77 – Can You Really Reverse Aging? Dr. Oberg’s Groundbreaking Insights

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Vic: Welcome to Health Further. We have a guest episode today. I’m really excited to talk about, uh, longevity with our guest, Dr. Erika Oberg. She is at Marquis Health. Erika, thanks for joining me. Appreciate this.

Dr. Erica Oberg: Thanks for having me, Vic. I’m looking forward to it.

Vic: Yeah. So we met a month or so ago at the Aspen ideas health conference, and I loved getting to know you and learning a little bit.

Vic: in between sessions about your work and really appreciate you taking the time to talk through this. So let’s start off, give the audience a little introduction to your background. What, where did you study? How did you get involved in integrative natural medicine and longevity? [00:01:00] What have you been up to in your career?

Dr. Erica Oberg: Yeah, sure. I’m a naturopathic doctor. I have been practicing for 21 years. I graduated from Bastyr University in Seattle. A lot of people ask what is the big difference between naturopathic doctors and medical doctors or osteopathic doctors? A lot of it’s the same, but there’s some differences in the details.

Dr. Erica Oberg: In terms of our training, we all go to four year medical schools. The first couple years are pretty much the same, right? All the anatomy and physiology and biochemistry and pharmacology. But where it really differs is in the, the clinical training. naturopathic doctors don’t do surgery or obstetrics. And so that opens up a lot of time in the curriculum to do a much deeper dive into nutrition, micronutrients, botanical medicine, a lot of actually, uh, counseling, lifestyle change, psychology, things like that.

Dr. Erica Oberg: So that’s the overview of training. [00:02:00] Like all doctors, we pass medical board exams after training to be licensed in the states we wish to practice in. Unique for a naturopathic doctor, I went on to do a residency and then a postdoctoral fellowship at the University of Washington. In the fields of health promotion, and so I actually spent the first decade of my career splitting my time between clinical practice and health promotion research.

Dr. Erica Oberg: So we ran a number of clinical trials. Essentially trying to reverse chronic disease with various different lifestyle programs and strategies and measuring the impacts of that on both health outcomes and also health system outcomes, such as cost and utilization across. The health systems.

Vic: Yeah, excellent.

Vic: So give me a little bit of your personal interest What attracted you to this specialty in medicine as opposed to all the other things you might have been [00:03:00] into?

Dr. Erica Oberg: Yeah, I’m just passionate about helping people thrive I just have I have a lot of energy myself And I just know how much better I perform when I’m taking great care of myself and eating I’m getting the fitness and the sleep that I need and I am just really passionate about helping people thrive No matter what stage of health or disease they’re in I think people can experience more health and wellness in the last months of their lives and they can Do that at any other point in their career whether you’re a busy executive or you’re a stay at home parent or you’re Struggling with a serious chronic disease.

Dr. Erica Oberg: They’re all opportunities to help bring a little bit more vitality and enjoy and function into people’s lives. And I’ve just been watching it happen for 21 years. And I just feel so blessed that I get to make a living doing something that makes life better for so many people.

Vic: Yeah. What struck me when we were [00:04:00] talking in Aspen and it resonates again right now There’s a different tone talking with you or others in this field, really in promoting health or being proactive about getting one of your patients.

Vic: On a road to better wellness, better health, more energy, as opposed to a lot of traditional medicine is about fixing a problem. Is that a fair distinction or would you categorize it differently?

Dr. Erica Oberg: We definitely fix problems too, but I think there is definitely a difference in attitude. There’s a lot of, uh, Pessimism and discouragement, I think, in a lot of traditional health care systems, and a lot of people show up in my office feeling disheartened, feeling confused, feeling like they’ve been given no hope, and it’s not really a matter of a hope, it’s a matter of, Just doing the appropriate investigations and finding where are the levers that we can [00:05:00] push on and engage to help somebody start getting better and improving their health really at that foundational root cause level.

Vic: For a motivational for review. It seems much more engaging, much more optimistic to be able to talk about solutions. Of course, we want to correct situations that are causing negative symptoms, but also leaning in and like making a positive difference, improving their overall health. is really uplifting or exciting for, I would think for patients.

Dr. Erica Oberg: Yeah, exactly. The, the idea of actually getting better, not simply signing up to manage a chronic disease for the rest of your life or slow progression, right. Which is often talked about in heart disease or dementia, but you can actually make improvements and gain health and functionality. And we’ve shown that in clinical trials and other people have shown that in clinical trials, that really is.

Dr. Erica Oberg: Yeah, it’s very [00:06:00] doable and attainable by, I believe, everybody.

Vic: And let’s talk about Marquee Health just for a minute. So you recently, in the last six to nine months, joined Marquee Health. You’re in California, but Marquee, I think, is nationwide, or at least across many states. Talk about Marquee just for a minute.

Dr. Erica Oberg: Yeah, I’ve recently joined Marquee Health as their medical director, and it’s a really exciting opportunity. Marquee Health specializes in the longevity space and in helping clients take really deep dives into their health. So we specialize in what we call An in depth executive physical that includes everything from your full body MRIs and your full genome sequencing to testing your microbiome and all of those other metrics of health and function.

Dr. Erica Oberg: And when we have that much data, we can really make very precise recommendations to help people optimize their life.

Vic: Excellent. So let’s dig in now. [00:07:00] This, uh, space is growing very quickly, a lot of excitement and attention around it. At least for me, the Peter Atiyah book recently, a lot of people more engaged in this, uh, maybe since COVID to really start paying attention to longevity, wellness, what their options in integrative medicine, there’s a lot of terms.

Vic: That I’m not sure I understand, and certainly the audience maybe doesn’t fully understand. So, how should we understand this space? Integrative medicine, regenerative medicine, precision medicine, can we spend a minute just talking about the terms, what they mean, or how you think about the audience should approach this space?

Dr. Erica Oberg: Yeah, definitely. A lot of the terminology is more in the branding space than in the medical specialty. So in terms of medical specialties that you can be board [00:08:00] certified in, naturopathic medicine, um, there is an integrative medicine board certification. Available now, and then there’s some certifications.

Dr. Erica Oberg: They’re not board level certifications, but the Institute of Functional Medicine offers a certificate. What’s common across all of those is that. Doctors and nurse practitioners too are eligible for some of those certifications. Doctors in that space are going to be taking that holistic approach, really looking at the root cause, not just the symptoms on the surface, but what’s really going on in the full physiology.

Dr. Erica Oberg: Underlying the cause and also where the interplays are with the lifestyle. So when people are looking for a qualified practitioner, it is nice to look for one of those certifications, either a naturopathic medicine degree or a functional medicine certificate or board certification by the. ABIOM, the Organization of [00:09:00] Integrative Medicine, those will really steer people towards clinicians that have been very well trained in this space, as opposed to, there are some brilliant health coaches out there, but there’s also a lot of people that maybe don’t have the depth or don’t have the credentials to order the diagnostic tests or really make the prescriptions that might be required after we find out what’s going on.

Vic: Okay, it’s interesting that you term them as branding or marketing Is it fair to say that longevity, vitality, anti aging, rejuvenation are all different ways to express a similar practice, or are there subtle differences that are useful to talk through?

Dr. Erica Oberg: There might be some subtle differences. There isn’t a board certification in longevity medicine, but there are some, some organizations that lead continuing education.

Dr. Erica Oberg: [00:10:00] Conferences for doctors that specialize in that, I think when we’re in the longevity space, we really are thinking about what can we optimize today with that preventive lens to, um, really focus on extending the health span, not necessarily the lifespan, but, you know, how we can help people be thrive and functioning.

Dr. Erica Oberg: Up until their last days, hopefully the regenerative medicine space that I love playing in that space that tends to get a little bit more into maybe some of the tools in our toolbox where we use some of the therapeutics like stem cells or exosomes or. Whether they’re derived from yourself or from exogenous sources, those are both available and that really plays into helping reverse some of the aging.

Dr. Erica Oberg: So those are some of the, the differences that that might come up when somebody’s looking at the, at Doctors who promote those different terms.

Vic: Okay. But [00:11:00] if they find a board certified practitioner like yourself in this space, they can, that, that, that clinician can then advise them on what’s best for their situation and then you or another clinician would advise the patient on how to approach, whether it’s longevity or regenerative or precision, these are all aspects of what you do.

Vic: Is that fair?

Dr. Erica Oberg: I would say so. I think the big differentiator probably is actually the patient, right? So practitioners such as myself, we’re generally focused on your goals, right? We don’t come to the conversation with, Vic, I’m going to help you live to be 110. If that’s not what you’re interested in, then that’s not your goal, then that’s not where our attention is going to be focused.

Dr. Erica Oberg: So I think with that holistic approach, Approach and that root cause approach. We’re really interested in your goals and how we can help you optimize to reach whatever you want [00:12:00] that to be, whether it’s getting on the floor with your grandkids or racing a sailboat across the Atlantic or living to be 110.

Vic: Yeah. Or like for me, I want to extend my health span. Uh, I think that’s a term that you threw out that I think is really valuable that my ability to live a productive, enjoyable, high quality life with good health, that’s more important to me than the number of years. But as you say, there may be different goals for different people.

Vic: Someone may love to sail and that requires certain strengths or conditioning that. That they would work towards.

Dr. Erica Oberg: Definitely. I think there’s a, and just as a little side note, I think there’s a public health aspect to this that I always think about as well. When we are functioning well and operating at the top of our game, especially people like you who are in positions to help change the healthcare system, right?

Dr. Erica Oberg: When [00:13:00] we are functioning at a higher level, we’re able to feed that forward into our companies, into our communities, into the people that we lead. And that makes for. A better world, a better health system.

Vic: Excellent. So now I want to get your advice on how should I think, or how should the audience think about, Uh, working with you or work with anyone in the integrative natural medicine space in relation to the traditional health care doctors, everyone, or most people have a primary care doc or they might have two or three specialists they work with.

Vic: Does working with you, is it an adjunct, is it additive or does it somehow replace one or more specialties? How should the audience think about that?

Dr. Erica Oberg: It can go both ways. For example, at Marquis Health, we offer essentially three basic tracks. We offer a deep dive core program that’s really [00:14:00] designed to access our doctors as specialists.

Dr. Erica Oberg: And so in that program, people come in for usually three months. And do a whole battery of tests and get some initial recommendations and some health coaching and basically a roadmap to go on their way. Now, we also have two tracks for people that want to stay with us and consider us their primary care providers.

Dr. Erica Oberg: And for those patients, We offer annual concierge memberships where we’ll continue to partner very closely with them as they move through their, their health journey. And that type of concierge primary care is what I’ve been doing for most of the last dozen years or so in my private practice.

Vic: Yeah. Okay.

Vic: So Marquis, you joining Marquis now allows you to expand the offering where you certainly can keep doing that concierge. You are the primary coach or the health advisor that might work with me to [00:15:00] understand my situation and then Together, we would decide, gosh, we should go see this other specialist, we should see an oncologist, or we should see, maybe there’s a surgical thing we need to look into.

Vic: And then you also, through Marquis, have these deep dive, where you give someone three months of very involved analysis, a lot of testing, almost a evaluation. And then they would have much more information to go back to their existing primary care doc and manage it themselves with, of course, the ability to come back to Marquis at a later date.

Dr. Erica Oberg: Yep. Yeah. We have people that like to just do their annual check in and use us more as a specialist. I think about myself as more of the quarterback, right? We’ve got a whole team, including our health coaches, our specialists, our radiologists that are reading our imaging reports, etc. Of course you and your family are the center of the [00:16:00] team.

Dr. Erica Oberg: So really my job as, as your um, longevity concierge doctor is to serve as that quarterback and help line up who are the other players on your team and how are we going to make sure they’re passing the ball back and forth appropriately.

Vic: Yeah. Okay, excellent. And then let’s talk about where people should best engage with this specialty or this part of medicine.

Vic: So is there an age range where people in their 30s or 40s or 50s or 60s, I’m 53, that they should really get involved or maybe any age is fine, but they’d be different protocols. What’s the, how does it affect ages? Um,

Dr. Erica Oberg: Yeah, there’s definitely different guidelines on what preventive screenings are appropriate.

Dr. Erica Oberg: But what phase of our life? I would say on average, most of our clients, patients engage with us in their forties and fifties, right? When we’re just [00:17:00] starting to get old enough to feel some of the aches and pains, right? The knees aren’t functioning as well. Maybe there’s been some alarming things on a basic screening lab panel, cholesterol or blood pressure or something like that.

Dr. Erica Oberg: Or maybe there’s been a scare with a friend. Who’s gotten a cancer diagnosis or something.

Vic: Yeah. I know for me, sorry to interrupt. I know for me that I think I was 43 when I went into my primary care doc and said, I think something’s wrong with my knee. I, I used to run every day. I ran, I did a lot of jogging and running.

Vic: And I said, I think something’s wrong. I might want to see an orthopedic. Oh. And his response was you’re over 40 now. You just can’t run anymore. That was really sad. I was not. that, but I didn’t know you, I didn’t know you, I didn’t know who to call. And of course I am [00:18:00] aging, but I think there, there could be.

Vic: Other strategies where you could keep running, but you might have to alter your diet or for me, I’ve started doing much more stretching and core. And then I found that I can run further without hurting. At least my Pilates instructor thinks that my posture is better.

Dr. Erica Oberg: Yeah.

Vic: So when you get that first initial, um, sign that you’re getting older, that’s when people start looking for other solutions and maybe come into a marquee or something like

Dr. Erica Oberg: that’s certainly the most common entry point.

Dr. Erica Oberg: And it’s a great entry point when we’re in our forties and fifties. We still have so much vitality and regenerative capacity that we don’t necessarily have to lean on some of the more advanced regenerative tools like exosomes or stem cells, which I have injected into my knees many times in my effort to remain a runner.

Dr. Erica Oberg: The earlier, We start that path of [00:19:00] prevention and optimization, the smoother the ride through the second half of our lives is going to be.

Vic: Okay, and then how do you think about disease states? Are there particular disease states that are very amenable to these treatments? Cardiac disease or cancer or neurological issues, diabetes.

Vic: Are there things that you would say really fit well with this or is it more of, uh, lots of things can be assisted?

Dr. Erica Oberg: I mean, that is the beauty of taking a Root cause approach is that it can improve the peripheral symptoms pretty broadly in terms of What we’ve demonstrated conclusively in the data reversing cardiovascular disease is very accessible reversing cardiometabolic disease diabetes very accessible One of my colleagues just published her book on reversing Alzheimer’s disease, [00:20:00] um, with a 74 percent success rate across a cohort of, I think, about 30 participants.

Dr. Erica Oberg: Pretty advanced dementia too. Reversing disease is, is very, very much within our reach and we can also look at the costs that saves the health system and all sorts of other things. But it comes with. Some investment, both mostly in terms of personal willingness to change some things in the lifestyle, right?

Dr. Erica Oberg: Whether that’s working a little less or drinking less or exercising more or any number of things.

Vic: Yeah. Or even exercising differently. Like I’ve found when I passed the forties. I can no longer just run every day, five to eight miles. I have to vary it more and better across training and healthier overall.

Vic: But when you’re younger, you don’t have to worry about those things. So there’s maybe. A variety [00:21:00] of interventions that are both behavioral, maybe there’s like supplements or other things you can add in based on what you’re trying to achieve.

Dr. Erica Oberg: Exactly. And doing some of those things that replete some of the things that do decline as we age, for example, our hormones or.

Dr. Erica Oberg: Our stem cells or collagen in our knees of our connective tissues. So regenerating some of those, those supplies can really help the body repair and, and heal.

Vic: So you’ve mentioned a couple of times, one of the things that I’ve been. Honestly, pretty pleasantly surprised about in the last 60 days as I’ve started to look into this is there’s a significant amount of research and published research and studies that are validating this.

Vic: It’s not your opinion, although certainly you have opinions that there is a pretty good body of research into these. [00:22:00] Interactions. This isn’t let’s put in some exosomes and see what happens. There’s lots of studies and people can, you can point to others can do research. It just takes a little bit of work to dig into it and find it.

Vic: The traditional health system, they’re busy. So maybe I don’t want to put blame anywhere, but they don’t necessarily point to these studies as often as maybe they could.

Dr. Erica Oberg: Yeah. The ER is not the right place for that conversation.

Vic: Needs to

Dr. Erica Oberg: happen a little sooner than that, but yeah. I am a strong proponent in educating my patients about the research and helping them sift through what’s on PubMed or what’s out there in the popular literature and figuring out, is this a strategy that’s going to be potentially appropriate for them?

Vic: Yeah, excellent. And then let’s talk about income level and costs. I, I believe [00:23:00] most of these tests are self pay, but maybe there’s insurance coverage for them. What is the reimbursement environment?

Dr. Erica Oberg: It’s mixed. We do use labs like Lieblen Heart Lab and LabCorp and Quest for, uh, reimbursement. A pretty in depth general workup, depending on your insurance, that’ll be covered per your deductible or whatever your arrangement is with the insurance company.

Dr. Erica Oberg: There are cash based labs that I use too, just because it takes the mystery out of that process. And, and as a, someone involved in the healthcare space, what the lab bills, the insurance company is significantly higher than what they bill an individual. So yeah,

Vic: sometimes the cash price. Can be lower than the deductible.

Vic: And in some cases, not every case, but a surprisingly high percentage of the cases. That’s true.

Dr. Erica Oberg: So that’s one of the things we’ve done at Marquis. Is our CEO [00:24:00] has all of those connections and has worked to facilitate excellent contracts with the imaging companies with the lab companies so that we can do that type of testing at a much more affordable, um, cash price, but some of the more.

Dr. Erica Oberg: The less standard things, microbiome testing, micronutrient testing, those ones tend to be cash pay. Unfortunately, even things like coronary artery calcium scores aren’t always covered by insurance. So it ends up being a little bit of a mix, a dance between what people have to invest in their own health and what we can maneuver through the existing traditional insurance system.

Vic: Yeah. And so for the audience, what, just give a rough frame of reference. What is the Jen, is it a monthly, uh, budget or maybe annual, how should I think about how much money would it cost to do that deep dive or to [00:25:00] engage with you as my concierge, uh, Just in right now. I’m sure every patient is different based on what you order and what you end up Give people a frame of reference.

Vic: Is it a thousand dollars? Is it a hundred thousand dollars? What’s generally what are we?

Dr. Erica Oberg: Somewhere in the middle, right? At marquee health we have Three programs of entry. We’ve got one, our base program starts at about 3, 000 and then our annual memberships are 000, depending on what all is included. So that’s for pretty high level care.

Dr. Erica Oberg: People can definitely get a good workout, work up for 2, 500 to 4, 500 if they want to do the full in depth everything, including like a full body MRI and coronary artery calcium score. If they’re interested in just a blood panel, or say they’re really young in their 30s, the price [00:26:00] point can come down in those.

Dr. Erica Oberg: And that’s not just for testing, of course. That’s also, we bundle it with the health coaching so that people can actually get started with somebody to help them implement my recommendations. Um, plenty of time sitting down to really get all those questions answered and develop that individualized plan, because it’s not one size fits all by any means.

Dr. Erica Oberg: It is a time intensive process. But the feedback we get, most people find it highly worthwhile. And

Vic: yeah, so I mean, I think if you are in your forties or fifties or even sixties, an investment, I’m going to call it an investment of 3, 000, 5, 000, even 20, 000 can really pay off in you experiencing a much longer health span, being able to do what you love to do, whatever that is.

Vic: Play tennis, go on a jog, play with your grandkids, go sailing. I like to hike on a hike, [00:27:00] but also I think there’s a delay. Or a reduction in the traditional health system cost of treating these symptoms that can certainly save you money over, over your life. So if you invest some now at being more healthy and really catching some of these things and treating them in a preventative or even rejuvenative way.

Vic: Then you prevent a very expensive health treatment later. That is that fair or is that mischaracterized?

Dr. Erica Oberg: No, that’s definitely fair. There’s lots of data on that. We published a booklet on the cost effectiveness of prevention. About a decade ago, the data is a little out of date now, but I was just looking at it before we got on this call and the, but the benefits are the audience for that was, was health systems trying to get them to improve insurance coverage for this type of care.

Dr. Erica Oberg: And the timeline, the [00:28:00] horizon is shorter than you would think. Making that investment in prevention and in reversing basic things, cardiometabolic disease, heart disease, really turns into savings like in two to three years in a pretty, pretty, most cases. On the more extreme end, My colleague that just published the reversing Alzheimer’s project, they did a cost effectiveness analysis of that, and as part of the research study, they were able to throw the kitchen sink at these participants, so they got diet changes, they got their social situations enriched, they got tons of supplements, they got a little bit of everything.

Dr. Erica Oberg: So, yeah. Physical therapy, they got sleep apnea fixed, whatever it took, right? And the cost analysis on that was about 20, 000. And if you think about the monthly cost of memory care,

Vic: 20,

Dr. Erica Oberg: 000 in a month, I know these people are actually functioning better and Enjoying life again.

Vic: That’s incredible. So yeah, [00:29:00] I’m a venture capitalist.

Vic: So I typically invest in startup companies and then we’re hoping to sell those companies in four to six years. So the return on this investment for your patients is much faster. Then some financial investments and they’re investing in themselves and their health and their family’s health and

Dr. Erica Oberg: right.

Dr. Erica Oberg: You actually get to enjoy feeling better. Like in a couple of weeks.

Vic: Yeah. Okay. So let’s talk about what you and I were talking before the call was some of the tools of the trade. When people come in, I know there’s some blood tests, there’s some genetic tests, what are the common things, let’s give people, not that, every patient would be unique, and you would advise them on their very specific situation.

Vic: But let’s give people a flavor for the type of diagnostic tests that can be run. [00:30:00] Because I think, unfortunately, not many people are that aware of the, what’s available out there.

Dr. Erica Oberg: Is there, is there a visual component to your podcast? If I do a screen share? Yeah,

Vic: we, we have both audio and visual, but probably about a third of the listeners will be able to see it.

Vic: And the ones that can’t should go onto YouTube. And watch it through that medium. And I’ll link, we’ll probably link in the show notes as well to some of these assets too.

Dr. Erica Oberg: This is a good visual for thinking about, um, some of the biomarkers that we immediately assess. So when I think about a preventive, uh, longevity, deep dive lab panel, the first things that I’m thinking about are those factors that are going to be root cause or underlying to.

Dr. Erica Oberg: Most disease, namely inflammation or oxidative stress, right? Those words are used interchangeably. And when we have [00:31:00] inflammation and oxidative stress, the big things that are impacted, of course, are the vasculature and then the mitochondria, which are the places in the cells where we make energy. So that’s what we.

Dr. Erica Oberg: Feel as the aging process is not literally not making enough energy and the

Vic: mitochondria stop working so well, or you lose functionality by the same

Dr. Erica Oberg: exactly. So when I’m thinking about lab tests.

Vic: So for people that are listening, we’re looking now at a cross section of a blood vessel, I think, is that right?

Dr. Erica Oberg: Yeah, we’re. Looking at the progression of cardiovascular disease from a nice clean open blood vessel to one that’s filled with plaque and thrombus and It’s basically becoming obstructed in the situation of an acute MI. And so we’ve got different biomarkers that can be measured along the way [00:32:00] to help us understand really the stage of disease without an angiogram.

Dr. Erica Oberg: So at the beginning are some of the early inflammatory markers, F2 isoprostanes, that’s going to be measuring some oxidative stress and the proteins of the body. Oxidized LDL, right? LDL cholesterol. Most people, uh, remember as LDL being their lousy cholesterol, right? HDL being healthy cholesterol. So the worst is oxidized LDL, which is going to be LDL that has that, That oxidization, and so it’s going to be interacting with the vasculature and having the propensity to stick and damage the endothelium.

Dr. Erica Oberg: And then once that starts to happen, we see more global inflammation, things that we can measure, like with a high sensitivity CRP or a sed rate, um, those are fairly nonspecific. We can measure more precise inflammation, like a myeloperoxidase, that’s a [00:33:00] blood test that tells us if the immune system is active.

Dr. Erica Oberg: In the vasculature is the body in an active recovery cleanup mode, trying to like wall off those plaques and solidify them so that they don’t rupture and cause further damage on things like L. P. P. L. A. Two is also going to be giving us that sense of it. And then finally, at the end of the day, we’re measuring biomarkers of acute injury, right?

Dr. Erica Oberg: Do we have high troponin levels because somebody’s in a acute coronary syndrome or having an M. I. And so those are the last things that we’re measuring on the trajectory. So that’s just thinking about the vasculature, but we can look at a similar set of biomarkers. So

Vic: before, before, before you go on. So for people that are listening, there are five markers that you have on the screen here, and they indicate the progression of, um, vascularitis, heart [00:34:00] disease over time, would you screen for all of them, or would You would start with the oxidation, the F two ISO peas.

Vic: I’m probably not saying that. Or do you do them all at once? How do you

Dr. Erica Oberg: we, we screen for all of them at once. Right? We wanna know where somebody is on the trajectory of. Of the disease. We also do an advanced lipid panel so that we can catch some of the genetically the markers of cholesterol that are more genetically related.

Dr. Erica Oberg: We also look at the blood sugar insulin landscape because that’s going to be an independent source of inflammation. So we start with a pretty deep dive on all of them. Um, not always the late and stage ones in a younger population, but we want to know the whole landscape. And then we also want to know, is there actual calcification already happening in there?

Dr. Erica Oberg: And that would be done with simple imaging, like a coronary artery calcium score. Yeah. So we’re doing that. [00:35:00] Sorry, if

Vic: the patient has that troponin T, I’m probably not saying that right. That means the heart itself has been injured in some way. Is that fair?

Dr. Erica Oberg: Exactly. Yeah.

Vic: That would be a very negative marker, but one that You’d want to catch, certainly.

Dr. Erica Oberg: Exactly, and that’s the one where you’re off to the specialist cardiologist, maybe to the interventional cath lab, and in that situation, stents might be the appropriate prevention.

Vic: Okay, so these, are these all blood lab tests, or are there a variety

Dr. Erica Oberg: of? These are all blood lab tests, and these particular ones all should be covered by insurance.

Vic: Okay, so that, that seems pretty straightforward. What else? Should people be thinking about, is there, I think you mentioned hormone testing, [00:36:00] testosterone, estrogen, insulin like growth factor, um, probably those are blood tests as well, or how do you test for that?

Dr. Erica Oberg: Those are all good to screen with blood tests.

Dr. Erica Oberg: Blood is not the optimal way to monitor hormones long term. For example, if we’re putting somebody on bioidentical hormone replacement, then I’m going to want a little bit more precision with, say, a urinary hormone test. Um, but blood tests are a good screening place. We can catch low testosterone or perimenopausal changes pretty easily with blood tests.

Dr. Erica Oberg: And, and then from there, it just helps refine where we can intervene to give somebody some more vitality, whether that’s Supplements that might be precursors to hormones to help your body make your own hormones better. We use peptides in that space a lot as well, especially in the growth hormone or whether hormone replacement is as [00:37:00] appropriate.

Dr. Erica Oberg: And often it is certainly by the time women are in menopause and men are in andropause, we generally all feel better with it. A little bit more replacement.

Vic: Okay. And then there’s been a lot of press, a lot of excitement around very early cancer screening. What are your thoughts about that? Is it helpful?

Vic: Is it a mixed bag where you get some benefits and some false positive? What are your thoughts about the early cancer? What do you do for early cancer screening, if anything?

Dr. Erica Oberg: Yeah, we do a lot. We use the GRAIL test, which is definitely the hottest, newest, most comprehensive multi candidate detection test. I use traditional methods as well, either digital mammograms or more often sending women out for MRIs because they’re a little more accurate.

Dr. Erica Oberg: A little less uncomfortable. But yeah, the grail I think has a lot of promise. Their science is pretty buttoned up. [00:38:00] They definitely skew towards a, a false, a higher chance of a false positive than a false negative, right? You’d much rather be scared rather than miss something. So that’s probably the biggest downside is the anxiety and the additional expense of a workup if you do find something.

Dr. Erica Oberg: They published their data over the first couple years in terms of what their actual detection rate is. It’s pretty low. That’s probably some population selection, they’re detecting things I think about three to five percent of the time, so it’s a pretty low, um, but that’s probably consistent with the, the incidence of early cancers in the population.

Dr. Erica Oberg: Um, it just seems

Vic: pretty realistic that if you screen a hundred people, three to five, or even three to ten. We’ll get a positive result, meaning [00:39:00] that there’s some indication of cancer and then there’s further workup, further attention. Certainly it is anxiety producing, but it is worse to not know that you have cancer growing.

Vic: In my opinion, it’s worse. And mine too. It’s follow up and it’s not, it’s not worth A significant intervention, then you had a false alarm and it’s okay. You had 30 days or 60 days of worry, but, um, then it’s okay. Is that right? Is that the way it proceeds?

Dr. Erica Oberg: Yeah, exactly. Some people don’t want to know. And if they don’t want to know, then I respect their decision.

Dr. Erica Oberg: Preferences on that. But yeah, when it does come back with a positive finding, it at least gives us enough information to know what organ system we need to go investigate with further imaging and testing. Yeah, and it can be life saving. [00:40:00] Simple things like thyroid cancers are relatively common, you know, you can detect that in a young person and that’s one that’s very curable and change the trajectory of their life rather than leaving young kids with a parentless situation.

Vic: Yeah. And, and I don’t know that there’s been a study, but my, my impression is that the incident of cancer has been increasing since COVID. I’m not sure why, but it seems like it has been. And so that argues that younger ages might consider this kind of broad grail cancer screening.

Dr. Erica Oberg: I think the grail screening is a great idea for younger adults.

Dr. Erica Oberg: Definitely people in their 40s and 50s. I’m not sure about the correlation with COVID, but certainly over the last 10 to 20 years, I think just our environmental exposures are so much higher. And that’s probably contributing to the increase we’re seeing in population [00:41:00] cancers.

Vic: Okay. And then do you go into metabolic function at all that diabetes and other metabolic diseases are really sadly growing incredibly quickly?

Vic: Do you dig into that? Do you have screening tests?

Dr. Erica Oberg: A lot. Yeah, definitely. We do a lot. Not just checking somebody’s say hemoglobin A1c, but also looking at They’re in the moment, glucose and insulin. I’m a huge proponent of continuous glucose monitors, the devices that you can

Vic: put on your

Dr. Erica Oberg: arm and watch on your phone.

Dr. Erica Oberg: Have you played with those at all?

Vic: I haven’t, but my partner in Jumpstart did. And he learned a ton in 90 days, just how his own body processes glucose and that he should go on a walk or not go to bed right after he learned how he should manage his diet and exercise and living. In a [00:42:00] way that I think was really helpful so that that encouraged me to get I haven’t I’m managing I’m trying to focus on sleep right now, but that’s the next thing i’m i’m working on

Dr. Erica Oberg: Yeah, sleep’s a huge one.

Dr. Erica Oberg: Definitely if you’re not getting good quality sleep Overnight is when we release the majority of our growth hormone, right? So if you’re not getting into deep sleep You’re not releasing growth hormone and that’s going to have an inhibiting impact on all the rest of your hormones So often when we can improve sleep You We can dial everything else in.

Dr. Erica Oberg: So we use lots of those biomonitors, the continuous glucose monitors, oral rings, Fitbits, Apple watches, all of that data. I love it because not only does it give me information, but most importantly, it gives you the lifetime information to make different choices, right? That’s what mostly our healthcare comes down to is making, A better choice.

Vic: Yeah. Okay, and then, how do you think about genetic testing? Is there a value [00:43:00] in that, or what aspects of genetic testing do you typically use?

Dr. Erica Oberg: Yeah, at Marquis, we do offer full genome sequencing and it has been very interesting and game changing for a number of people. We look at those SNPs, those single nucleotide polymorphisms, because those ones are very useful for, for helping to dial in.

Dr. Erica Oberg: Where we can make really nutritional changes. One area where we look at the SNPs a lot is in the area of methylation. There’s a number of genes that control how efficiently we methylate, which impacts how we read our DNA, how Yeah, how the whole

Vic: epigenetic coding is Put together and then changed over time.

Vic: If you’re not methylated correctly, it doesn’t function very well.

Dr. Erica Oberg: Exactly, exactly. So I find that type of testing can be really helpful to dial in somebody’s individual, um, nutrition and supplementation. [00:44:00]

Vic: Yeah. Okay. Anything that we missed as far as the tools of the trade or things that are your. Most important go to

Dr. Erica Oberg: I would say the rest of it really falls into choosing the interventions that we do after it.

Dr. Erica Oberg: We haven’t touched upon anything mind body related, but I do think it’s important to help people find and cultivate things that get their brains and out of the racing. Minds that we normally have and into some of those calmer states. So whether that’s guided meditations or a yin type of exercise like yoga or walking on the beach or prayer, there’s a lot of, yeah, well, you can

Vic: get out of that fight or flight, chronic stress situation or, or body reaction into a more relaxed, uh, sympathetic mode.

Dr. Erica Oberg: Exactly. Exactly. And that helps everything, right?

Vic: Right. Okay. [00:45:00] Now, I’m personally very interested in heart health. I set a goal to end heart disease by 2035. Really for three reasons. One, it’s the number one killer of people in the U. S. and really in most developed countries. Secondly, I think early screenings are not very expensive, don’t have a lot of downside.

Vic: And if we catch heart disease Early, the traditional healthcare system has lots of tools to assist patients in managing heart disease if you catch it early. And obviously the tools are less effective if you don’t catch it early. And I think it’s possible. We need a lot of patient indication. We need a lot of effort in getting screening earlier, getting access to folks.[00:46:00]

Vic: But I’m optimistic. I think we could knock heart disease out of the number one place as a killer of humans. And then, and I have heart disease. And so selfishly, I’m interested in digging into it because of that. In your experience, how treatable is heart disease? How realistic is it to think that if we got education, early screening, better interventions, we could knock it out of the number one cause of death.

Dr. Erica Oberg: I think it’s certainly doable. The interventions are there, whether it’s getting people to the cath lab quickly or using innovative things like chelation or phosphatidylcholine infusions. I do a lot of those in my practice. Plasma exchanges, there’s all sorts of interventions that we can do just better cholesterol management, right?

Dr. Erica Oberg: Better blood pressure management, where I would like to share your optimism and enthusiasm as whether we have the willpower to put in the [00:47:00] efforts on the lifestyle front, right? To be active for 30 minutes every day, no matter what, and. Choose to eat a more balanced, vegetable rich diet and not rely on fried chicken and fries.

Dr. Erica Oberg: So I think a big piece of it would be really involving changing our food system and our transportation system and making our environments more conducive to health. Cause right now the easy choice is to walk into a 7 11 and get a meat stick and a Slurpee, right? And drive to your next destination. Yeah.

Dr. Erica Oberg: Yeah. Yeah.

Vic: Yeah, that’s fair. I am a venture capitalist, right? So I typically invest in early stage things that don’t really, are not effective yet, but there’s hope that they’ll be effective. And that’s how I’m approaching this. I have a belief that’s not at all validated. And so I want to say that up front because you’re a clinician used to scientific validation.[00:48:00]

Vic: But at least for me, and it’s a data point of one, but once I understood that I have heart disease, I was much more attentive to my diet, exercise, sleep, and something like a calcium score if it’s not very expensive. I don’t think there’s that, there’s a little bit of radiation, but it’s fairly minor. And if, just for instance, if we gave it to anyone who was 35 or older,

Dr. Erica Oberg: Right.

Vic: My belief is the result of the calcium score should be you have a zero calcium score. And if you’re 35 years old and you don’t have a zero calcium score, there is something that needs attention. That means you have plaque in your Veins and arteries that has been sealed over with calcium, which is the helpful [00:49:00] step the body takes, but also is indicative that your arteries are hardening.

Vic: Your arteries are beginning to be damaged.

Dr. Erica Oberg: Yeah, I think absolutely getting that type of information to a younger population that should have some motivation to Stay healthy to be around for their kids, their families, their careers, whatever motivates them. But I think it’s, I think your goal is 100 percent reachable for those that, that want to try.

Vic: Yeah, that’s right. So if they, if let’s say someone is 35 and they get a calcium score of 20 or 40 or 50, they should Now talk to you, talk to a cardiologist, get better treatment, get more treatment, maybe get on a statin, start managing their diet, monitoring it more carefully. And now we would catch the escalation of heart disease much earlier because it’s [00:50:00] asymptomatic.

Vic: It’s part of the issue. People don’t know they are slowly building up this disease in their veins and arteries. Until they have some event or until they are 50 or 55 or 60 and their LDL or cholesterol scores go up

Dr. Erica Oberg: right until it’s pretty progressed,

Vic: right? Definitely

Dr. Erica Oberg: getting that early intervention and do a younger population would save the health system so much money on those late stage interventions.

Vic: Yeah, it would save money, and it would lead to much better public health across the entire population. Now, if you get a negative calcium score, meaning you have early heart disease, and then you choose to do nothing about it, and you keep going to 7 Eleven and getting the, whatever you call it, the stick of meat that is not that healthy, Then [00:51:00] that person probably won’t see much improvement, but now we’re talking about personal choice.

Vic: And I think we’re in America, people can choose to be unhealthy, but it would be good to at least have awareness around that.

Dr. Erica Oberg: Yeah, I’m, this is why I’m in this space is I’m a huge fan of data, right? Knowledge is power when you know what’s going on, especially with your own health. Then you can be empowered to make different choices, and you might not need to make those choices every single day, right?

Dr. Erica Oberg: Everybody gets a cheat day to go out and have a burger and fries, and it doesn’t have to be 100 percent on all the time, but when you know your numbers and your data, then you can choose how stringent you need to be with your choices.

Vic: So, do you have any stats of the prevalence of Osteoarthritis in 35 year olds, it’s not very low.

Vic: You would think it’d be low cause they’re young, but [00:52:00] with the diet we have. I think there is a percentage of the population that has heart disease pretty early.

Dr. Erica Oberg: Yeah, I don’t have that statistic off the top of my head, but I know it’s a moving target, and they’re seeing some of the early cholesterol streaks even in elementary age children now.

Dr. Erica Oberg: So it’s definitely an issue that’s hitting the younger and younger population.

Vic: Yeah, and you don’t have to be morbidly obese and experiencing Physical symptoms that you feel to have arthritis in your veins and arteries and begin having the long term effect of the disease, I think, yeah, yeah,

Dr. Erica Oberg: there’s a reason why it’s the number one killer because it’s largely undetected.

Vic: Yeah, it’s undetected and accrues over years or [00:53:00] decades. And so the idea is to try to catch it early so we can begin putting these interventions in place.

Dr. Erica Oberg: Ah, it’s exciting. Potential’s there.

Vic: Yeah, yeah. I think it’s, I’m going to keep working on it. I, I, I’ve just started talking about it. Now, this is my third podcast focused on, um, health and wellness as it applies to heart disease, but let’s end with what you, where do you recommend someone who’s listening right now that wants to learn more about what’s available?

Vic: Where should they start? I’ll put a link to Marquis website in the show notes, but is there a, uh, An article or a book or something that you’re published or what’s the best place for people to learn more and try to think about their own situation and apply it to, to this offering.

Dr. Erica Oberg: [00:54:00] Yeah. I mean, there’s lots of resources out there.

Dr. Erica Oberg: You led with Peter Atiyah’s book Outlive. I mean, there’s, it’s on the.

Vic: That’s probably the most commonly cited one. It’s a, I don’t know, it’s whatever list bestseller, lots of people are talking about it.

Dr. Erica Oberg: And he’s solid. He’s got great information, makes it very accessible. People are interested in some of the more nuanced conversations.

Dr. Erica Oberg: I do a lot of blog posts on my website at drerikaoberg. com. People can explore some of the organizations that are involved in promoting these more integrative approaches. If they’re interested in finding a naturopathic doctor, they can do that at naturopathic. org. If they’re looking for a functional medicine doctor, it can be at the Institute of Functional Medicine.

Dr. Erica Oberg: org. So those are good resources for finding clinicians. I wish there was a better way to find [00:55:00] all of us, but I think you, Part of the challenge was what you laid out right at the beginning, right? There’s a lot of different words for kind of the same Root cause approach and so it can be challenging to find practitioners like us out there in the world

Vic: So i’ll put these links in the show notes so people can easily get to them And really appreciate your time doing this and I’ll just end with, there’s lots of resources, but I think probably your personal website is where everyone should go and then they can start there and learn about what you offer and then link out to different places and go from there.

Dr. Erica Oberg: Yeah, that sounds great. Definitely. And definitely keep me abreast of your, your efforts to end heart disease. I let me know if I can help. Let’s see to reality.

Vic: Yeah, I think the first year, which we’re in right now is really me learning in public and doing [00:56:00] a podcast like this and reading a lot and I’m experimenting with my sleep right now, and then next year is going to be trying to take those learnings.

Vic: And bring it out to more people, but I want to be realistic and also self aware that I’m certainly not a clinician in any sense of the word. I’m much more of just an interested patient myself and maybe ambitious enough or disruptive enough to say that I think we can end heart disease. I

Dr. Erica Oberg: love it. Dr.

Vic: Eric Oberg, thank you for doing this. Really appreciate your time. We will link to your website and a couple of these other sites in the show notes. And I’m excited to continue the conversation over time with you.

Dr. Erica Oberg: It sounds wonderful. Thanks so much, Vic. I really enjoyed the conversation.

Vic: Okay. Thank you.

Vic: Have a good day.

Dr. Erica Oberg: Take care. Bye

[00:57:00] bye.