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Colin Renaud, PA-C explains why the training session is not where muscle actually gets built, what muscle does for metabolism and blood sugar, and why recovery is the part most people skip. Muscle affects metabolism, blood sugar regulation, mobility, bone health and how resilient the body is as it ages. What body composition testing actually shows, how muscle and insulin are connected, why recovery and sleep do the building rather than the workout itself, and what protein intake really needs to look like. Functional medicine for adults in Maine and New Hampshire.
Colin Renaud, PA-C explains why the training session is not where muscle actually gets built, what muscle does for metabolism and blood sugar, and why recovery is the part most people skip.
Muscle affects metabolism, blood sugar regulation, mobility, bone health and how resilient the body is as it ages. What body composition testing actually shows, how muscle and insulin are connected, why recovery and sleep do the building rather than the training session itself, and what protein intake really needs to look like.
In this episode:
Med Matrix is a functional medicine practice serving Maine and New Hampshire. Learn more at medmatrixusa.com
This episode is for educational purposes only and is not medical advice. It does not create a patient provider relationship. Always talk with your own qualified healthcare provider before starting, stopping or changing any treatment, medication or supplement.
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Welcome to MedMatch Podcast, where we talk about everything functional medicine. Today's episode is called Muscles Medicine, Why Strength is the Key to Aging Well. And we've been looking forward to talking about this one because it's something we see all the time. We talk about muscle every day in the clinic. Patients who are focused on weight loss, fatigue, joint pain, metabolism, or aging, but have been told how important muscle is to the full picture. We're gonna be talking about today. So I'm excited to be joined today by one of our lead functional medicine providers, Colin Renard, who is gonna break down what patients should actually understand about muscle strength, metabolism, and all that. So here's how today's episode is gonna go. If you're joining us for the first time, first, we're gonna start with discussion. We're gonna talk about the conventional approach, the functional approach, real strategies. If you guys have questions as we go along, make sure to drop them in the comments below because after that, we're gonna do real patient case studies, and then we're gonna do live Q&A with the amount of time we have left, and that's always my favorite part. Just a reminder before we get started, this episode is for educational purposes only. This is not meant to be personal medical advice, and it should not replace the care from your own medical provider. If you are interested in receiving personalized medical guidance from one of our providers, we'd love to help you. You can go to our website, book a discovery call, and start the process of becoming a patient. All right, let's get started. Colin, why don't you introduce yourself for those who may not know you? Yeah, sure, Cole. Like you said, I'm Colin Renard. I'm one of the lead clinicians at MedMatrix. I have a unique background in various disciplines. I have a background in chiropractic medicine and natural medicine. I am licensed in practice medicine as a PA at MedMatrix, and I am multiple board certified in anti-aging medicine, natural medicine, and in nutrition, and I also am fellowship trained in anti-aging and functional medicine. So I've been doing this a little over 10 years now. I've been really excited about this topic. I mean, I am a bodybuilder. Muscle is like a huge part of the conversation with all my patients. The studies are overwhelmingly positive about how, and we can talk about the specifics, but how muscle mass improves your longevity, makes you live longer. So I think this is a really important topic for our audience, and it's something people ask all the time. When we talk about exercise, you know, how do I exercise, what should I be doing? So I think this is a really important topic. Fantastic, yeah, I'm excited. So when you say muscle is like super important, muscle is medicine, what do you want patients to understand about that? So why we say that muscle is medicine essentially is it is not just an appearance thing. I mean, partially, but muscle affects metabolism, it affects blood sugar regulation, it affects your mobility, it affects your strength, your bone health, and how resilient your body really is when it ages. There's been, as I said before, there's been studies that show that, especially for certain populations over a certain age, like for example, women over 60, if you increase your muscle mass, you can decrease your risk of death by so much percent over so many years. And there's multiple studies that show that having higher muscle mass is an independent survival factor. Basically, the higher your fitness level, you will live longer no matter what other comorbidities are going on. So having an increased muscle mass is almost like a longevity organ to what you can do to preserve and prevent, I guess prevent death, not that that's preventable, but extend it and make it not happen as fast. So it's something we talk about with, I do anyway, and all the clinicians in the practice do, we talk about muscle mass all the time. Because unfortunately, it's something that, people aren't necessarily, I don't want to say they're lacking, it's just something that people, well, they are, but it's not something that's at the forefront of a lot of people's minds, especially at a certain age. And people just don't, they might not know how to even build muscle mass. Like, what does that even mean? Especially sometimes for women. It's like, well, I don't want to look like a, you know, I don't, whatever. It's like, no, it's not necessarily about that. It's about having a certain amount of mass, you know, buried in there so that you're keeping healthy. So. Totally. Yeah, I'm so excited today to get into, like, the actual strategies behind building muscle mass for myself personally, but also, like, I think a lot of patients, like, they're trying to do the right thing at the gym. They know muscle is important, but there's actually, I mean, you've clearly, not only deeply understand it as a functional medicine provider, but also personally in your life, just looking at your jacks. I'm trying. Why does, so, like, okay, you're saying, like, muscle is important as you get older, but, like, what is actually happening, like, physiologically, chemically, biologically, that, like, makes muscle so important? Yeah, so muscle becomes really important as people age because it can become hard to build muscle as we age, and it's easier to lose it as we age. So this can affect people's strength. It can affect people's energy, their balance, their independence. That's a big thing. We just had a podcast the last week with my colleague, Dr. Rose, who's in the practice, and we were talking about muscle issues from, like, an aging perspective, and one of the biggest issues we run into as a society amongst the elderly is weakness. As you age, right, you're in your 70s, your 80s, your muscle mass significantly declines, and your independence can decline with that, right? You're prone to falling. You know, a lot of people, as they age, or an elderly, if they fall and break something, that could be the end of their independence altogether, especially in the elderly population. You know, if you break a hip at a certain age, it's very hard to recover from that. So what we're trying to do is educate people on understanding what this means. This isn't necessarily aesthetic. This is, you know, when you're 70, 80 years old, you have proper balance, right? You can move around and function in the world and not be worried about a potential fall that could completely ruin your independence for the rest of your life, however long that is. So we try to address these things early, right, while people are midlife or earlier, so that they understand what this means as they age. So that's a big, big important part of what we're talking about. You know, things like osteoporosis, things like osteopenia, which is, you know, essentially the bone matrix is becoming less fragile or more fragile. And then, like I said, independence, falls, all that stuff is really important. Yeah, so what actually happens as you age that leads to muscle mass? Like what's happening on a physiological level that makes it harder to maintain muscle mass as you get older? Yeah, one of the biggest things is it's a nutrition problem. So when people are not eating the right food, not eating enough protein, eating enough of the nutrients that you need to actually maintain muscle mass. And then one of the other things is hormone decline. So men and women's hormones decline as we age. And the hormones are really important for maintaining the muscle mass at sort of a microscopic level. And then unfortunately, lack of physical activity. So if people aren't doing any type of resistance training, you know, in older years or middle age and beyond, it can significantly impact your muscle metabolism where you're just actually putting on fat. You just continuously are putting on fat and your body fat percentage goes up and up and up and up. And any muscle you do have becomes very fragile, very weak. You know, I see patients in their 50s and 60s and it's like, yeah, I don't have the best mobility and like my balance is off and blah, blah, blah. And it's like, gosh, you could live another 30 years and your balance is already starting to be a problem. So this is where we need to educate people on the changes that happen early on. So, yeah. Yeah, and I think part of the problem is like data, right? So like, what does the scale, because people just step on a scale, most scales aren't gonna tell you you know, muscle mass. It's something that's not super commonly talked about when you go to your primary, they're not looking at your muscle mass per se. Like, what does the scale normally miss? Like, what are the numbers that people should be looking at? Well, the scale misses just what your body composition looks like. So, for example, as a new patient at MedMatrix, we are always doing a full body composition analysis from the get go. And we do it repeatedly as you go through care. And what our composition looks at is a lot of different parameters from actually what you weigh, which you know, it's important but it looks at how much body fat do you have? How much muscle mass do you have? How much water do you have? And the reason why those things are important is because when you translate weight into just a number, it is a formulation of a lot of different variables, not just how much mass do you have, right? For example, me, I am technically overweight for my height and how much I weigh because I am of a certain amount of muscle mass. So it's important to understand those parameters because it's important to understand where people's risk factors come from, right? How much visceral fat do you have? How much body fat percentage do you have compared to muscle? All of that plays into our understanding of treatment. And it could also change as treatment is initiated, right? From hormones to something like a weight loss medication, all of these things will have an effect on mass and muscle mass. So we need to understand all those parameters. Yeah, let's talk about some of those things that actually affect mass. So first one being the lifestyle side of things. So what, in your opinion, it's kind of a trick question, what affects muscle mass more, nutrition or exercise? Ooh. I always say, I've said this for years, you can't exercise away a poor diet. Right. But if you don't do resistance training, it's very hard to build muscle mass. But if you're, so let's take, for example, not to give my case study away, but let's take, for example, a male with low testosterone, say he's 50 something. His muscle mass will decline quicker because his hormones are low. If he optimizes his testosterone, he could build muscle mass with proper nutrition without resistance training, just because of the metabolism of the way the hormone works on the body. So it's really hard to say which came first, the chicken or the egg kind of thing. It all kind of goes together, but it really does depend on the patient and the objectives, like hormones, the biomarkers. Right. And people don't need to do a lot of exercise either to make change. Like there was a study, I don't remember what year this came out, but it was a study published in the British Journal of Sports Medicine that said, and this is kind of one of the bases of how we understand muscle metabolism, that you need only 90 to 120 minutes a week of resistance training to reduce your, what we call all-cause mortality, which means dying of anything, by about 15%. So if you don't do anything else different from a health perspective, but do resistance training for three hours a week, you will live for 15%, your cause of death will reduce by about 15% from any cause. So there's huge amounts of benefit in that, but again, if you're not supporting it with the nutrition, that's hard too. It's a really delicate balance. It's a hard question to pinpoint. It depends on the age too. It's a huge factor. Yeah. Totally. Well, you talked about testosterone for a second. You talked about how like a man with optimal testosterone, sounds like at any age, is gonna have a lot easier of a time building muscle, and testosterone is just as important in females as it is males, right? Yes. How does testosterone play a role in building muscle mass for men and women? Yeah. I mean, we can sort of broaden the topic too, and just say hormones affecting people as we age, and we can talk about testosterone specifically, but testosterone, estrogen, and specifically thyroid hormones, things like insulin too, which control your blood sugar, all influence muscle recovery, the metabolism of the body, and strength. So hormone changes, specifically as we age, can make muscle harder to maintain, and it can be something that needs to, that should be evaluated early on. In my clinical opinion, we shouldn't wait until it's low, or people are symptomatic. I think we should be checking hormone levels when people are 30 and beyond, just to be proactive about it. But testosterone specifically for men and women is going to promote muscle metabolism and fat loss. So especially if you're a man, if you're trying to lose that weight around your midsection, if you have low testosterone, or just try to reduce your body fat altogether, if you have low testosterone, it's gonna be very hard for you to do, because your body is not in the muscle-building mode that it needs to be. It's really in the fat-storage mode. So like I said before, if you don't have hormones on board, and you're trying to work out in the gym, and you're trying to eat well, you might not be building muscle at all. And I hear that from a lot of guys in their 40s, 50s, 60s. I've been in the gym for five years, and I still look the same. Why do I look the same? Why am I not jacked like these other people? Well, because your hormones are not helping you build the muscle. So there's a lot of variables, but hormones are extremely important. Yeah. What about everyone's favorite hormone to talk about, which is your stress hormone, cortisol? How can, how does stress and cortisol, because everyone has their opinions about cortisol, and a lot of them aren't very educated. So what's the real, real about like, how your cortisol affects, and stress affects building muscle? I mean, stress affects everything, but chronic stress works against strength and recovery because it does a lot of things. It can disrupt sleep. It increases inflammation. It affects your blood sugar significantly. And chronic stress raises cortisol. Cortisol is one of your major stress response hormones. And what this can basically do is it can reduce your body's ability to recover appropriately. And also it makes your heart, it makes it harder for your body to repair itself and build muscle, essentially. So the whole world, it seems, is chronically stressed, and so many of our patients are. And if you can't dial in the stress part, it can be also really hard from a muscle metabolism perspective to make that work. So you could be doing all the right things, diet, lifestyle, you're in the gym, hormones, but if stress is not there, you're gonna miss a huge part of it. So unfortunately, that's where people are, I don't wanna say failing, but they're just not succeeding, right? People's diets aren't adequate. Their hormones are not adequate. They're stressed out to the max. So when we talk about trying to help people get healthy, it's not a one variable system that we have to control. It's really multiple things. We have to talk about their sleep. We have to talk about their stress. We have to talk about diet. We have to talk about hormones because it all works together. Your body is supposed to function that way by working together. So with something like stress, you could have all of the variables right, but if the stress is bad, it's a tough, tough sell. Yeah, gotcha. Some other things that, what would you say the other really important things that are gonna affect your ability to build muscle? We talked about nutrition, exercise. We talked about your hormones, testosterone. What else can really affect someone's ability to gain muscle? Other things that affect someone's ability to gain muscle can be really simple in terms of like nutrition, like not eating enough protein could be an issue. If they're lifting in the gym is not appropriate. So if they're not lifting to actually stimulate muscle fibers, they're doing too much cardio, right? It's just gonna just burn calories and you're not gonna build muscle that way. Sleep, sleep's a big one. If you're not sleeping well, we did a whole podcast on sleep. We should probably do more, but basically sleep is when your body recovers overnight and it repairs itself. So if you're not giving yourself that reparative ability, that's you're kind of out there too. If you're not regulating your blood sugar, if you're pre-diabetic or have diabetes, that's gonna impair muscle building as well. And then we talk a lot about on this podcast, inflammation. So inflammation can just be a broad term of the body's inflamed from poor diet, from blood sugar issues, from stress. And that's another big part of what can impair muscle metabolism. So there's a lot of different parameters. And unfortunately, it all kind of has to line up. And I think that's where patients are struggling is so many of these variables are not lining up and they're just struggling to understand why they can't change their body composition, lose fat and or build muscle. Yeah, can you talk more about inflammation? Like the kind of simple, this causes this, which causes that explanation of like how inflammation leads to or making it harder to put on muscle. Yeah, I mean, inflammation can make it harder to put on muscle because it can really affect recovery, which is a big one. It can cause a lot of pain. So if you're inflamed and you don't feel good, your joints hurt, your muscles hurt, your back hurts all the time, right? If you're overweight, who's gonna wanna work out? And also it can affect significantly the reparative ability of tissue. So if tissues are constantly inflamed, it can be very hard for you to kind of get that restorative nature that the body needs to build muscle mass. Yeah, okay, let's talk about kind of what a lot of people are maybe experiencing right now. Where does the conventional care often miss the muscle conversation? Yeah, I think they just don't have it. The conventional care model just does not talk about muscle mass. Well, maybe they do in certain settings, right? If this is orthopedic medicine, if it's sports medicine, rehab medicine, physical therapy, is gonna talk about muscle metabolism. It is gonna talk about muscle mass when it comes to functionality, especially in say the geriatric or older patient population. But I think from a baseline, most people are not going to their primary care doctor to have a discussion about muscle mass. It probably very rarely happens. Patients are probably often told to lose weight or move more, right? Just quote unquote, whatever that means. But there's not a really good understanding of what that means for the patient, right? What does exercise mean, right? Cole, if I said you need to exercise more, I don't know. Does it mean walk? Do I need to run a marathon? Do I need to bench 350 on a chest press? What does that mean? And the other thing that's really lacking too from a conventional medical perspective is the emphasis on nutrition, the emphasis on protein intake, the emphasis on insulin resistance, hormones affecting muscle mass, sleep affecting muscle mass, and then also recovery. So these are things that we do really well at MedMatrix because we understand all of the parameters in order for a patient to optimize their goals from a body composition perspective. And it's just not part of the standard approach from the conventional side of things because we've said on the podcast many times, we do not disrespect our conventional medical colleagues. We have the utmost respect for, we are not anti anything, but we just don't feel that the conventional medical system does a well enough job of proactive aging as I call it or longevity awareness and things like that. Yeah, okay. Yeah. Yeah, totally. Let's talk about something that's like been a hot topic lately, which is trying to lose weight or weight loss without thinking about muscle. I'm kind of like hinting at GLP-1s because I think that's happening to a lot of people is they're losing weight. Yeah. They're getting muscle and that leads to a lot of problems. So what's going on with that? People trying to lose weight without paying attention to muscle. What's happening? Yeah. And the GLP-1s are a big part of this. So if you are a weight loss first approach person and you are not worried about muscle mass when that is as a part of the equation, you may become weaker. You may be more metabolically fragile, which means that you don't have a lot of resilience. And the ability for the body to regain weight is much more likely, especially if we're talking about a GLP-1. We've done podcasts on the GLP-1s like trizepatide or semaglutide. So what can happen is if people are just trying to lose weight and you're not focused on what type of weight, right? Because weight is just, when you look at the scale, this goes back to our conversation a few minutes ago of like why is body composition really important versus just a number on a scale. If you're measuring just numbers on a scale and oh, I lost 10 pounds. Well, what is that 10 pounds? Is it fat? Is it water? Is it inflammation? Is it muscle? You know, we have to understand all those parameters because we wanna lose fat, right? We don't wanna lose muscle. We don't wanna lose the bad stuff. We wanna keep the good stuff and lose the bad stuff. So that's a huge part of what we talk about when we talk about weight loss, what I do and I know my colleagues do is really trying to make sure we're losing weight the right way. We're losing fat weight. We're losing visceral fat or the fat in your abdomen and we're preserving muscle so that people can be strong and hopefully potentially get stronger as they lose weight. Yeah. Totally. Okay. Sweet. Now let's talk about functional medicine and like kind of just real strategy. So how does functional medicine look at muscle mass and building muscle differently? Yeah, so the functional medicine approach to muscle and strength is really different because we look at the whole system as I've sort of alluded to this a few times already. We're looking at nutrition. How much protein do you get a day? How much should you get a day based on your age or gender? We're looking at strength training, right? And we have resources in our clinic to help people understand strength training better. I mean, I'm not a trainer. I know a lot about it, but only for myself. But we do have resources in the clinic that can help people get set up with understanding strength training better because that is a huge piece of why this is not successful for people. They don't know how to work out. Or they go to the gym and they hop on the elliptical for an hour. Nope, don't want you to do that. We want you to lift things. But they just don't know how. They don't know how to get started. They don't want to hurt themselves. So having that knowledge is really important. And that's not necessarily a functional medicine perspective. That's just understanding that it's an important part of muscle building is how to do it from a weight training perspective. A huge part of the functional medicine approach across the board is hormone optimization. Whether you're a MedMatrix or some other functional medicine clinic around the country or anywhere, probably hormones are gonna be addressed. That's a big one. Also thyroid, how well your metabolism works is really important. Also your blood sugar, how well that's going, how well that's working. And like I said, some of the things we talk about with all patients from sleep to stress to gut health to nutrient status, your body composition, and then how well you recover. So those are all things that we're doing from our perspective. And those are all questions that we ask during the very first visit with patients. We get all these parameters right from the beginning so we can really understand what needs to be improved and then to start educating people on how it affects their goals. Yeah, okay. So you said something that's interesting versus like men versus women and how it's different. I also imagine that what you're gonna recommend to patients based on their age might be different, but I also might be wrong. So we'll play a little game. We'll go through like decade and gender and then what your favorite size is for that general type of patient. Oh, okay. For like a patient in their like, let's start all the way at the beginning. Patient in their 20s, try and do muscle mass. What do you think the best types of exercise are for them? For the younger generation, men and women, anything full body. You know, you're doing your upper body, your arms, your shoulders, you're building your back, your legs. There was a study done, I don't remember when, but basically said the stronger your legs are, the longer you will live. So strong legs. So in young life, strong legs. Because the stronger your legs in young life, the more mobility you will have in older life. It's harder to develop strong legs in older life and that's where we see hip fractures and falls and things. Right. And it's also, isn't there something to be said too about once you build muscle, it's not only easier to keep, but it's also easier to rebuild? Easier, right. Once it's there, it's easier to maintain and it's easier to build upon and it protects you longer. And if you lose some of it, right, it's easier to build up again because your body has the memory of it being there. Yeah. So it takes a long time for it to get there, but once it's there, it helps you and it can help you. You know, if you were to have some sort of tragic accident, you were in a car accident, you needed rehab, you would rebuild it faster than if it wasn't there to begin with. Yeah. You wouldn't lose it. And what about patients, men, women in their 30s? 30s, same thing, full body stuff, focusing on upper body strength, focusing on lower body strength, focusing on balance is also really important. So I often, for myself too, but I often see trainers in this age group, 30s, 40s, working with people to do single arm stuff, like single side, whether it's, you know, working on shoulders, arms, back from one side of the body, same thing with legs, because what it does is it builds balance. It starts to incorporate some of the really small muscles around your joints that help keep your balance, help you be balanced, and also your spinal muscles and your abdominal muscles keeps everything in balance, so that's important. Okay. When does it, when would you change the style of workout to go from full body balance focus? When do you start changing that, if ever? So you don't really ever start changing it, but when people are elderly, you have to be more focused on how much weight you're moving around, and then also balance is really important in the elderly if they have good balance. So if they've worked on it, it's important to work on it more, but you wanna, in the elderly, you wanna be focusing on smaller movements that don't have as much potential for risk, or, you know, falls or things like that. I see in my gym women in their 80s, and they're like squatting, and it's like, yes, I wanna be that person. But they have a really good foundation. So if you are of an older age, like 65 beyond, and you're trying to build muscle, you really wanna be focused on the smaller muscle groups, you know, biceps, triceps, focusing on your lower body, but doing it with more of your own body weight until you develop some strength in there. So you really need to work with someone to really understand, this is where you're not trying to heavy deadlift and like lift heavy. You know, in your 20s and 30s, 40s, you can lift really heavy and kind of go for it if you have the foundation for it. But as we age, it's really about function. It's about, you know, the function of the muscle, utilizing the function of the muscle, not trying to like bust the gut when you're 70 years old, deadlifting, you know, hundreds of pounds, so. Yeah, when is enough muscle enough? Or is it? No such thing. Well, that's for me anyway. But muscle, you can, I don't know, this is where I forget the biology of it, but you lose, you can lose like a couple percent of muscle in only a few days if you're not maintaining it. So muscle building is a constant effort and it might not necessarily be building more, but maintaining what you have. Because like I said, if you're not keeping up with the resistance training and the dietary intake over the course of your lifetime, you will lose. You know, if you work out in the gym consistently, you'll go on like a week vacation, two week vacation, you don't work out at all and you come home and it's like, oh my gosh, I'm so weak. Yeah, because you have lost some muscle mass in that short period of time. So you can lose it very quickly. So keeping up with the maintenance part is also really important. Yeah, totally. Yeah. Okay, so let's go back to like some of the more fancy functional medicine stuff. So lab, what are like lab markers or specialty tests that can kind of give us an indication into how easy it is for someone to build muscle? Yeah, so some of the common laboratory analysis that you do to understand muscle metabolism in general is blood sugar markers, things like fasting insulin. Insulin is the hormone that controls your blood sugar. Your fasting glucose, which is actually your blood sugar. There's something called a hemoglobin A1C, which basically tells us how well you control your blood sugar over a couple of months at a time. I mentioned this before, but understanding your thyroid. Your thyroid gland is basically the control center of your metabolism. So that's really important. And then also looking at your hormone markers. We talked about that a few times. You know, testosterone, estrogen, progesterone in both men and women. Nutrient markers are really important too. Vitamin D, vitamin B12, iron, ferritin, really, really important nutrients for building muscle. If those are not there, it's gonna be really hard to do. Looking at markers of inflammation, looking at markers of how well your kidneys and your liver are functioning. And then also just some more basic stuff. Blood counts, red blood cells, white blood cell markers. And then the body composition is really important. And this is something that guides us in terms of treatment. You know, it gives us a place to start and gives us understanding of how people are progressing. So all of these biomarkers are things we do with patients from their very first visit at MedMatrix. We do over 80 biomarkers from the first visit. So we get a really good understanding of the muscle metabolism and muscle health rates from the beginning. Yeah, can we talk about metabolism? Because you talked about how like, because it works on both sides, right? Like you talked about thyroid metabolism. And for metabolism sluggish, that makes it harder to build muscle, right? Yeah, and then. Yes. But then if you don't have enough, the more muscle you have, the faster metabolism is and it's easier to use, right? Because when you're working, I've heard you talk about this. When you're working with patients who wanna lose weight, the first thing you're talking to them about is like, let's get you more muscle. So it's gonna be easier. So can you talk more about like how metabolism plays a role in building muscle on both sides? So both sides is if the metabolism is too slow, basically what can happen is it can, and your metabolism is a summation of all of your body like things, all of the stuff your body is doing from breathing to your heartbeat, to blood sugar control, to production of cells. I mean, it's just a summation of everything your body is doing together. So if your metabolism is too slow, what happens is fat deposition is greater and muscle loss is greater. So, and then what we're trying to do is really understand, or what I'm trying to do is make patients understand metabolism from almost like a machine perspective. If you are trying to run more efficiently, you wanna run a little faster and you need to give the body the adequate nutrients to do that. So what we try to do is try to understand how the metabolism is being affected by hormone imbalance, by nutritional deficiency, by laziness, I hate to use that word, but if you're not physically active, if you have a very sedentary job, if you're not doing any sort of walking, resistance, nothing, your metabolism will just slow as you get older and you're not challenging it. So it does go both ways of it can be slow, making it worse. And then if you're not pushing it, it's gonna make it worse too. So the metabolism is a really important part of this. Okay, yeah. What about the other side of things that people are all interested in, the peptides, the hormones, supplements, creatine, like where do all these things play a role in building muscle and weight loss? Yeah, supplements, peptides, hormones, nutraceuticals all play a really important role in muscle metabolism, but they have to be considered when appropriate and they really can't replace the foundation of things. You can't just consume protein powder six times a day and that's it, that's not really gonna work. So the functional medicine approach can evaluate whether the patient actually needs additional support based on symptoms, their labs, their goals, safety, what the root causes are, but there's a lot of really great things that we're trying to focus on. Like you said, creatine. Creatine is the single most studied nutrient ever in the medical literature, thousands and thousands of studies done on creatine and its benefits for people of all ages. It is one of the best nutrients that we can take to help build and maintain muscle mass at any age and there are studies on all ages proving that. So something like a creatine, what? You know the numbers off the top of your head roughly how effective creatine is, whether it's like if you take creatine or build muscle this much faster or? Oh, no, I'd have to look up some of the studies, but some of the studies have been shown, the important part is creatine has been studied in all the different age ranges, so I have, and I make recommendations for 30-year-olds, 70-year-olds, 25-year-olds of both sexes to be on creatine. And it's, like I said, it is the most rigorously tested supplement in history ever. So its effects on athletic performance and it's also its safety profile are making it a really important piece of a muscle building program and I have a lot of people, should I be on creatine? Yes, 100%, no matter how old you are. And it's very easily accessible, it's very safe. So certain things could preclude you from, you know, if there's like a chronic kidney disease or something like that, but for the most part, there's a lot, most people are taking it. We talked about hormones, you know, hormones play a huge role in muscle building. Peptides are another big thing we do a lot of at the clinic in terms of accelerating growth hormone and building muscle, so there's a lot of potential for peptides to be used with muscle building. It really, like I said, depends on your goals and what's most appropriate for you, but having a skilled provider sort of guide you through all this is really important because you could get lost in the noise of all of this if you try to understand it for yourself, just through like social media or just, you know, watching videos online, it's a lot. Yeah, 100%. Real quick, can you explain what peptides are and then how you properly use peptides to help someone like build muscle mass, not like just some thing, you know, not just some like quick, actually a root cause solution? So a peptide is a combination of what we call amino acids. So chemicals in the body come from food as well in certain chains together, certain configurations together and basically a peptide affects a receptor or hormone of another part of the body. So peptides can be used for inflammation, the GLP-1 medications that we talk about all the time, the ozempics, the semaglutides, the trizepatides, those are peptides. We can use peptides for skin hair and nail health. We can use peptides for gut health and we can also use peptides for muscle growth, specifically peptides that simulate growth hormone. So growth hormone is really important for when you grow, right, when you're an adolescent and a child to make you taller and bigger. So your growth hormone will, you'll stop growing at a certain age because your bones can't grow any bigger, but growth hormone support when you're of adulthood age, when you're not growing like taller anymore can support muscle metabolism significantly. So I do use some of the peptides that support growth hormone with patients that are looking to build muscle mass, specifically more often with men that are looking to build muscle mass, lose fat. So they're really, really, really important part of things sometimes. Okay. Yeah, totally. What about recovery? Why is recovery just as important as training when it comes to building muscle and how do you properly recover? Ooh, good question. Recovery is just as important as training when it comes to building muscle because if you're not giving your body the time to regenerate, you're just gonna keep hitting it. So muscle is built during recovery, right? Muscle is built when we're sleeping. You do not build muscle when you're at the gym. When you're at the gym lifting something, you are causing what we call micro tears to your muscles. So you're kind of tearing them up a little bit. And then what happens is when you recover, when you sleep, when you give your muscles a chance to heal, that's when hypertrophy happens or they get bigger. So poor sleep, high stress, deficiencies, if you're under eating, right? If you're not eating the protein you need can all limit your progress. And then one of the biggest things is overtraining. I'm guilty of this. I overtrained for a long time. If you're just consistently damaging your muscles, they're not able to regenerate. So a really nice way to look at this is if you have a cut on your skin, right? If you keep picking at it, it won't heal, right? So the muscle works the same way. You have to, if there's an injury, which is what working out does, micro tears, you have to let it heal. So if you're not letting it heal, it's not gonna regenerate. That's kind of the basic way to look at it. So recovery is really important. And then how do people recover? Sleep's the big one, right? Maintaining stress, eating a good diet, and not working out, hitting the gym two hours a day, seven days a week like I used to do. I made that big mistake. I never saw any progress. You have to kind of, sometimes do less. You have to listen to your body, right? If your body's telling you it's really stressed, if your body's telling you it's in pain, you gotta listen to those signals. Okay, so let's say I'm sore, right? If you're sore in that muscle group, should you not work out that muscle group until you're not sore in that area? It depends. So this is gonna depend on athleticism level too. So this is gonna depend on your age, how much of a baseline you have, and what your goals are. So like for me, for example, I work out my muscle groups twice a week. But do I recommend that for all people? No, but I have a certain level of experience, and I've been weight training for 15 years. If you are new or a novice at muscle building or working out, if you're sore, that might not be a good thing. It might be that you're dehydrated. It might be that you're doing too much. It might be that you're not properly recovering. So soreness is not always a good thing. It depends on the context. So that's a very hard question to answer because it depends on the context. But soreness, like if you worked out really hard and you're really sore, that's not necessarily a good thing. It could mean that you're overdoing it, essentially. So you wanna be training until you feel fatigued, but not like, oh my gosh, I can't function. But it depends on the muscle group, too. If you're working out your lower body, if you have muscle soreness, leg day, everybody hates leg day, and you can't, the joke is like you can't get up off the toilet because you're kind of stuck there because you're so sore. I mean, that can be, but again, it depends on your level of athletic ability at that point. So it's very, very variable. Should elderly people be sore after they work out? No, they should feel more energized. Should women that are trying to lose fat and not necessarily be bulky but have lean muscle mass, should they be sore after doing a workout? Maybe not. Maybe they're overdoing it or something like that. So there's a lot of different things to consider there. Okay, gotcha. And I'm not a trainer. I'm not a trainer either. I understand how I work out, and I understand how certain people can work out, but I am not a fitness trainer. I am not certified in those things, so I don't wanna speak inappropriately either where I might not be sure. I just kinda know what I do for myself and what is good for certain people, but not everybody either. So this is where you need the help of someone to understand things, yeah. Okay. All right, so when someone comes to MedMatrix wanting to build strength or protect muscle, where does that process begin? So coming to MedMatrix, I mean, first you'll start with a discovery call with one of our patient coordinators to see what your goals are, and then from there we start gathering a full health history. We start reviewing your symptoms, you know, nutrition assessment, exercise history, sleep, stress evaluation, and we do a lot of this at the very first visit with one of the clinicians like myself or one of my colleagues. We do a full review of your medications and all your supplements you're taking, and then as I mentioned a couple times, we do a full body composition analysis when you come in for your initial blood draw before you meet with your clinician for the first time, and that gives us a really good understanding of how much muscle mass do you have, how much fat do you have, what's your weight, what's your BMI, and then we discuss all of those parameters during your initial visit, we go over all your labs that I mentioned earlier, and then we come up with a plan of action of how do we achieve your body composition goals based on where you are now, what do we have to change, do we need to change your diet, do we need to change your hormones, do we need to change your physical activity, what are all those parameters? The thing I want patients to understand and remember is that no one is expecting you to make all these changes overnight because they're not going to happen overnight, and no one's expecting you to be perfect, and no one is expecting you to know how to do all of this from the get-go, right? It's our job to provide you resources to educate you on how to do this because it's not simple. If it was, you would have done it already, right? Like I said before, a lot of people struggle from a muscle perspective because they don't know how to work out. They have absolutely no idea, clueless, and it's very intimidating. I hear that from a lot of people. Going into a gym is very intimidating for people, especially if they've never done it before. They don't want to look stupid. They don't want to hurt themselves. They don't want to be judged. So that's another big part of my education on patients is to understand what your knowledge is so I can get you the resources you need to start to make these changes and make these lifestyle adjustments. So it's a lot of stuff from the beginning, a lot of discussion. Okay, yeah. And then what might a personalized muscle and health anti-aging plan include for a patient, like a patient at MedMatrix? Yeah, so a personalized muscle and healthy aging plan at MedMatrix for a patient could include nutrition goals, protein goals. It could include strength training guidance, like I mentioned before. If you're new to the game, if you want to work out but you just don't know where to get started, we have resources to help you with that. And it might be coming from the clinicians directly. Depends on the goals, depends on the knowledge. We're educating and creating a plan around blood sugar support, making sure that diet is sufficient for that. We're talking about sleep optimization and ways we can improve that parameter. Talking about stress regulation. Doing a big hormone evaluation, right? Are you a candidate for hormone replacement therapy? Would it help you? Would it help with muscle mass? Is that one of your goals? Another big thing is beyond just diet, but repleting nutrients. There are certain nutrients that are really important for muscle metabolism, aging well, things like vitamin D, vitamin B12, iron levels. So you might not necessarily be eating poorly, but if some of those things are deficient, we want to address those. We might have to look at your gut. You know, we might have to look at gut health. Are you absorbing things the right way? Are you having chronic GI issues, which could be affecting your metabolism, which could be affecting your hormone levels, your ability to recover, your ability to work out. And then we're tracking your body composition. Like I said, depending on your goals. For most patients, we are doing body composition every three to six months. When patients come in and do blood work so that we can see the trends and monitor things ongoing. It's cool. It's cool when we see things, especially like at six months after people start a program or something. And it's like, wow, you've gained seven pounds of muscle mass and you've lost like 8% body fat. It's like, holy crap. That's a huge, huge change. So it's really cool. Yeah. Awesome, love it. What would you want the biggest takeaway for someone who wants to age and be stronger from this episode? So the biggest takeaway that I would say for patients or anyone listening that's conscious about strength and aging well is that muscle, I mean, it helps, but muscle is not just about looking fit. I mean, that's nice. But it is one of the foundations of healthy aging. Like I said before, there are studies upon studies that show the more muscle mass you have, the longer you will live. You want to live to be 100, be stronger, have good leg strength, upper body strength, and have good balance. If you want to have better metabolism, if your energy wants to be better, stronger bones, better blood sugar control. And I mentioned this at the beginning of the podcast, but longer independence, right? If you want to be an elderly person and be more independent, living on your own, living more independently physically and doing what you want to do, protecting muscle has to be part of that plan. If it's not, you are unfortunately going to be one of the people that we see ending up in nursing homes, wheelchair bound. Well, we fortunately live longer in this country because of modern medical technology, but a lot of people are living longer, very poor health quality, right? They live in a nursing home for five, 10, maybe even longer years. And it's like, for what, right? What's the benefit of that? So we really want to educate people on living longer, but living well, living strong. So functional medicine and us as clinicians at MedMatrix, we really help uncover what it really takes to build muscle and coming up with a personalized strategy to support strength for people. And like I said, not necessarily just the way you look, but the way you look, it helps. Perfect. Yeah. All right, let's go into a case study. And then for any people who are live with us right now, feel free to drop some questions and maybe we'll answer a few of them. Sure. So I had to think about this one because it, this is, so I'll talk about a specific case, but this kind of applies to, and I'm not, this is not sexist, but I see this just a lot more with men because the power of testosterone on men is the power of testosterone on women is very high. But because men's bodies rely heavily on testosterone, I see much more body composition change with men on testosterone. So I had a patient last week or the week before, I can't remember. He's, I think about my age, I can't remember. I'm 37. I think he was 34, maybe something like that. But he was really struggling to change his body composition. He didn't come, so he didn't come to me with the goal of building muscle. But when we started talking, it was like, yeah, I kind of want to do that, but I didn't really think about it that way until I started kind of to, like started to talk to him about it. Some of his chief concerns were just kind of feeling tired, feeling run down, not being as strong as he used to be, just from like doing manual stuff around the house, cleaning the garage, whatever, and then sexual libido issues. And I know that's kind of like a separate issue, but he had very suboptimal testosterone. It was almost like barely above the normal range. So we talked about all the different risks and benefits and potential outcomes and options, and we decided to try testosterone replacement therapy. And I saw him in follow-up, like I said, maybe a week or two ago, and this would have been a three-month follow-up after he initiated the hormones. So at three months, you're gonna start seeing some significant improvement in your energy levels, your physical stamina, all those things from a testosterone perspective. So when I reviewed his body composition analysis, he had gained, I wanna say seven, no, six pounds of muscle mass in three months. That's huge. And he was determined to be part of the single-digit body fat club, which I am very proud to say I am in that club. It is very hard to achieve, but being less than 10% body fat is something he was really happy to try to achieve. And he had gotten there. He was at like 9.7 or 9.6% body fat on follow-up. And he made this very funny comment. He said, I went to, he had gone to like a party or something on a beach with some friends for the Fourth of July. Fourth of July was recent, if you're listening to this in the future. But one of his college friends made a comment about his abs. And I was like, he was like, I couldn't have felt so good about myself when my college buddy was like, damn, dude, you are like shredded. Like your abs look so, and he was like, it was just funny this conversation we were having. Cause he was like, yeah, I didn't come to you to get abs. But the fact that my, I have sort of totally changed my body composition. Not only is my confidence better, my sexual confidence, the way I feel about myself, my mental clarity, my energy. But he's like, I have just kind of essentially changed the way I view how I look for the rest of my life. Because I want to maintain this level of elite, almost performance from a physical level for as long as I can. And it was so cool to kind of hear that. It was such a cool thing. Like I said, he didn't necessarily come to me saying, I want abs. But when it kind of happened, it was a really cool conversation. Cause it just changed his entire mindset about the way he performed right around exercise and this sort of elite kind of performance level he was looking for. So really cool, really, really fun. That's awesome. And then with the muscle, did other things start to fall in place too that he originally came for? Yeah, like I said, he was struggling with some libido issues and he was having trouble building muscle mass. So we had to go into a whole education on dietary intake and he was eating like less than half of the amount of protein he needed every day. And for a man that's going to be really hard to build muscle if you're eating really little protein, and especially a man on testosterone replacement therapy, if you're not optimizing the protein, it's going to be really hard. So the different parameters that you really have to understand to do this successfully is really important. So we did all this work three months. It was a huge change. So we do see that a lot when people are committed and we can get some of these variables set in motion really, really early. People's outcomes are quite remarkable. Fantastic. Yeah, so I love seeing all the patient testimonials and people who, their lives. Well, yeah, that's it. I mean, that was such a fantastic episode. I've learned so much. I hope you guys who watch this live or you're watching the recording, I hope you learned a lot. Colin, anything you want to take us home with? I mean, I said it a lot. You know, my take home message from a podcast devoted to muscle is medicine is essentially the more you have, the longer you'll live. You know, being strong makes you live longer. I said this to a patient the other day. I used to think about, I thought about often my grandparents when they lived in nursing homes as part of their end of life. It was really sad because a lot of people, like I said, when you're elderly, you're in a wheelchair, right? You can't move. You're lacking your independence. If you want to be independent, if you want to live a long time and feel good, you really have to try to be strong. And strength is a really, really important part of that. So try to understand what that means for yourself, whether it's with us or another skilled functional medicine clinic where you live. Try to understand how to get stronger and all the parameters around that because it will really, really extend your longevity and it will help you live longer and happier. Yeah, that's my biggest take home. Well said, perfect. And yeah, whether you're watching this live recording, make sure you share this with a loved one or a friend to kind of spread the knowledge. Health is wealth, right? And if you're interested in working with providers like Colin or working with our medical team at MedMatrix, you can go to medmatrixusa.com, apply to become a patient and have that conversation with a patient coordinator, see if we can help you and go from there. With that said, Colin, thank you so much for your time. Appreciate it. Thanks, Cole. It's been fun.