sure.

Dr. Wong

Right, right and certainly we also see a lot of people with chronic infections they have low natural killer cell counts with things like TB4 and other things help with in theory help with the immune system that way with like boosting that innate immune system in natural killer cells.

Mary Ann

Adaptive I would say, more not to remove you from the innate you're not in that hyperactive mode for sure.

Dr. Wong

Okay yeah.

Mary Ann

Which is where you are when you have autoimmune right, your body is attacking itself.

Dr. Wong

Right.

Mary Ann

So you can't tell the difference anymore. Everything reacts right you have to start to develop these food allergies you never used to have so I mean, I think my favorite is low-dose naltrexone but I'm finding people are reacting to low-dose naltrexone like I don't like it. I can't like well then we start lower yeah at 0.5 milligrams.

Dr. Wong

Ultra low yeah…

Mary Ann

Really low and stay low for a while until they, you know don't feel a response and then go back up again.

Dr. Wong

Got it and then going back to the supplements and meds what other things do you recommend that are kind of your go-to for use for anti-aging I think beyond peptides?

Mary Ann

For anti-aging specifically?

Dr. Wong

Yeah. Just in general yeah…

Mary Ann

Or in general, for hormones you know obviously I do magnesium, zinc for sure, for blood glucose control I like chromium and vanadium and coq10 because you need eight molecules of chromium to get that insulin inserted right so I, you know there's a couple of products I like from metabolic code. Glut Reg 4 is great but when it comes to like anti-aging I put them on a protocol. So if they want to do like a stem cell or a can't say stem cells but decelerate growth factors infusion I usually get their bodies prepped so there's that five-day fasting, fasting mimicking diet they can do from L-Nutra Prolon that's what would be five days in fact I probably need to do that because I've been cheating these past few days you know eating.

Dr. Wong

Time for a ProLon.

Mary Ann

It's a great way to just detox and you know that weight

Dr. Wong

Yeah, that's awesome.

Mary Ann

But then I do like you know fisetin so you can do that just for five days you can do quercetin about 500 milligrams twice a day and resveratrol you know those are some great products and there's a product I think it's called Zombie Dust 1212 it has all of it in there fisetin, resveratrol and yeah I think those are the only products in there and I can send you those links.

Dr. Wong

Sure that'd be great zombie dust to kill off the zombie cells. Is that why is it called?

Mary Ann

Well yeah, zombie, just developed those zombies.

Dr. Wong

I love that it's good not just for halloween right for all.

Mary Ann

No. I know, I know people like they love the name and yeah I think, I mean that, that's really what I do for longevity you know. It's about balancing hormones it's lifestyle you know there's other peptides like Epitalon there's DSIP you know it's really about improving that deep sleep you know. I, you know, I used to like the Oura ring until they start you know tracking you

Dr. Wong

Oh! do they? No, I don't know. I have one so I have to check it out.

Mary Ann

I had a friend that just took it off and stopped, and stopped wearing it because he didn't want to sign the waiver to be tracked.

Dr. Wong

Yeah, yeah. It's one of those things double-edged sword yeah double-edged sword.

Mary Ann

It's a great way to manage or to measure your deep sleep and that's really key if you're not sleeping well and you're not going to the bathroom every day that's number one right.

Dr. Wong

Yeah, you need the deep sleep to detox yeah for sure.

Mary Ann

Yes sir.

Dr. Wong

What are your thoughts about increasing deep sleep? How do you increase deep sleep? What have you found to be?...

Mary Ann

There's a couple of products I like, like honokiol. There's one from deep blue sleep that I've used however it does cause some weird dreams. I like DSIP Delta-sleep-inducing peptide so you can do you know 20 to 30 units three, four times a week plus Epitalon also helps with sleep and it helps increase those telomeres so they say I would do a test first like true diagnostics is a great test that can measure epigenetically what's expressed right and it can even give you your age based on your immune system you're only as old as your immune system but I always thought you know you're always over as well as your blood vessels too so I would always do a baseline first then start this program and then do another one in six months and see how it's changed.

Dr. Wong

Yeah. I love that test because it really kind of tells us that it's not just about the amount of methylation but where we're methylating and de-methylating in the body that true diagnostics test it's, it's really about the quality of the methylation which is really nice. And then let's go into nutrition a little bit. Let's touch on that since you're also a certified clinical nutritionist. What kind of I mean this could be a whole other, a talk, but what kind of general food patterns or you know health, healthy kind of food patterns would you recommend for someone that really wants to maximize longevity and health span and all that?

Mary Ann

Food wise I would say the Mediterranean diet yeah. I would say Mediterranean. I usually do a metabolic food diet 1800 calories or 1500 calories for women and then that in combination with intermittent fasting you know avoid inflammatory foods like gluten, dairy, soy, nuts, those are eggs, you know those are some inflammatory foods first, you know for a few weeks while we're doing this weight loss program and then you can slowly introduce it.

Dr. Wong

Do you feel egg is inflammatory foods?

Mary Ann

It's inflammatory too yeah.

Dr. Wong

It can be.

Mary Ann

It can be.

Dr. Wong

That's too bad, that's too bad.

Mary Ann

I know, I know, especially my daughter's big into weightlifting she's been, she hates eggs but she started eating them because she knows she needs the protein yeah she forces herself to eat it but it is inflammatory you know and even whey protein you know like that. What do we do? you know, but I, you know, I think you know just having a balanced diet and improving that ability to convert to a water soluble so making sure you're taking a good amount of magnesium about 7.5 milligrams to 10 milligrams per kilogram is what I recommend 10 milligrams per kilogram for those that are heavily working out 7.5 milligrams per kilogram per day okay so that's going to help facilitate that excretion so regardless you're eating well but you're not oxidized right you're not going through oxidative stress so not really really key and then beets you know spinach, arugula, optimizing your nitric oxide as you know you talk to Beth Shirley who's my mentor who I love her.

Dr. Wong

Yeah, Beth is great.

Mary Ann

It's all about nitric oxide right? So how do we optimize that through her supplements but also a good quality of diet that supports that nitric oxide support.

Dr. Wong

A lot of leafy greens. Let's talk about sauna. I'm kind of getting into that too. We know that sauna can help with both nitric oxide but also there are some studies from Finland I believe, that show that sauna can promote longevity. Do you use sauna in your practice or either personally?

Mary Ann

I do. I actually have one here at the house that I do very often because I, you know, I haven't done a metal testing on myself. I've been meaning to, I had one and ended up not doing it right. I'm going to do that soon, we're worst advocates right?

Dr. Wong

Every, everyone is high in metals by the way yeah that's…

Mary Ann

Yeah, I think it does.

Dr. Wong

Pretty much, yeah.

Mary Ann

Yeah. So it does help remove that mercury that's the only way that I know you can so in terms of it increasing nitric oxide that is interesting. I haven't read that study from Finland so people..

Dr. Wong

I think it just increases circulation so you're kind of the heat you know just through the heat and, and I think you know with the, then the near-infrared light you know is more involved with the mitochondrial biogenesis and things like that I think similar to like especially if you have sauna plus infrared light that would be a good combo you know potentially but that's good too yeah that can be helpful. And where were you on exercise or like we like to say your movement? How important is that for anti-aging you talked about I think before kind of addressing sarcopenia and you know building muscle mass and that's a big predictor of longevity and health span? So what do you generally recommend for exercise for people?

Mary Ann

Sure. I would recommend at least three to four days a week of resistance training plus about two to three days a week of cardio. It doesn't have to be a whole hour you know HIIT training is just it's suffice but really that resistance training doing weights is really key and if you're not building muscle you know I have we have a lot of patients that are elite athletes that do who are ex-military you know so they're you know they're going to the gym five-six days a week and they're just not performing. So I, you know, I help them with that regard with some peptides right that help increase that growth of muscle tissue but they're also you know you can't perform because they're in pain right they can't do what they used to do so that's why that's another added effect to that but I would say for sure resistance training at least three days a week you can even just do that band you know get it if you're at home you know you don't necessarily have to have you know personal trainer or anything but I would definitely recommend some good weight lifting and then grip strength you know. Check your grip strength that's really number one too is I mean people forget that's the fundamentals of anti-aging is how strong can you open up a jar of you know jelly or not jelly you don't want to have jelly. What are we opening these days?

Dr. Wong

Let's see, open up some BPC maybe there's like a really tight BPC jar that you could… Yeah. Well, you know what I thought about this morning.

Mary Ann

So I did cheat this morning.

Dr. Wong

Hey, at least that little fruit in it may be a little fisetin right I think strawberries are high in fisetin. You could, you could do a grip strength with like a thumb wrestling you know like you know.

Mary Ann

Oh yeah yeah.

Dr. Wong

I'm mean thumb wrestling with your kids, I'm…

Mary Ann

You mean Thumb war?

Dr. Wong

Yes, yes! Thumb war one two three four yeah!

Mary Ann

Yeah, that's fun!

Dr. Wong

Yeah, fun ways to promote grip strength. What do you think about weights? Like do, does it have to be like like free weights or can it be like body weights for people? Can you, can you do, can you build up muscle just through body weights?

Mary Ann

Oh of course yeah with your own body resistance training you mean just planking.

Dr. Wong

Body resistance,

Mary Ann

Yeah for sure, yeah. I think that's the best way. I think yoga is really helpful you know which is pretty much your own body's weight right you help sustain but you're not gonna build so much muscle but it's gonna help with that flexibility. I think it's a combination of doing that because you also want to push yourself a little bit more at the gym you know. I think for me anyway that's just how I am.

Dr. Wong

I was trying to get the yoga comment in here because we have some yogis in our practice so I'm kind of curious about how they're going to build muscle and maybe there's a, maybe there's a new combination sport like yoga, yoga weight training or something.

Mary Ann

Yeah. You know, it's like jiu-jitsu which is forced yoga which I tried but it wasn't for me, so that.

Dr. Wong

Yeah. Okay, nice, nice. So let's talk about, let's talk about some more fun questions. I think this is a great overview of anti-aging and thank you so much for coming on Mary. You're very expert in this area so definitely have to talk more offline on this too. Let's talk about your morning routine if you don't mind you know morning routines are really really helpful for kind of establishing a daily you know repetitive in a way pattern of healthy habits that will promote longevity and promote health. So if you don't mind sharing your mary's morning routine here.

Mary Ann

Sure. I'm an early riser. So, I, actually. I'm a boxer. So, I box three days a week Monday, Wednesday, Friday and that starts from six to seven. I when, I usually sleep between nine and ten. So I sleep pretty early I have a routine like my dog knows like, oh it's time for bed you know they feel it so that's really the key is honoring that time for sleep but even before that when I wake up in the morning. I just learned I'm like you know, what we really need to program our minds? What we want right? yeah you can do all these things you can deep sleep but telling what telling your body telling your mind what it is you want to feel when you wake up or how you want to how you just what you want to do before you go to sleep is one of the most powerful things we can do and I just tapped into that just recently and I'm going to start doing that even more then you wake up you feel great right you want to tell yourself how do you want to feel when you wake up and what time you want to wake up try it and you will.

Dr. Wong

I will, I will definitely try that thank you for that advise.

Mary Ann

Instead of like setting your alarm, tell yourself I'm going to wake up at 5:55 or at 4:45 whatever time it is but I firmly believe in allowing yourself that time to wake up to have that coffee to be into yourself right and to meditate you know and or prayer or surrounding myself right now. I'm you know, I believe in God and I've been praying and I've been doing that and that's been helping me you know either reading scripture or you know surrounding myself around that.

Dr. Wong

I think the mindset and affirmations really framing that day like you said even the night before that's so powerful yes it's so healing definitely gonna try that thank you for that.

Mary Ann

You're welcome.

Dr. Wong

And what do you do every day to cultivate joy? It sounds like there's probably a lot of options there that's another kind of…

Mary Ann

You know I, it's sometimes you push yourself to do things that you know will bring you joy until that joy happens does that make sense? Because it's easy to sulk in misery it's easy to be alone and it's easy to think about and let all these negative thoughts into your mind but what you do is you allow yourself to do something that you know will bring you joy like I started golf again went and bought golf clubs. I started go to the range even if I'm just by myself playing that's okay but it brought me joy and you do those things until you do or giving or service, talking to someone, looking at them and connecting that for me brings me joy is that connection because we're all connected we don't live on this planet alone and we all need that you know because who knows where we're going to be you know but what we do have is humanity and no one can ever take that away so that's how I find my joy is through people.

Dr. Wong

Yeah. I think the connection is huge and it's really something that as you know we kind of evolved or were created in tribes you know like villages in a way and sometimes that social connection is really life-giving you know it's just by connecting to others and being of service but also kind of just connecting to people you know is so healthy it's so healthy and we see that even in I think even in research on longevity and health span is that the people that are more connected they live longer, they're happier, they have more joy you know all these things. So really the human connection is in a way one of the ultimate anti-aging you know strategies I would say is to stay connected to your tribe you know so thank you so much Mary, I know you have a few sites where people can kind of access your wisdom work with you so how can listeners learn more about you and work with you.

Mary Ann

Gee… I guess they can go on my website it's my practice name is boutique wellness so the website is “boutique wellness and then nc north carolina.com” so it's boutiquewellnessnc.com.

Dr. Wong

Are you doing telehealth or do they have to be a resident?

Mary Ann

Well, I am doing telehealth as long as it's not controlled substances that I can do a ton of nutrition and I also work at a practice TRTMD. So we do see patients there it's in Maryland.

Dr. Wong

Okay.

Mary Ann

And they're probably the number one prescriber and provider of hormones in Maryland actually.

Dr. Wong

Oh! I don't think I know about that where is that located?

Mary Ann

They're in Severna Park. Okay, so I do a lot of their consulting as well.

Dr. Wong

Cool! Alright, will check that out.

Mary Ann

Great patients and great staff it's really great family there.

Dr. Wong

Awesome.

Mary Ann

Along with my practice in Winston where we do a lot of IV Therapy. I just purchased an ozone device so we do ozone therapy too and hormones. I do a lot of just hormone packages but I am happy to see you as long as you just see me once a year I'm happy to do telemedicine anywhere in the country and then soon we're going to be providing it overseas as well.

Dr. Wong

That's awesome super exciting Mary. Great to connect with you again here and we'll chat soon thank you so much.

Mary Ann

It was a pleasure, thank you!

Dr. Wong

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