As a physician I was taught to ask my patients, “Are you stressed?” If the answer was no, I would take it at face value.

We feel the consequences of stress often before we recognize stress as an emotion in our body.

My Chaotic Gut

In my second year of medical school I was bloated, had acid reflux, bouts of diarrhea and constipation. I assumed it was what I ate.

But stress changes the way the intestines move and how enzymes are released to digest food.

The same food I ate 2 years later weren’t causing any problems.

Appetite Skyrocketed

Stress puts the body in the fight and flight mode. We want to constantly get simple carbs in us to quench anxiety.

I developed a binge eating problems sometime around the first year of medical school but it didn’t really bloom until my third year.

If I ate enough, I would eventually settle down. The food would overfill my stomach, signal my parasympathetic system, and my stress hormones would crash.

My Mood Crashed

Most of the time my mood was fine. But it took very little to overwhelm me or make me irritated.

I experienced this again a few years later when I was dealing with a medical board investigation. On the surface I was still cooking, exercising, and socializing. But my internal processing of signals was overamped.

These days, when I feel irritable I know I have to check in to see what my stress level is. The stress bypasses our ability to calmly assess a situation. Our presentness gets hijacked and we lose our ability to process.

Energy & Stamina Were Rock Bottom

A few months ago I was onboarding new team members in my practice and the first thing I noticed was that my stamina in the gym was lower. I hadn’t changed anything else.

My amygdala was likely firing constantly with no way for me to override it. This crashed my nervous system, unable to make my muscles fire the way I wanted.

Cognition Couldn’t Keep up

The ability to focus, process information, and form new memories is highly dependent on our stress levels.

There are lots of studies, such as the 2009 Lupien et al, that track how adults with higher cortisol levels often have lower cognitive function.

Currently, in my practice, stress management is our top priority for any health coaching client experiencing cognitive difficulties.

Worse Aches & Pains

Our body has a natural way of suppressing excess pain signals. But chronic stress lowers the brain’s ability to mute pain. This was demonstrated in Pola et al, 2024.

I felt this in my lower back in 2016. I was slowly transitioning out of the insurance-based world and launching my own medical practice came with stress. No matter what I did, I felt pain in my back.

I was fortunate to work with a great personal trainer who showed me that I had excess tension in the paralumbar muscles. Once I got a handle on my stress, the pain disappeared.

Immune System Couldn’t Recover

Between 2010-2012 I was always sick. I was a full-time physician at Kaiser Permanente in the family medicine department, I picked up shifts in the urgent care and in pediatrics, and I had way too many hobbies outside of medicine.

High catecholamines suppress immune cells such as NK cells and increase inflammatory molecules like IL6. This combination crashes the immune system, which is needed not just for fighting off infections but fighting off cancer cells.

Segerstrom et al reviewed 300 articles to show that while fight-or-flight stress can improve the immune system temporarily, chronic stress caused global suppression of it.

Blood Pressure Was Super High

We have a lot more data on stress and blood pressure. And my system certainly wasn’t naive to it.

In 2016, during my career transition, my blood pressure was routinely in the 170s/100s range. It wouldn’t have made sense to take a blood pressure medication because I would have just masked the problems.

I still tried a blood pressure medication but it crashed really bad. Fortunately, as soon as I made the career move my BP was down to 90/60s, like usual. This was the biggest ah-ha moment for me.

10 Things I’ve Since Learned About Stress

1. Breathing is one of the most effective ways to lower stress.

You can try the box breathing method below. My personal favorite is the 4-7-8 breath.

2. Natural sunlight protects against stress.

While many fear skin cancer, we forget all the benefits from the sun. It’s not just about vitamin D but also mood.

3. “Release” stress by going for a walk or doing a hard workout.

I do my health coaching meetings when I go for a walk. It’s better than sitting behind a computer screen.

4. Don’t ignore the constant, low-level stress.

If there’s something bothering you, talk about it, journal about it, or at least do some mindfulness to avoid obsessing over it.

5. More sleep time is needed because stress dampens sleep.

When stressed, the same 8 hours in bed will be more like 6. So add a little more bedtime if possible.

6. Stretching your muscles lowers your stress hormones.

Eda et al measured salivary stress hormones and showed that stretching decreased cortisol and increased testosterone.

7. Caffeine is the enemy of stress (and sleep.)

During high-stress days, it’s best to cut back on caffeine. It’ll take longer to get cleared from the bosy, negatively affecting sleep.

8. Socializing can be frustrating when stressed, but it’s therapeutic.

When I’m stressed I don’t want to socialize. But if I can do it in a supportive space, it’s healing.

9. High-intensity exercise during stress is as bad as caffeine.

I’ve learned from my patients that intensity has to go down when stress levels are high.

10. Stress is physiological, not cognitive. You can’t think your way out of it.

Overanalysis, repetitive thinking, and having internal dialogues often are more harmful than helpful.

Taking New Health Coaching Clients!

If you’ve been looking for a partner to help you solve a health mystery, this is your chance. Below are 3 ways to work with me to help you feel better:

1. One-Time Deep Dive (60 minutes)
   This is a focused session to review your symptoms, labs, and lifestyle. In this physician-led health coaching hour you can pick my brain. I’ll share my experience and the latest research relevant to you.

2. Monthly Coaching
   Ongoing support with one live session per month plus direct messaging.
   This is best for making steady progress with accountability.

3. Weekly Coaching
   This is much more hands-on, with weekly live 1-hour sessions and close guidance.
   Ideal if you want faster and more structured change.

Find out more at https://drashori.com/health-coaching/

Disclaimer:

Dr. Mohammad Ashori is a U.S.-trained family medicine physician turned health coach. The content shared here is for education and general guidance only. It is not personal medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Humans are complicated and context matters. Always talk with your own healthcare team before making medical decisions, changing medications, or ignoring symptoms. This information is to help you add more depth to those conversations.

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Cancer, diabetes, fatty liver disease, and autoimmune diseases have a higher risk if there’s underlying metabolic disease. And since there’s no one test that can check for it, this is the approach we take in my practice.

TL;DR

• Start with insulin, not glucose.

• Look at how your body responds to glucose/stress.

• Measure fat distribution, not just weight or BMI.

• Liver fat is an important metabolic signal.

• Simple tests like waist measurement still matter.

1. Fasting Insulin (HOMA-IR)

Insulin levels change before glucose does. That’s because major glucose spikes can be dampened by secreting more insulin.

You can get your fasting insulin and glucose done separately and calculate a HOMA-IR score using an online calculator. Ideally this should be ~1.5, not much higher.

Note: Fasting, exercise, or a late-night high-carb meal can all affect your HOMA-IR score. We follow a strict protocol when measuring this to avoid noise.

2. OGTT

This is the oral glucose tolerance test. Think of it as the treadmill stress test for your metabolism. This is how your body handles a hefty glucose load.

For an added layer of accuracy, you can get this test done with both glucose and insulin levels.

In our practice, we look at the curve but also how the person feels after ingesting the Glucose Drink. We check at 30, 60, and 120 minutes.

Note: If you’re keto, fasting, or slept bad, your numbers won’t be accurate.

3. Visceral Fat

I like DEXA scan because it’s cheap and easy. But MRI’s are becoming more popular.

Bioimpedance devices do a good job of overall fat but they can’t localize it to the fat that accumulates around the organs.

Note: DEXA/MRI are accurate but not 100%. If you’re borderline, follow up with other tests. Trends matter more than absolute numbers here.

4. Liver Fat (ALT)

You can’t have a normal cardiometabolic system without a healthy liver. Your liver’s ALT enzyme is one of the more accurate tests for this.

We still get a liver scan to be sure but if someone has a high ALT and it drops with the right lifestyle changes, no need to check further.

Note: You can have fatty liver disease with normal ALTs. And exercise, statins, and other drugs can falsely elevate your ALT.

5. Waist-to-Height Ratio

I don’t know any other practice that uses this. I’ve never met a patient who’s calculated their WtHR. It’s not sexy but it has incredibly solid evidence behind it.

All you need is a tape measure. More than 50% and your risk is high. Lower, and chances are your metabolic health isn’t too bad.

Strong Secondary Markers for Metabolic Disease

Many don’t know that your lipid numbers are often an accurate reflection of your metabolic health. Poor metabolic health will lower your HDL, raise your Triglycerides and your LDL.

• Triglyceride / HDL ratio

• ApoB

• Uric acid

• High-sensitivity CRP

• Blood pressure

Who We Test

If your diet, exercise, stress, and sleep aren’t optimized, testing is a good idea.

Before any testing we ask: “What changes can we or are we willing to undergo if the result is abnormal?”

The Goal of Testing

I test for metabolic disease early because if we intervene then we potentially prevent:

• Diabetes

• Heart disease

• Cancer

• Autoimmune disease

We test so that we have data to take action on. But we don’t obsess over absolute values and instead focus on how to get the results to trend lower over time.

Taking New Health Coaching Clients!

If you’ve been looking for a partner to help you solve a health mystery, this is your chance. If you’ve been looking for a partner to help you solve a health mystery, this is your chance. Below are 3 ways to work with me to help you feel better:

1. One-Time Deep Dive (60 minutes)
   This is a focused session to review your symptoms, labs, and lifestyle. In this physician-led health coaching hour you can pick my brain. I’ll share my experience and the latest research relevant to you.

2. Monthly Coaching
   Ongoing support with one live session per month plus direct messaging.
   This is best for making steady progress with accountability.

3. Weekly Coaching
   This is much more hands-on, with weekly live 1-hour sessions and close guidance.
   Ideal if you want faster and more structured change.

Find out more at https://drashori.com/health-coaching/

Disclaimer:

Dr. Mohammad Ashori is a U.S.-trained family medicine physician turned health coach. The content shared here is for education and general guidance only. It is not personal medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Humans are complicated and context matters. Always talk with your own healthcare team before making medical decisions, changing medications, or ignoring symptoms. This information is to help you add more depth to those conversations.

Follow me on:
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YouTube
Facebook
Reddit

What Does Low Testosterone Feel Like in Men?

From the European Male Aging Study and the HIM Study by Mulligan, we know exactly what symptoms show up when testosterone drops below necessary levels.

This testosterone decline usually happens right after age 30, when most men are at the peak of their careers. They have stress, weight gain, less exercise, and less focus on their health. Which can all be confused for low testosterone.

• Reduced libido

• Erectile dysfunction

• Reduced morning erections

• Low energy

• Reduced physical strength

• Depressed mood

• Reduced motivation

• Poor concentration

• Sleep disturbances

• Increased body fat

It’s important to differentiate ‘normal’ stress from hypogonadism. Of course, these are just symptoms and lab tests are helpful to differentiate the real underlying cause.

1. Low Sexual Desire

When it comes to decreased sexual desire related to low testosterone, we’re not comparing you to your 18-yo self, but how you were 1-2 years ago.

What to look for:

• Noticeable drop compared to prior baseline

• Less spontaneous desire

• Less mental preoccupation with sex

Of course, this could also be due to thyroid, blood sugar, or various other medical issues. Your doctor will know how to rule out all potential conflicting diagnoses.

2. Reduced Morning Erections

Men with healthy testosterone levels typically wake with erections several times per week. More noticeable when your bladder is full.

A biologic sign of testosterone decline includes a progressive decline in:

• Frequency

• Firmness

• Duration

3. Reduced Drive/Motivation

There is male go-getter-ness that perhaps you had when you were in your 20s and early 30s. It’s a natural inclination towards competitiveness.

When T levels drops it’s common to experience:

• Less motivation

• Less drive to pursue goals

• Feeling “flat” or blunted

4. Increased Visceral Fat

Without adequate testosterone levels your waist starts expanding. It’s a 2-way street with a poor lifestyle which drives and is driven by low testosterone.

• A bigger belly

• Growing love handles

• Softer muscle tone

More fat → more aromatization → lower T → more fat.

5. Reduced Muscle Recovery

If you work out regularly then you know it takes a certain amount of time to recover. Both to feel fresh again and to prevent injuries.

• Slower strength gains

• More soreness

• Harder to maintain muscle mass

6. Depressed Mood/Irritability

No desire to do anything fun? Especially if it shows up with irritability then it’s likely related to hormonal changes.

It’s really important to differentiate between major depressive disorder (MDD) and hormone related changes to mood:

• Low energy

• Low desire to do fun things

• Not suicidal, still able to get out of bed

7. Increased Fatigue & Energy Crash

This is crashing by 3 pm and not having any energy to do anything else. It’s not likely that your energy will recovery later in the evening.

• Not able to pick yourself up

• Crashing towards the end of the day

• Not better with rest

8. Sleep Fragmentation

Low testosterone and poor sleep reinforce each other. If you’re not able to adequately exert yourself throughout the day, it’s unlikely that you’ll get restful sleep.

• Snoring

• Mild sleep apnea

• 2-3 am awakenings

• Not feeling rested after adequate sleep

9. Gynecomastia

It might not be dramatic breast tissue like many boys develop during puberty. But there will be excess fat and tissue accumulations around the breasts.

• Puffy areola

• Softer chest contour

• Softer muscle mass overall

10. Abnormal Metabolic Functions

If you’re doing everything right but you notice increasing A1C, higher Triglycerides, higher blood sugars and insulin levels, that could point to testosterone problems.

• Lower HDL

• Higher HOMA-IR score

• Increasing LDL-C or apoB

It’s Not in Your Head

If a doctor has ever dismissed your symptoms as “it’s in your head” or “psychosomatic”, you have my permission to push back.

In my practice, I rarely see any value in telling someone it’s in their head. If you’re feeling something new with your health, it’s real. The goal is to figure out what you can do to help you feel better. That’s what I do as a health coach.

5 Ways to Improve Your Testosterone Levels

Now that we covered what symptoms you’ll experience if your testosterone levels get too low, here’s what you can do about it.

The current narrative is that if your T is low, you need testosterone replacement. That’s false for most men. The first things you need and can do are:

1. Lose Visceral Fat

Subcutaneous fat won’t matter. Visceral fat:

• Increases aromatase activity (T to E)

• Suppresses the hypothalamic-pituitary pathway

All you need is around a 5% reduction and you’ll see better sleep, more energy, and better mood.

2. Lift Hard or Very Hard

Of course, you’ll have to work up to this gradually. But the act of lifting weights or just exerting yourself physically stimulates testosterone production directly.

• Compound lifts

• Larger muscle groups involved

• Progressive overloading

Once you master the correct form, my favorite exercises are:

• Squats

• Pull ups

• Push ups

• Deadlifts

3. Get More Restful Sleep

10 hours in bed after caffeine, alcohol, and a heavy meal will give you at best 6 hours of halfway decent sleep.

Testosterone is produced primarily during sleep.

Even one week of 5-hour sleep can drop testosterone 10–15%.

Key issues in 30s–40s men:

• Late screen use

• Alcohol at night

• Sleep apnea

• Irregular schedule

4. Focus on Fuel

There’s no “heart diet”, just as there’s no “testosterone diet.” You need enough food to fuel your body, not more, not less.

In my TREND framework, N = nutrition. We need the right amount of calories and nutrients to keep this body functioning. If you need help figuring it out for yourself:

Book a private session

5. Replace the Stress

If you do stressful things, you’ll experience higher cortisol. It’s not easy to get away from it but spending more time with friends, outdoors, exercising, and leisurely reading can help a lot.

Disclaimer:

Dr. Mohammad Ashori is a U.S.-trained family medicine physician turned health coach. The content shared here is for education and general guidance only. It is not personal medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Humans are complicated and context matters. Always talk with your own healthcare team before making medical decisions, changing medications, or ignoring symptoms. This information is to help you add more depth to those conversations.

Follow me on:
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I chose to pursue medicine because I saw health all around me. A mother who had the stamina to run after us 2 kids. A father who had the strength to lift 50 lbs produce boxes to deliver to restaurants.

My body could jump, climb, and avoid falls on the edge of river boulders. My sister could swing a mean forehand on the tennis court.

I wanted others to enjoy the same health. Growing up in Iran and later Germany, not everyone was fortunate. From untimely infections to unfortunate autoimmune diseases, my family and friends were at the mercy of and experienced incredible transformations by doctors.

I wanted to be that doctor.

If Medical School Taught Health Care

The Krebs cycle, the renal glomeruli, and the connective tissue between fascia and muscle are what were taught. They are the building blocks of the human body doctors learn to take care of.

Health, however, is a personal definition, not defined by an elite group of physicians on a guideline panel. It’s what I needed to learn to define for myself when in training, so that I could one day tease it out from my patients.

I learned pharmaceutical names, prescription guidelines, how to interpret research studies, anatomy, physiology, psychology, and pathology. But never getting close enough to the health I recall having definitely before, certainly not during medical school.

The Medical Care Complex

The sterile clinic of today is the battle ground where the doctor attempts to sell the patient on a new diagnosis, accompanied by related drugs, treatments, and lab testing.

The patient attempts and very quickly gives up because the propaganda of clinical medicine is so powerful. From the cellular to the magnetic imaging, it’s really tough to stand up against this convincing behemoth.

The patient goes in every 3 months, stripped of their autonomy, showered with acronyms and latin words, leaving with a lighter pocket after their final visit to the pharmacy.

The are often waiting for the next symptom to show up, desperately hoping to never have to go through the same phone tree, talk to yet another new receptionist, or, much worse, see yet a new clinician whom they’ve never met before. NP, PA, or was it a DO this time?

The Diseases That Compete With Health

Now, 2 decades and 100,000 patient visits later, I know what health is. I’ve defined it for myself but need to define it over and over every time I enroll a new patient in my medical practice.

The 20 year old often coasts on the great genetics most of us have in our first two decades. There’s resilience, easy recovery, and sleep will happen even if you don’t want it to. Alcohol, weed, and fast food go down easily, rarely making you feel like you’re on fire.

It’s in the 30s and 40s when you need caffeine to avoid the headaches, the purple pill for the reflux, the yellow powder for constipation, the red bottle for aches and pains. These are the convenient OTC solutions until they become our gateway drugs to the prescription bottles.

It’s diabetes, hypertension, cancer, dementia, and autoimmune diseases that eventually take us down. The over the counter runs won’t do it anymore. It’s time to go sit on an exam table, half naked, with an middle-aged, white-coated person standing over you.

Lost Health

It was just a few years ago that you were doing bunny hops on your bike and taking dives off your surfboard into the waves. What changed? You haven’t done a thing different than your early 20s.

And, honestly, you don’t feel as bad as this wrinkled white coat is making it out to be. The last thing you want is to be on a bunch of meds. The dropped faces of those waiting in line at the pharmacy are enough to keep you from ever going back.

Not Joe Rogan, Peter Attia, Andrew Huberman, or Rhonda Patrick actually care about your health. You figured that out because the $2,900 red light therapy device didn’t do anything. Your $349 Oura ring just made you more anxious. And the creatine, magnesium, and 10,000 milligrams of vitamin D or, was it E, just made you bloated.

But there’s no lying - that LCD screen is definitely showing 148/92. The Quest lab says you’re in the prediabetes range at 5.9. And these were the good numbers you’re using to make yourself feel better.

Living Well

On Reddit people say how terrible these doctors are. Gaslighters, patronistic, condescending, rude, and dismissive long white coats. These doctors are making money on ordering MRIs but never tell you to lose weight, sleep better, or exercise.

Back when I used to work as a family medicine doctor at Kaiser Permanente, I wondered why we’re doing what we’re doing. Then again, everyone, including the president, was praising what a great example KP was as a healthcare system. All the while, I’d escalate prescription dosages, add new meds and new ICD 10 codes to their member’s charts.

The only 2 people I recall in my decade-long stint at KP who escaped my clutches were 52 year old CP and 83 year old EM. He got tired of more and more diagnoses and didn’t want to end up like his dad, a pulmonologist who had a pharmacy on his nightstand and lived at the hospital dialysis center. She had retired 2 decades prior and completely disconnected from society but wasn’t about to start her first prescription and decided to reverse her diabetes and high blood pressure with her plate and feet.

They are both still alive. Both doing well. But no longer my patient.

A Life Coach You Didn’t Want

Nor Aetna or Cigna are going to pay me to talk about exercise, diet, stress, and sleep. At least not when someone’s numbers are in the red. If I didn’t fear the insurance companies denying my claims I had to fear the lawyers coming after my medical license for not forcing a statin down my throat’s patient.

My mechanic wants to explain to me that the error code is coming from one of the 3 computers my car has. I just don’t want to hear it. I don’t speak wrench - please just fix it and tell me where to tap my phone. Just as my patients don’t want to hear about the glucose transporter on their myocites. So we all just talk at each other but don’t know what the other person is saying.

While the 3rd computer is replaceable, your coronaries aren’t. So I decided to test a hypothesis of preventing over treating. If I can keep your vessels clear, your liver lean, and your muscle cells working, maybe you wouldn’t get sick. You wouldn’t be in a doctor’s office or the long pharmacy line.

It worked. Blood pressures and cholesterol and CRPs came down because I health coached more than I doctored. People felt better because they had a life coach who wasn’t bound by clinical conflicts of interest. They got their 20s back in their 40s. And now they knew what health was. They didn’t need me much because they were empowered.

No more bamboozled by the banker turned carnivore dietician. Free from the clutches of the supplement dealer. And no more having to listen to someone who’s on an ACE-I, statin, and injectable testosterone who’s telling you how to stay healthy. The freedom!

It Starts Here

As long as we’re in these human bodies we’ll need ER, ICU, and rheumatology doctors. But it turns out that even ICU stays and aortic dissections are preventable. It starts by knowing that they are preventable.

Smart, caring, dedicated doctors don’t believe that. Because their paychecks depend on them believing their training. We are, after all, human. My biases are as colorful as yours. Except I’ve been fortunate to question my clinical biases and my health coaching clients are reaping the reward.

UCLA, the Cleveland Clinic, JAMA, nor the AHA aren’t about to turn on this dime. They certainly aren’t dying on their hill. Their disciples are building them mansions on top of them. From PBMs to vertically integrated healthcare systems, you only need to go in for acid reflux and you’ll come out with a prostate cancer diagnosis.

It starts with knowing what’s at steak. Your Health. And who actually cares about it. You. And who is on your team to help you achieve your definition of health vs. try to convince you that they have the solution to your health safely stashed behind the counter.

https://drashori.com

The good news is that it’s a completely preventable condition. Think of it like a car accident - if you don’t speed and drive attentively, you’ll avoid a crash.

The Early Symptoms

For most adults it starts with your energy dipping down in the afternoon. You feel like crashing after some meals - especially lunch. And you start craving something sweet to get through the day.

But this isn’t just about your energy or appetite. There’s a hormone problem brewing that also affects your hair, skin, sleep, blood vessels, and tendons. All of this is happening with perfectly normal standard lab results.

The goal is not to wait until your labs signal a metabolic problem. We want to catch it years ahead and prevent diabetes in the first place.

Insulin & Your Muscles + Liver

Your muscles are the largest place your body can store glucose (70-80%). If you’re not using your muscles, you can’t store the glucose, which means it’ll float around in your vessels.

Over time, your body has to produce more insulin to push the glucose into the muscles and the liver - that’s the second best place to safely store glucose (10-20%).

But the more insulin your body releases, the more insulin resistant you become. And that won’t show up on a fasting glucose or an A1C test. We’re still a decade out from that.

Are You At Risk?

We are all at risk. That’s because our bodies are meant to prioritize glucose absorption for survival.

As I’m sitting here, intensely focused on writing this article, my body is freeing up glycogen to feed my typing fingers and my revving brain. That means that my glycogen stores are running low.

Our sedentary lives, stress, interrupted sleep, refined foods, and even prescription medications are all contributing to higher blood sugars. This is the risk we all face.

The 10 Habits That Protect Against Type 2 Diabetes

My mom is nearly 80 and went to her doctor and told that her A1C is nearing diabetes. She doesn’t carry a gram of extra weight on her. She eats well and exercises.

But with time, our pancreas, liver, and muscles slow down their function. The good news is that even if she develops diabetes, she’ll have pushed it far into her future. It won’t be happening anytime soon.

Here are the habits my mom and my patients have learned to avoid or delay diabetes for as long as possible.

1. Walk After Your Heaviest Meals

My wife and I had some Cubano sandwiches. This is the perfect definition of a carb/fat bomb going off in our bodies.

The good news is that your body can handle this, as long as everything else is going well. And right after this delicious food, we went for a walk.

As the refined carbs in the bread get absorbed into the bloodstream, the flexing muscles during our walk are transporting the glucose into the muscle and storing it as glycogen.

2. Build Your Muscles 2x/Week

My mom started doing resistance training in her late 60s. It has helped her avoid falls, improve her resting tremor, and get her thyroid levels back to normal.

You don’t need much - 2x/week of a structured resistance program is more than enough. Do it without weights (body exercises) or do resistance bands.

Focus on big muscles and compound movements like squats, pushups, and pullups.

3. Switch from Refined Carbs to Complex Carbs

Me and my wife don’t have a lot of risk factors for diabetes but we still avoid refined carbs. High-carb foods like that cubano sandwich is something we’ll have very rarely.

If your health is solid, a little refined carbs timed properly shouldn’t be an issue. For everyone else it’s a food that your body will really struggle with.

4. Protect Your Sleep

There’s no such thing as perfect sleep but there’s always something you can do to protect it. If I eat after 6pm then I’ll be tossing and turning until the wee hours.

If you’re someone who wakes up in the middle of the night and can’t go back to sleep, check out this article:

5. Feed Your Gut Bacteria

Your gut bacteria make the short chain fatty acids that lower inflammation and improve your metabolism. They also make vitamin K2, certain B vitamins, and about 90% of the serotonin you need for your mind-body connection to function properly.

Your gut bacteria subsist on fiber. With a healthier gut flora you’ll slow down sugar absorption, lowering your chance of diabetes.

6. No Liquid Calories

In my health coaching practice, liquid calories are a non-negotiable. I’ve tried to be lenient with it in the past, only to see the blood sugars and cholesterol shoot up suddenly.

Liquid calories are mostly juices and soda. But they include alcohol and some shakes. Soups aren’t in this category.

7. Lower Cortisol

Stress is unavoidable and one could say that stress can lead to growth. But how your body responds to stress is something you can improve over time.

High cortisol releases more insulin and also increases inflammation. While meditation, breathing exercises, and relaxing activities can help lower it.

8. Maintain a Healthy Waist Size

Visceral fat is the enemy of insulin resistance, prediabetes, and diabetes. To lose it you must engage in aerobic activities and consume fewer calories than you burn.

The good news is that your body is a master/mistress at burning off visceral fat. You just need to give it a chance to do so.

9. Limit Late-Night Eating

As I shared above, eating late at night terribly disrupts my sleep. Without enough deep sleep, I can’t recover, which means more inflammation. And more inflammation means worse metabolic health.

Our heart rate stays higher longer with late-night meals, our temperature regulation worsens, and it’s generally harder for digestion to take place.

If you eat late, just set it back by 1 hour. That will already make a big difference.

10. Stay Consistent, Not Perfect

When I sign on a new health coaching client, we focus on small habits they can do consistently. We never aim for perfection because that’s a recipe for failure.

Small, daily, consistent habits have the benefit of compounding over time.

The TREND Method for Better Health

My TREND method focused on testing (T) to determine what we need to focus on. Using the following metrics I determine if someone is at risk for diabetes or having early signs of insulin resistance:

• HOMA-IR

• Tg/HDL ratio

• Oral Glucose Tolerance Test

Then we pick one small habit from the other categories to change and keep consistent:

• R - relationships

• E - exercise

• N - nutrition

• D - downtime

If you’re dealing with any fatigue or health issues related to your metabolic health, what are some challenges you’ve faced?

Disclaimer:

Dr. Mohammad Ashori is a U.S.-trained family medicine physician turned health coach. The content shared here is for education and general guidance only. It is not personal medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Humans are complicated and context matters. Always talk with your own healthcare team before making medical decisions, changing medications, or ignoring symptoms. This information is to help you add more depth to those conversations.

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If you’ve watched your parents suffer the steady decline of type 2 diabetes, you may wonder if you’re bound to end up with the same disease.

Type 2 diabetes has a strong genetic component. But genes alone aren’t enough. You can design a lifestyle plan for yourself to avoid it.

Genetics ≠ Diabetes.

Welcome to the Healthy Aging Newsletter, a free publication translating trustworthy medical research into simple habits to age well, free of chronic disease. I’m Dr. Ashori, a family medicine doctor turned health coach.

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Factors Most Likely to Lead to Diabetes

I only have one grandmother who developed diabetes late in life. But even without a family history, anyone can develop diabetes, given the right factors.

Back in the day, genes that raised the risk of type 2 diabetes conferred survival advantages. But since we no longer live in those calorie-starved environments these genes are more of a liability.

1. Visceral Fat

Visceral fat is the enemy here. With enough of it, the pancreas and liver will have a hard time functioning properly.

Fat can also make its way into the muscle and prevent glucose balance. Think of that prized marbled beef - it’s a cow with metabolic disease. It’s not what we want for our own muscles.

What we do in my practice:

We build moderate intensity exercises to maintain a high aerobic capacity which burns fat. This forces visceral fat to melt off. We confirm it with a DEXA scan and/or Waist-to-Height Ratio.

2. Break up Sedentary Stretches

If you have any diabetes risk, it’s more important to avoid being sedentary rather than just getting workouts in. Exercise is important, but constant low-level movement may matter more.

It is also possible that the same thrifty genes that raise diabetes risk make maintaining high activity levels more difficult in today’s low-demand environment.

We do this in my practice:

We want our patients to maintain regular activity by breaking up long sitting. 2 hours of watching Netflix should be 30 minutes at a time, with a break to go and do some dishes. Try a walk after heavier meals.

3. High Cortisol Levels

It may be the cortisol hormone or how stress affects our appetite for calorie-dense foods. Stress can’t be avoided but we can build strong coping techniques.

Today is Friday and I have a long list of things to hand off to my team before the weekend. But I try to keep my focus on what I’m doing in the moment. I don’t think about the growing to-do list.

We do this:

We teach meditation to our patients - even those with experience meditating. Time is finite and the more you squeeze into one day the more stress you’ll feel. You have much less control over your life than you realize. This is liberating.

4. Calorie-Dense vs. Nutrient-Dense Eating

A bowl of broccoli tastes bland. Sprinkled with some olive oil and we’re getting somewhere. Covered in Sriracha Mayo and now we’re talking.

Your diabetes genes are clever and crave something calorie-dense. I’ve seen it over and over again with my patients. It’s just that we no longer live in those food-scarce environments.

We do this:

Trick your body with healthy high-volume food instead of calorie-density. This is going to need a little habit formation. More fiber added to your meals will leave you more satiated. Fill up with some nuts, hummus, and fruits if you still need to satisfy your calorie cravings.

5. Functional Musculature

Muscles are a great way to dampen the glucose spikes from meals. You don’t need large muscles but functional ones.

As we age we lose some muscle. We also lose it when we are sedentary. And the times we are at peak muscle activity is right after a heavy exercise. This is the time to have your highest-carb meals.

We do this in my practice:

We time sweet foods like dessert after your fiber-rich meals or after a good hike. It’s not to say that you can’t have it at other times. But when you understand the inner workings of your physiology you have a leg up.

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Need help designing a custom lifestyle plan? Don’t wait until you have borderline high blood sugars. Being proactive here means that you’ll save yourself decades of financial and physical headaches. You’re not alone in this.

Book a call with Dr. Ashori today!

Disclaimer:

Dr. Mohammad Ashori is a U.S.-trained family medicine physician turned health coach. The content shared here is for education and general guidance only. It is not personal medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Humans are complicated and context matters. Always talk with your own healthcare team before making medical decisions, changing medications, or ignoring symptoms. This information is to help you add more depth to those conversations.

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Several large scientific reviews have tried to answer a simple question: What protects memory as we age?

One of the most influential efforts is the 2024 Lancet Commission on Dementia Prevention, which analyzed decades of research on preventing memory loss with age.

Their conclusion is quite encouraging. It proves that a large portion of memory decline risk is preventable.

10 Habits That Improve Memory - Supported by Evidence

1. Protect Your Sleep

Deep sleep is when the brain consolidates memories and clears metabolic waste. Without this step you can’t form or recall memories.

Poor sleep impairs learning the next day and increases long term dementia risk.

You don’t need perfect sleep. You don’t even always need restful sleep. But if you know you have to wake up early the next day, you simply can’t afford to go to bed late.

2. Exercise Regularly

Aerobic exercise improves blood flow to the brain and increases brain derived neurotrophic factor (BDNF), which improves neuron health.

You don’t need a gym membership. Being active at home (chores) or going for daily walks is considered aerobic exercise.

3. Improve Your Metabolic Health

Insulin resistance, fatty liver disease, and metabolic syndrome are strongly linked to cognitive decline.

The amount of visceral fat you have, how much you move daily, and the foods which spike your blood sugar are all factors in how your body’s metabolism functions.

4. Lower Your Blood Pressure

High blood pressure damages small brain vessels and is one of the strongest drivers of vascular cognitive impairment.

Just as it’s the main driver for kidney and heart disease, it also can wear down your sensitive nerves.

I’ve written about blood pressure management a lot. It’s been one of my most successful tools in managing hypertension without medications.

5. Protect Your Hearing

Untreated hearing loss is one of the largest modifiable dementia risk factors.

The explanation is simple - without the right stimulus to the brain, it begins to atrophy. Your vision, sense of touch, taste, and most other senses are just as important as your hearing.

6. Stay Mentally Active

Learning new skills builds cognitive reserve.

Play the piano, learn a new language, find a new sport. This is how complex neural networks are formed in the brain.

Nowadays our attention is much shorter. If you can’t finish a complicated book or sit down and write a long article, you’d benefit greatly from more deep work.

7. Stay Socially Connected

Social interaction stimulates multiple cognitive systems simultaneously.

All your senses come alive and you have to handle multiple conversations and your emotions all at the same time. This is the best workout for your brain.

8. Limit Your Alcohol

Alcohol interferes with memory formation and sleep architecture.

Alcohol is the thing you can have when everything is working perfectly fine in your body.

9. Eat Nutrient-Dense Foods

Patterns similar to Mediterranean diets appear protective for brain health. That’s because they are more nutrient-dense and less calorie-dense.

10. Manage Your Stress

Chronic stress elevates cortisol which impairs hippocampal function.

You don’t need to avoid your stress but you should learn ways of coping with it.

When I know that I can’t cope with stress, I try to avoid it whenever possible.

Reducing Risk of Dementia

These habits don’t improve your memory but they also reduce dementia risk.

If you need help structuring these into your daily routine, reach out below.

Book a 1-hour Call with Dr. Ashori

Disclaimer:

Dr. Mohammad Ashori is a U.S.-trained family medicine physician turned health coach. The content shared here is for education and general guidance only. It is not personal medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Humans are complicated and context matters. Always talk with your own healthcare team before making medical decisions, changing medications, or ignoring symptoms. This information is to help you add more depth to those conversations.

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The new American Heart Association/American College of Cardiology 2026 dyslipidemia guideline still treats lifestyle as the foundation of lipid management, even when medications are used.

The guideline emphasizes that lifestyle changes should begin before medication and continue alongside it. However, in practice, it’s rare for lifestyle changes to precede medications.

If you want a lower lifetime risk of heart attacks, stroke, heart failure, and atrial fibrillation, this is what the science says.

1. Dietary Pattern (Most Important Intervention)

The new March 2026 guideline emphasizes overall dietary pattern, not a single nutrients.

Sorry, protein, despite what the marketers and influencers say, having more protein doesn’t seem to make you healthier.

Recommended eating patterns:

• Mediterranean diet

• DASH-style diet

• Plant-forward diet

At its core, the goal is to increase the following items in your food, assuming you have a mostly Westernized (aka, American) diet.

• vegetables

• fruits

• legumes

• whole grains

• nuts

• seeds

• fish

• unsaturated fats (olive oil)

Most Americans will also need to reduce their intake of:

• saturated fat (dairy, meats)

• ultraprocessed foods (packaged junk food)

• refined carbohydrates (white rice, white flour)

• added sugars

• processed meats

Saturated fat target

The health conscious American look at chicken or beef and sees protein. They are trying to eat more protein as recommended to them by perhaps well-intentioned health influencers.

But this kind of diet comes at the risk of excess saturated fat.

I know, I know, “Saturated fat doesn’t cause heart disease, it’s sugar!” This is the keto camp argument. And it’s a strong argument. But right now, we’re focusing on the guidelines.

The goal is to keep saturated fats under <7-10% of daily calories, depending on your individual risk.

2. Fiber Intake

The guideline strongly highlights soluble fiber. This is the kind that dissolves in water and becomes gel-like.

Fiber blocks cholesterol absorption and binds bile acids, both lowering overall serum lipids.

Examples include, oats, barley, beans, lentils, fruits, vegetables.

And even though the guideline recommends psyllium husk as a supplement, I highly recommend against it if your goal is better cardiovascular health. Though it does lower your cholesterol.

Recommended target:

• 25–30 g/day total fiber

• 5–10 g/day soluble fiber

In my opinion, this is too low. I know this because when I’ve bumped up fiber goals my patients have felt better. But of course there are exceptions.

3. Body Weight Reduction

Weight loss is recommended when BMI or visceral adiposity is high.

This is easily measured with a DEXA scan or bioimpedence or a good old measuring take for a waist to height ratio.

Lowering excess visceral fat reduces triglycerides and increases HDL. It also improves insulin sensitivity.

The guideline emphasizes waist circumference and visceral fat as key cardiometabolic drivers.

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4. Physical Activity

The dose of exercise really depends on the individual and their unique risk factor.

The recommended minimum is 150–300 minutes/week moderate activity (aka, zone-2)
or 75–150 minutes/week vigorous activity.

Moderate activity means that my 47-yo self would need to get my heart rate up to 130-ish and maintain it for at least 30 minutes.

The guideline also recommends 2 resistance training sessions/week.

When my patients have high triglycerides, one of the best ways to lower it is to have them do more zone-2 training and resistance training.

5. Alcohol Reduction

Alcohol raises triglycerides and contributes to metabolic dysfunction.

If you have no metabolic problems and at a very low risk of heart disease, reducing your alcohol may not do much for these arenas.

Guideline recommendation:

Limit alcohol as such:

• ≤1 drink/day women

• ≤2 drinks/day men

In patient with high triglyerides:

• avoid alcohol completely.

Personally, 2 drinks per day is a LOT of alcohol if you’re dealing with any cardiometabolic problems. But, don’t kill the messenger, this is directly from the guidelines.

6. Smoking Cessation

Smoking affects lipid metabolism and vascular biology.

Some of you read this and say, “Come on! Who still smokes?”

Quite a lot of my patients. That’s who.

The benefits are that stopping smoking will increase your HDL, lower inflammation, and reduce plaque buildup.

7. Sleep Health

The guideline newly acknowledges that sleep duration, circadian rhythm, and metabolic syndrome are important factors when it comes to heart disease risk.

Poor sleep is associated with:

• higher triglycerides

• insulin resistance

• weight gain.

The guidelines recommend getting 7–9 hours/night. Of course, that’s total sleep time. If you take an hour to fall asleep and are awake for another 1.5 hours randomly throughout the night, you’ll need a minimum of 9.5 hours in bed to get your 7 of sleep.

Important Guideline Philosophy

The guideline explicitly states that lifestyle is necessary even when medications are used.

The reason I love this is because we’ve seen so many patients who are on medication but are still suffering all the ill consequences of a less-ideal lifestyle.

Medications reduce LDL (and apoB), but lifestyle changes address:

• inflammation

• insulin resistance

• triglycerides

• obesity

• endothelial dysfunction

All of which contribute to ASCVD risk beyond LDL.

Conflicts of Interest

Well, my main conflict of interest is that I’m trying to sell you my health coaching services to help you fight fatigue, poor sleep, stubborn weight, and your risk of heart disease, cancer, or dementia.

The conflict of interest of the ladies and gents who created this guideline is a bit longer:

Research funding from pharmaceutical companies, institutional research grants for lipid-lowering drug trials, consulting fees from lipid drug manufacturers, advisory board membership for cardiovascular drug development, participation in pharmaceutical scientific advisory committees, speaker honoraria from pharmaceutical educational programs, participation in industry-sponsored continuing medical education programs, lecture fees from drug manufacturers, stock ownership in biotechnology or pharmaceutical companies, equity holdings in cardiovascular diagnostics companies, stock options in pharmaceutical or biotech firms, royalties from medical textbooks or guideline-related publications, intellectual property related to lipid metabolism or cardiovascular therapeutics, patents related to cardiovascular diagnostics or lipid treatment, participation in clinical trial steering committees sponsored by industry, data safety monitoring board membership for pharmaceutical trials, trial investigator roles in industry-sponsored lipid-lowering drug trials, consulting for PCSK9 inhibitor manufacturers, consulting for statin manufacturers, consulting for omega-3 lipid therapy companies, consulting for cardiovascular diagnostics companies, consulting for medical device manufacturers involved in cardiovascular care, advisory board participation for pharmaceutical pipeline development, honoraria for participation in guideline or policy panels funded by medical societies with industry sponsorship, reimbursement for travel to speak at educational conferences sponsored by industry, research collaboration agreements between academic institutions and pharmaceutical companies, grant funding from nonprofit cardiovascular research foundations that receive industry support, board membership in nonprofit cardiovascular research organizations with industry funding, editorial board roles in journals receiving pharmaceutical advertising revenue, leadership roles in professional societies with industry partnerships, consultancy for biomarker testing companies, consultancy for lipid diagnostic laboratory companies, consulting for companies developing cardiovascular risk algorithms, consulting for companies developing lipid-lowering biologic therapies, consulting for companies producing cholesterol-lowering monoclonal antibodies, participation in industry-funded cardiovascular registries, involvement in pharmaceutical sponsored epidemiologic studies, consulting for companies developing RNA-based lipid therapies, consulting for companies developing antisense therapies targeting lipoprotein pathways, consulting for companies developing gene-based lipid treatments, consulting for companies producing cholesterol absorption inhibitors, consulting for companies producing triglyceride-lowering therapies, advisory board participation for companies developing cardiovascular prevention drugs, consulting for companies developing inflammation-targeting cardiovascular therapies, consulting for companies producing cardiovascular imaging technologies used in atherosclerosis research.

I sure hope you’re not getting your medication advice from this guideline. But the lifestyle advice is solid. I vouch for it.

Disclaimer:

Dr. Mohammad Ashori is a U.S.-trained family medicine physician turned health coach. The content shared here is for education and general guidance only. It is not personal medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Humans are complicated and context matters. Always talk with your own healthcare team before making medical decisions, changing medications, or ignoring symptoms. This information is to help you add more depth to those conversations.

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Motivation is often the side effect of doing something long enough to see results.

When daily habits start producing real changes, better energy, better health markers, better physical fitness, motivation begins to grow naturally.

The episode I explores:

• Why excitement is often mistaken for motivation

• How journaling and reflection help uncover your actual priorities

• Why consistency is more important than inspiration

• How positive feedback loops create long-term motivation

Download my free 6 Healthy-Aging Habits ebook: https://drashori.com/ebook/longevity-habits/ Book a health coaching session: https://drashori.com/health-coaching/ Subscribe to my free Healthy Aging newsletter: https://newsletter.drashori.com/

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Disclaimer:

Dr. Mohammad Ashori is a U.S.-trained family medicine physician turned health coach. The content shared here is for education and general guidance only. It is not personal medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Humans are complicated and context matters. Always talk with your own healthcare team before making medical decisions, changing medications, or ignoring symptoms. This information is to help you add more depth to those conversations.

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UPDATED: March 27th, 2026

Welcome to Beyond the Labs, a weekly deep-dive into untangling your health mysteries. I help adults in their 30s and 40s crack the code on brain fog, fatigue, and stubborn weight gain, so they can reclaim their energy and focus.. I’m Dr. Ashori, a board-certified MD. I look Beyond the Labs through virtual Direct Primary Care in California and personalized health coaching for professionals worldwide.

A 38 year old entrepreneur came to see me because her memory was failing even though she felt that she was living a healthy lifestyle.

She ran a successful business, exercised regularly and labs were all “normal.” But she was forgetting conversations, had to reread emails, and would lose words during a meeting.

While she was worried about dementia, it was clear that something in her routine was affecting her cognitive abilities. We eventually pinpointed it to her late-night eating, worsening insulin resistance, and very interrupted sleep patterns.

This isn't a one-off story in my practice. As a health coach, I often see people who experience dramatic improvements after making a few subtle lifestyle changes. That's exactly what happened with this businesswoman - she's now back to her old self.

Memory Problems

Memory problems worry people of every age. Adults in their 30s and 40s often notice distraction, stress, and poor sleep affecting their memory. Adults in their 60s and 70s worry about looming dementia.

This guide is a goldmine for troubleshooting memory issues. It's crucial to distinguish between brain fog and mild cognitive impairment, which is the stepping stone to dementia.

Memory Formation & Recall

Memory is the brain’s ability to encode, store, and retrieve information.

The 3 main stages:

• Encoding to take in information.

• Storage to safeguard the information over time.

• Retrieval to access the information effectively.

If any of these steps fail, you experience a memory problem. For example, you never encoded the information because you were distracted. Or, as in the case of the businesswoman, she stored it poorly because of sleep deprivation and she couldn’t retrieve it because of her high level of stress.

In your 30s and 40s, attention problems are at the source of most memory problems.

Don’t Underestimate Memory

Without good memory your day is so much harder. You’ll have to do double duty to get the same amount of work done. Frustration accumulates, your sleep will be affected, and your stress hormones rise.

Memory allows us to:

• Learn and improve skills

• Build meaningful relationships

• Make important decisions

• Maintain independence as we age

Memory is the canary in the coal mine. It is also one of the earliest brain functions affected by poor neurological function.

I repeat this phrase a lot to my clients, “Most memory complaints in midlife are not dementia.”

You don’t have years to wait for “normal” labs to finally catch up to how you feel. Let’s fast-track your cognitive recovery with a personalized plan tailored to your unique biology.

Work with me 1:1

Brain Fog vs Memory Loss

What many label as a memory problem is often an attention problem. If you never properly stored a memory because of inattention, you can’t recall it.

Brain fog is usually a problem with attention and focus. I’ve written about it in the following articles:

The symptoms of brain fog are:

• Difficulty concentrating

• Slower thinking

• Trouble finding words

• Needing to reread things

• Feeling mentally exhausted

With brain fog, the brain often never encoded the information clearly in the first place. If information is never encoded, it cannot be remembered later.

Memory loss is different. Here, the person is doing everything right to consolidate the memory but is unable to and therefore can’t recall it.

Symptoms of memory loss are:

• Repeating the same stories or questions.

• Forgetting recent conversations completely.

• Getting lost in familiar places.

• Difficulty managing medications or finances.

This type of memory problem may be associated with conditions such as mild cognitive impairment or dementia. The reassuring reality is that most memory complaints in adults in their 30s and 40s are brain fog, not neurodegeneration.

It’s never too late to catch early symptoms of dementia. I’ve written about strong evidence on it here:

• Dementia is Preventable - The Evidence-Based Changes to Make Today.

• Memory Loss Isn’t Dementia - What’s the Difference?

Current Evidence on Improving Memory

Large reviews from groups such as the Lancet Commission on Dementia Prevention (2020) and recent WHO consensus statements consistently highlight the same modifiable factors.

Evidence‑supported habits that protect memory include:

• Improving neurovascular circulation.

• Improving quality of slow-wave sleep.

• Addressing sensorineural deficits early.

• Addressing any cardiometabolic disease.

• Improving cognitive skills.

• Increasing social engagement.

• Limiting neurotoxic substances.

These factors influence both day‑to‑day memory performance and long‑term dementia risk.

6 Reversible Causes of Memory Problems

1. Multitasking Overload

Modern work and lifestyles are an assault on the senses. Attention is like cooking, you can’t shortcut it, or else information never gets encoded into memory.

Classic inattention is forgetting what you just read, walking into rooms and forgetting why, or re‑reading the same email several times.

What you can do to improve focus and attention:

• Single‑task whenever possible. This trains your focus and memory.

• Turn off notifications.

• Write things down to address later.

2. REM Sleep Disruption

Memory consolidation happens during sleep, especially REM sleep. This happens later in the night, so if you get up early or have too much noise in the house you’ll miss out on it.

REM problems show up as forgetting conversations, trouble recalling recent information, brain fog, decreased creativity, slow thinking, and irritability.

Protect your sleep architecture:

• Aim for a consistent sleep schedule and protect the last 90 minutes of your sleep.

• Reduce or avoid alcohol, especially close to bedtime.

• Screen for sleep apnea.

• Look for potential REM disruptor medications.

3. Chronic Stress

The hippocampus is at the core of memory formation and recall. If it’s overloaded with cortisol, it can’t do its job.

Common symptoms are losing words mid sentence, forgetting familiar names, and inability to stay concentrated.

In my TREND framework I talk about D, which stands for downtime. You need a break from thinking and stress the same way you need a break from exercise. And what better break than exercising! Another great tool is breathing exercises.

4. Too Many Stimulants

Caffeine, sugar, supplements and some medication can improve alertness but worsen memory if you’re already overloaded.

This might show up as racing thoughts, feeling jittery or overly stimulated, trouble focusing on a task long enough to get anything done, and feeling wired later in the evening.

5. Alcohol

It might have been okay in your 20s and 30s but now in your 40s or 70s - not so much. But it’s always worth testing because you might not be affected by alcohol at all.

We know that alcohol suppresses glutamate, a neurotransmitter involved in memory. We just don’t know how sensitive each person is to fluctuating glutamate levels.

I love a good IPA but I have to deal with 2 days of bad sleep, anxiety, and terrible exercise recovery. Maybe it’s my Middle Eastern genes or just age.

6. Medical Problems

Several medical conditions impair memory. They require closer management to improve memory.

Examples include sleep apnea, thyroid disorders, hormone decline, vitamin deficiencies (rare), mood disorder like depression, and side effects from medications like beta blockers, benzodiazepines, and even certain antidepressants.

Disclaimer:

Dr. Mohammad Ashori is a U.S.-trained family medicine physician turned health coach. The content shared here is for education and general guidance only. It is not personal medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Humans are complicated and context matters. Always talk with your own healthcare team before making medical decisions, changing medications, or ignoring symptoms. This information is to help you add more depth to those conversations.

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Maybe it’s a rare autoimmune disease.
Maybe an unusual infection.
Maybe a complication that doesn’t show up in textbooks.

Medicine is too large for any one physician to master completely.

That’s where Figure1 comes in.

Most patients have never heard of it because the platform is designed for healthcare professionals. Think of it as a global clinical forum where physicians post difficult cases and get input from colleagues across specialties and countries.

Unlike large language models like OpenEvidence, Figure1 is not an AI tool. It’s a community of human physicians sharing real-world experience to help solve difficult clinical problems.

And sometimes that collective knowledge can make all the difference for a patient.

Solving Hard Cases

Imagine you have a really complicated rheumatology case, such as a retroperitoneal fibrosis.

There isn’t much literature on it and the world’s leading experts on the topic are busy being leading experts - so you have to manage it yourself.

While many believe that LLMs have the answers, personally I’ve mostly gotten bad or biased advice from them when managing my patients.

But perhaps that’s a user error.

Fortunately, I can take a case like that and post it on Figure1 and get the input from doctors all over the world, from all different specialties.

Time Needed to Post

The average U.S. doctor has less than 15 minutes with a patient.

The rest of the time goes to documentation, prior authorizations, and care coordination.

To make a post you have to collect all the right information, get the patient’s consent, formulate the right question, add the right images, post your case, and engage with replies.

The doctors who are doing this are not your average doctor.

But sometimes you need someone who is not average.

Patient Consent & Protected Health Information

Most of the Electronic Health Records are constantly collecting patient data and sharing it with third-party companies to figure out how to squeeze more money out of each patient.

This isn’t a fringe opinion.

Electronic health records were supposed to improve care coordination. In reality, many have become billing and documentation machines.

So, what about that xray of the patient’s foot? Well, it belongs to the patient, no doubt. Your data should be your data. But the problem is that it’s not, right? Large medical group and insurance companies are using it without your expressed permission.

When I take your foot x-ray and post it to get clinical feedback, that’s considered disclosing protected health information. Even if the intention is good, I need direct patient consent.

This makes the work much harder. Because now I am exposed to risk and have to find my patient and not only get their permission but I have to get permission from my medical group to use the image which was taken on their premises.

It’s messy and it’s hurting patients. And it doesn’t need to be.

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Learning From International Doctors

When is that last time you read about treating leishmaniasis or MDR malaria? Or how to manage a cancer patient when you don’t have access to an MRI?

The cumulative knowledge of 10 doctors is a very powerful force when it comes to patient care.

Sometimes you have to turn to other countries because your patient can’t afford a CT scan or a certain medication.

• How do they do it?

• How do they choose when they don’t have all the necessary information?

Figure1 vs. LLMs

LLMs = pattern recognition from literature.
Figure1 = real physicians discussing real cases.

Figure1 has been around a lot longer than LLMs. But LLM AIs have penetrated healthcare so easily. Hardly anyone has batted an eye.

Patients are being recorded, their data is being scraped by AI, and AI is even making diagnoses in the EHR.

The reason LLMs have won over case forums like Figure1 is that LLMs are considered unbiased and aren’t humans.

An AI will digest information from a patient’s chart and it won’t go disclosing that data to another person.

But it will take the information and use it as training data (for free) and also aggregate that data to help make better financial decisions when it comes to patient care.

I guess, I would want things to be more equitable, more fair. Let LLMs rise but don’t silence far better existing tools under the pretence that we’re protecting sensitive patient information.

How Does Your Doctor Expand Their Reach?

The next time you feel chummy with your MD, ask them what they do when they have a tough case. Perhaps they nudge a colleague or present the case in a grand round.

Working in a silo will prevent me from becoming the best doctor I can be. I won’t grow and I’ll only be semi-effective for my patients.

Of course, we first need to develop the vulnerability with our patients to honestly answer such a question. But hopefully you have that kind of relationship with your doctor. If not, it’s worth it to start forming that.

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Disclaimer:

Dr. Mohammad Ashori is a U.S.-trained family medicine physician turned health coach. The content shared here is for education and general guidance only. It is not personal medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Humans are complicated and context matters. Always talk with your own healthcare team before making medical decisions, changing medications, or ignoring symptoms. This information is to help you add more depth to those conversations.

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Our modern narrative is that aging is something that happens to you and you have little control over it. Far from it.

We’ve all collected a few habits over our lifetime. Most of them we haven’t questioned. Let’s do that in this article so that you can age healthy, age well.

Welcome to the Healthy Aging Newsletter, a free publication translating trustworthy medical research into simple habits to age well, free of chronic disease. I’m Dr. Ashori, a family medicine doctor turned health coach.

1. What’s “Aging Well”

Most people define aging well as “not getting sick.” That’s a really low bar to set.

I believe that you can age well without feeling too much pressure or feeling blamed for not doing it right.

Aging well means:

• You have the energy you need to live your life.

• You recover well from illness or slammed work weeks.

• Stress doesn’t excessively spill into sleep, eating, or mood.

• Your body feels stable, not fragile.

I love Dr. Andrew Weil’s definition of healthy aging. He’s my favorite physician author on the topic.

“Health is wholeness and balance, an inner resilience that allows you to meet the demands of living without being overwhelmed.”

— Dr. Weil

2. We Assume Normal Aging = Disease

Aging creeps up on you when you normalize day to day health changes. Your knee pain is at first subtle. Next, you’re not exercising, but it doesn’t feel all that bad at first.

Humans normalize slow change because it’s less of a shock to the system.

We believe that low energy is normal - “it’s part of getting older.” It’s not. That’s called fatigue, and it’s a medical condition that should be addressed early.

• You accept poor sleep as normal.

• You power through stress instead of addressing the root cause.

• You normalize joint pains as arthritis.

• You assume your brain gets less sharp with age.

When I lived in Spain I would see people in their 80s and 90s out for a walk early in the morning and again after dinner. Vibrant, active, and oblivious to the “aging narrative.”

3. There Won’t Be a Wake-up Call

By the time a health problem is on your radar, it’s tough to do something about it. Habits tend to grow roots unless you’re regularly taking inventory.

Waiting usually means:

• Fewer options to change.

• More effort for the same results.

• Change is driven by desperation.

Healthy aging works best when you notice small changes early, normalize what’s going on, and create a health strategy you actually believe in.

Check out my free eBook on the 6 most important healthy aging habits:

Get your free ebook copy!

I see it in my diabetic patients, who usually get their official diagnosis in their 40s or 50s. But long before that there was the frozen shoulder, recurrent infections, urination problems, poor sleep, skin changes, and crashing long before bedtime.

4. Creating a Check-in Habit

I don’t think we should let someone else define health for us. Health is a personal topic and often a decision.

What does health mean to you?

Ask yourself from time to time:

• Do I have consistent energy most days?

• Am I sleeping in a way that feels restful?

• Can I handle stress well without feeling drained?

• Does my body recover well after injury or infection?

I’m 47 and it takes a bit longer for my joints to loosen up when I stretch. That’s not a joint problem. It just means I’ll feel better if I give myself more time stretching.

5. Awareness is Much More Powerful Than Motivation

It’s hard to change if you don’t feel motivated. But motivation doesn’t happen to us. It’s something you have actively find for yourself.

Doing a symptom inventory helps you figure out what’s out of sorts. The motivation comes from valuing your future self and how you feel.

I try to be aware of my body. Not excessively, because that just adds anxiety. But that’s what they mean when they say, “You’re in tune with your body.”

6. Take The Quiz!

I sifted through all the data on aging and turned it into a quiz. This questionnaire accurately calculates if you are on track to age well.

Of course, nobody can predict the future. But more often than not, healthy habits tend to result in a healthy body.

Take this free healthy aging quiz

7. Common Healthy Aging Myths

• If my labs are normal, I’m doing fine.

  • Symptoms matter more than lab biomarker.

• Low energy and brain fog is age-related.

  • It’s usually stress related or not recovering well.

• I don’t have time to deal wit my health now.

  • Your body decides when you’ll pay attention to it.

• Healthy aging means living the perfect life.

  • Just a 10-20% improvement goes a long way.

Disclaimer:

Dr. Mohammad Ashori is a U.S.-trained family medicine physician turned health coach. The content shared here is for education and general guidance only. It is not personal medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Humans are complicated and context matters. Always talk with your own healthcare team before making medical decisions, changing medications, or ignoring symptoms. This information is to help you add more depth to those conversations.

A lot of health conversations get stuck on labs, meds, and biometrics. Health also lives inside relationships.

In the TREND method, R stands for relationships. This episode is a conversation with my wife, Niloo, a rheumatologist, about how romantic relationships shape sleep, stress, anxiety, energy, and day-to-day health.

A big myth gets challenged here. Sleeping in separate beds or rooms does not automatically mean something is wrong. Sometimes it is a smart, temporary move to protect sleep while a couple works through snoring, light sleep, illness, stress, or burnout. Better sleep often makes the relationship stronger, not weaker.

The episode closes with 5 ways a romantic relationship can improve health:

1. know personal needs outside the relationship

2. protect time for those needs

3. communicate with curiosity and vulnerability

4. support a partner's priorities while checking expectations

5. reconnect intentionally through shared time and rituals

Links, Products, Services Mentioned

• TREND Method, "R" for Relationships

• Attachment styles (anxious, avoidant, secure) as a relationship stress lens

• Couples therapy, individual therapy, journaling

• Sleep strategies for couples: separate rooms, sofa, extra bedroom, window cracked, fan on, two mattresses side-by-side

--------------------------Download my free 6 Healthy-Aging Habits ebook: https://drashori.com/ebook/longevity-habits/ Book a health coaching session: https://drashori.com/health-coaching/ Subscribe to my free Healthy Aging newsletter: https://newsletter.drashori.com/

Follow me on Instagram: https://www.instagram.com/DrAshoriMD

Join me on Facebook: https://www.facebook.com/DrAshoriMD

---------------------------

Not ready to book any sessions? Get your healthy aging score or find out your healthy aging type by taking these fun, free quizes on my website. Thank you for listening to this week's episode of Doctor Turned Health Coach by Mohammad Ashori MD. I would love your support by subscribing to this podcast, sharing it with someone you love, and leaving me a review on your favorite podcast app. Disclaimer: I care about each listener and want you to receive care that fits your life and medical needs. Always speak with your own licensed clinician before starting, stopping, or changing any health plan, medication, or routine. The information in this podcast is for general education. It is not medical advice. Listening does not create a patient–doctor relationship with me.

-Dr. Ashori MD

Seasonal allergies feel unpredictable. One day things are fine, the next day symptoms are on fire. This episode breaks allergies down as a threshold problem.

Symptoms show up when allergen load + immune reactivity + baseline inflammation exceed tolerance.

A practical roadmap follows that same framework:

• Lower allergen load (air, bedding, dust, outdoor exposure)

• Tune immune reactivity (hormones and the gut microbiome)

• Treat inflammation with a stepwise approach, starting local, then systemic only if needed

Specific tools covered include sinus rinses, filtration, bedding protocols, high-histamine foods to test, and a clear medication ladder (nasal steroids, nasal antihistamines, eye drops, oral antihistamines, plus when allergists and immunotherapy make sense). The goal is fewer flares, better control, and fewer "guessing" days.

Links, Products, Services Mentioned

• NeilMed sinus rinse (saline squeeze bottle kits)

• HEPA air purifiers (room units)

• HVAC air filters (whole-home filters)

• Intranasal corticosteroids: fluticasone (Flonase), mometasone (Nasonex), budesonide (Rhinocort)

• Intranasal antihistamines: azelastine, olopatadine

• Allergy eye drops: olopatadine, ketotifen (Zaditor), azelastine ophthalmic (varies)

• Ipratropium nasal spray (Atrovent) for runny nose

• Oral antihistamines: fexofenadine (Allegra), cetirizine (Zyrtec), loratadine (Claritin)

• Diphenhydramine (Benadryl)

• Montelukast (Singulair), usually with allergist involvement

• Immunotherapy: allergy shots (subcutaneous), sublingual immunotherapy for select allergens

--------------------------Subscribe to my free Healthy Aging newsletter: https://newsletter.drashori.com/

Follow me on Instagram: https://www.instagram.com/DrAshoriMD

Join me on Facebook: https://www.facebook.com/DrAshoriMD

--------------------------- Not ready to book any sessions? Get your healthy aging score or find out your healthy aging type by taking these fun, free quizes on my website.

Thank you for listening to this week's episode of Doctor Turned Health Coach by Mohammad Ashori MD. I would love your support by subscribing to this podcast, sharing it with someone you love, and leaving me a review on your favorite podcast app. Disclaimer: I care about each listener and want you to receive care that fits your life and medical needs. Always speak with your own licensed clinician before starting, stopping, or changing any health plan, medication, or routine. The information in this podcast is for general education. It is not medical advice. Listening does not create a patient–doctor relationship with me.

-Dr. Ashori MD

It’s not like you’re forgetting your kids’ names or getting lost driving home. But your cognitive abilities are not what they used to be. You feel like a fog is sitting on your brain most of the day.

Brain Fog, at any age, is not normal aging

If you’ve been in a high-functioning role long enough, eventually your brain will take a hit. It shows up as emotional decline for some and for others it’s cognitive.

While some people will burn out, lose sleep, get depressed, others will become forgetful, take longer to find words, and feel a deep sense of frustration with mentally taxing work.

What brain fog feels like

Here is how my patients describe brain fog:

• “I just don’t feel as sharp as I used to.”

• “It’s hard to focus, especially in meetings.”

• “I keep forgetting simple things.”

• “I walk into a room and forget why I’m there.”

• “I lose my train of thought mid-sentence.”

• “It takes me longer to process information.”

• “I’m easily distracted.”

• “I feel spaced out.”

• “By the afternoon, my brain just shuts down.”

• “I’m mentally exhausted even if I slept.”

The 8 Root Categories of Brain Fog

From a functional medicine perspective, the underlying cause of brain fog can be categorized as:

1. Sleep or circadian disruption

2. Blood sugar or metabolic

3. Stress or high sympathetic tone

4. Hormonal or neuroendocrine

5. Inflammation and immune activation

6. Mood and psychosocial

7. Medication side effects

8. Neurologic or structural

The brain relies on a delicate balance of neurotransmitters, receptors, and nerve connections. Anything that disrupts oxygen, glucose, or recovery affects cognition.

The problem of normal labs

C. is a physician and one of my health coaching clients who is at the peak of his career. He came to me after a fairly extensive workup for what he called “brain swelling.” When he needed to push himself mentally, he’d feel like his brain would swell, things would slow down, and the noise around him was turned up.

His liver function test, cholesterol, sugar, and inflammatory markers were normal when you look at any one lab test. Of course, normal in mainstream medicine means that it didn’t meet the diagnostic criteria for a disease that would be reimbursed by an insurance company.

In fact, his trends were concerning, the labs were not optimal, and this was proven when we worked together for 6 months and his “normal” labs became optimal.

The most common patterns I see in my practice

The sleep you needed in your 20s may not serve you in your 40s. The stress you’re experiencing might feel like excitement. But you’re slowly damaging your neurons chasing that next career high.

Metabolic health is not just about blood sugar balance but it also involves the way your liver functions.

Those hard HIIT sessions you’re doing in the gym may give you the physique of a 30 year old, but at 64, it’s hard to recover adequately.

Don’t ignore red flags

There’s nothing worse than a patient who sees me for gradually worsening brain fog without ever getting the proper workup. These are the symptoms that I call “red flags” and need a much more thorough medical workup:

• Progressively worsening memory or attention

• Personality change noticed by loved ones

• Neurologic deficits of any sort

• Memory loss that doesn’t come and go

• Muscle and skin changes that are new

If you feel “off” but your labs are normal, this is exactly the type of case I’m excited to take on.

At DrAshori.com we look beyond the labs and create a custom plan that restores your focus and maintains your memory throughout the day.

Book a 1-hour call with me today!

Disclaimer:

Dr. Mohammad Ashori is a U.S.-trained family medicine physician turned health coach. The content shared here is for education and general guidance only. It is not personal medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Humans are complicated and context matters. Always talk with your own healthcare team before making medical decisions, changing medications, or ignoring symptoms. This information is to help you add more depth to those conversations.

You will learn the step-by-step process:

1. Recognize the signal and write it down clearly.

2. Write down the story, fears, and assumptions that show up.

3. Identify which "buffer" might be running thin: sleep, nutrition, stress, or recovery.

4. Run a mini 1-week experiment with 1 small change.

5. Let your body give you feedback: better, worse, or different. Adjust accordingly.

This is how healthy aging begins.

Disclaimer:

Dr. Mohammad Ashori is a U.S.-trained family medicine physician turned health coach. The content shared here is for education and general guidance only. It is not personal medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Humans are complicated and context matters. Always talk with your own healthcare team before making medical decisions, changing medications, or ignoring symptoms. This information is to help you add more depth to those conversations.

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One of my health coaching clients asked for advice for her dad, a retired man who is 5'8", 196 pounds, eats restaurant food daily, and has blood pressure around 157 over 80 to 90.

He is also dealing with a salivary gland stone, which can be linked to dehydration and mineral balance.

We focus on three levers that reliably lower blood pressure:

• stress reduction, using simple breathing and a short daily calm routine

• exercise beyond walking, with a very low barrier approach to resistance training

• nutrition that balances sodium with potassium and minerals, without needing perfection

This is not about extreme dieting or complicated routines. It is about doing small things daily that add up and stick.

--------------------------Subscribe to my free Healthy Aging newsletter: https://newsletter.drashori.com/

Follow me on Instagram: https://www.instagram.com/DrAshoriMD

Join me on Facebook: https://www.facebook.com/DrAshoriMD

---------------------------

If you are looking for a customized health plan to help you navigate your health, book a 1-hour paid session with me. Not ready to book any sessions? Get your healthy aging score or find out your healthy aging type by taking these fun, free quizes on my website.

Free eBook to help you live long and live well! Download your 6 Healthy Aging Habits Ebook and start putting the steps into action. Thank you for listening to this week's episode of Doctor Turned Health Coach by Mohammad Ashori MD. I would love your support by subscribing to this podcast, sharing it with someone you love, and leaving me a review on your favorite podcast app. Disclaimer: I care about each listener and want you to receive care that fits your life and medical needs. Always speak with your own licensed clinician before starting, stopping, or changing any health plan, medication, or routine. The information in this podcast is for general education. It is not medical advice. Listening does not create a patient–doctor relationship with me.

-Dr. Ashori MD

For this article, it’s good to understand the key players in male sex hormone health:

• Total testosterone

• Free testostosterone

• SHGM

• Albumin

• Insulin

• Cortisol

Prevalence of Hypogonadism By Age Group

I am writing this article because a lot of men end up on testosterone without feeling better. At least 40% end up stopping their testosterone in less than a year because the real problem was something else.

How common or prevalent is male hypogonadism?

• Age 30-40 - 2%

• 40-50 - 4%

• 50-60 - 8%

• 60-70 - 16%

• 70-80 - 24%

The above numbers capture the men who have low enough testosterone levels that they must take action. Fortunately, the action rarely needs to be TRT.

Subscribe now

5 Facts to Understand Your Testosterone After 30

In men, testosterone will naturally decline with age, which is normal. The key is to catch a disease-level low testosterone. If you understand the following 5 facts about testosterone, you’ll get more out of your doctor’s appointment:

#1. The 1% Rule of Decline

The Baltimore Longitudinal Study of Aging and the Massachusetts Male Ain Study showed that normal, healthy men will have a 1% drop per year of their testosterone, starting in mid-life.

That’s a drop of 3 ng/dl per year, independent of obesity, stress, smoking, etc.

Meaning, your testosterone should go down with age. That’s because your body will have a lesser need for it.

#2. Testosterone Availability

As men age, their bodies produce more Sex Hormone Binding Globulin (SHBG), which binds to and reduces the amount of bioavailable and free testosterone in their systems.

Certain health problems will increase this SHGB (that’s a bad thing), which will decrease the free testosterone that can act on various organs:

• Increased visceral fat (more estrogen).

• Metabolic syndrome (inflammation).

• Higher cortisol (more stress).

• Sleep apnea.

• Medications.

• Insulin resistance.

#3. It’s Not Just About Sex Drive

Sex drive is almost always affected when someone has clinically low testosterone (aka, hypogonadism) that requires testosterone replacement therapy.

Here are the other important roles of testosterone in your body:

1. Muscle mass & strength.

2. Preserve bone density.

3. Libido.

4. Mood stability.

5. Cognitive function.

#4. How to Accurately Test Your Testosterone

The most accurate way to check testosterone is early morning total testosterone. Ideally, measure 2 separate times.

The most accurate method of measuring total testosterone is the LC-MS/MS (liquid chromatography-tandem mass spectrometry). The more common way it’s measured, which is far less accurate, is through an immunoassay.

For the most accurate free testosterone we prefer the calculated method that requires the measurement of your total testosterone and SHBG. Look for the Vermeulen or TruTT calculation method on the lab test.

Remember, total testosterone is often the “screening test” and free testosterone is often better to decide on whether treatment is needed.

#5. Lifestyle & Testosterone

As mentioned above, when testosterone is low, we’d first look at lifestyle factors before replacing someone’s testosterone.

In descending order, the main causes for low testosterone are:

1. Obesity.

2. Metabolic syndrome.

3. Chronic stress.

4. Sleep disorders.

5. Sedentary lifestyle.

If I can decrease your visceral fat, lower your insulin, and drop your cortisol, I’ll lower your SHBG, which will free up more testosterone. You’ll often feel better without any medical interventions.

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Disclaimer:

Dr. Mohammad Ashori is a U.S.-trained family medicine physician turned health coach. The content shared here is for education and general guidance only. It is not personal medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Humans are complicated and context matters. Always talk with your own healthcare team before making medical decisions, changing medications, or ignoring symptoms. This information is to help you add more depth to those conversations.

Welcome to the Beyond The Labs Newsletter, a weekly deep-dive into solving your health mysteries. I help adults in their 30s-50s solve the ‘Normal Lab’ mystery of brain fog, fatigue, and stubborn weight, to reclaim their energy and focus. I’m Dr. Ashori, a board-certified MD. I look Beyond the Labs through virtual Direct Primary Care in California and personalized health coaching for professionals worldwide.

The art of communication in our modern culture also happens to sharpen our brains. It’s a way to connect with others and think deeply, emotionally, and critically.

Writing, whether a brief text or this long article, is like going to the gym and working out your muscles. I usually start by writing a few bullet points. Then I come up with an engaging title. All of this cognitive processing.

Cognitive Offloading

In a busy world it makes sense to simplify things but only up to a point. I can offload my cognitive skills by automating certain processes. But beyond that I’d lose my cognitive skills.

What’s a cognitive skill? It’s taking environmental inputs, analyzing it, processing, making a decision, and executing. It’s not always fun but it it is neuroprotective.

AI Writing My Articles

I’m a family medicine physician and I do health coaching. I have a ton of data to process, minute by minute. I just got a text from a client in another country who’s worried about his knees and running.

When I write these articles online I could just put my prompt into an LLM and copy & paste the output. The problem is that I wouldn’t learn anything.

When I did the research for this article I came across the term, “cognitive offloading.” I wouldn’t have used the same terminology but thought it was clever. Now, I have this new vocabulary. And by writing this article I have the grammar to communicate cognitive load to my patients.

This is a great skill that I would miss out on if I automated this process.

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Brainstorming With AI

A better skill to acquire is to learn to work and grow with this current version of AI - which is sure to evolve quickly.

1. Write, Then Improve

Write your email and ask for clarification. Before you read the answer, ask yourself what changes will likely be suggested. Compare answers. Whichever version you choose makes little difference.

2. Start the Brainstorming Process

Before asking AI for your article, write your bullet points, come up with a title idea, and then ask AI for more bullet points to add. Again, consider what it will suggest before reading the result.

3. Master Prompting

Spend as much time writing a solid prompt as you do editing the ChatGPT version of your article. This will train your brain to stay one step ahead of tools like LLMs.

4. What Was Missed?

Remember, AI isn’t creative, it’s creating a random output of text based on what it was trained on. It’s just that the output falls within certain, recognizable parameters.

When you read your output, ask yourself, what was left out? How can you make this more unique or creative? That’s your cognitive flexing.

Asking AI Medical Questions

The AI you’re chatting with can’t look through the thousands of patients they saw, the textbooks they read, and synthesize a critical thought process.

I’ve shared scenarios on other channels where AI completely drops the ball when analyzing labs or recommending treatments. A classic example is someone who had an H Pylori diagnosis but never needed treatment based on their risk.

What dictates care in clinical medicine is guidelines. And guidelines are mostly industry funded. They definitely have a purpose and can be a great resource for doctors but they can’t dictate care because care can never be generic. Agree?

When you ask AI a medical question it’s best to have it help you identify and gaps in your understanding or knowledge. I have some great AI prompts here you can check out.

Bonus: Write By Hand

There’s a reason that written language has evolved in so many different places in so many similar ways. There’s an important connection between thought and writing.

Don’t lose that skill. The good news is that you need very little of it to maintain and benefit from the skill. Write a postcard, write in a paper journal, or write your to-do list for the day in a small notebook.

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Disclaimer:

Dr. Mohammad Ashori is a U.S.-trained family medicine physician turned health coach. The content shared here is for education and general guidance only. It is not personal medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Humans are complicated and context matters. Always talk with your own healthcare team before making medical decisions, changing medications, or ignoring symptoms. This information is to help you add more depth to those conversations.

This is a practical, step-by-step guide focused on daily actions that help protect your enamel and reduce the risk of cavities getting worse.

We cover:

• How cavities start and when they can still be reversed

• Why brushing too hard can damage enamel

• A simple brushing routine that actually protects teeth

• How sugar and frequent sweets drive acidity and enamel erosion

• What to do after sweets to reduce damage

• Why waiting before brushing after meals matters

• When higher-fluoride toothpaste can help remineralize early cavities

• Dry mouth, alcohol, caffeine, and why they increase risk

• When cleanings and X-rays are useful, and when they may not be necessary

• Flossing vs water picks, and how to make flossing actually work

The goal is simple. Keep your teeth as long as possible, minimize pain, minimize antibiotics, and avoid procedures whenever you can.

-------------------------- Main Website: https://www.drashori.com

Subscribe to my free Healthy Aging newsletter: https://newsletter.drashori.com/

Follow me on Instagram: https://www.instagram.com/DrAshoriMD

Join me on Facebook: https://www.facebook.com/DrAshoriMD

---------------------------

If you are looking for a customized health plan to help you navigate your health, book a 1-hour paid session with me.

Not ready to book any sessions? Get your healthy aging score or find out your healthy aging type by taking these fun, free quizes on my website.

Free eBook to help you live long and live well! Download your 6 Healthy Aging Habits Ebook and start putting the steps into action. Thank you for listening to this week's episode of Doctor Turned Health Coach by Mohammad Ashori MD. I would love your support by subscribing to this podcast, sharing it with someone you love, and leaving me a review on your favorite podcast app. Disclaimer: I care about each listener and want you to receive care that fits your life and medical needs. Always speak with your own licensed clinician before starting, stopping, or changing any health plan, medication, or routine. The information in this podcast is for general education. It is not medical advice. Listening does not create a patient–doctor relationship with me.

-Dr. Ashori MD