251. Dr. Labib Ghulmiyyah: How to Improve Sperm Count and Fertility Naturally

16:19Dr. Labib Ghulmiyyah:I mean, if I answer this question, a lot of people are going to, you know, also put me in the controversy standpoint. But I do agree fully with you that, yes, those could play a role. They're not maybe the major thing. If you go by the guidelines today of our, you know, ACOG and other things, they do not recommend to do those on everyone, even with women that have miscarriages. But again, I think it's logical. Yeah. Sometimes, you know, the studies, you know, could be not well designed. So you can criticize a lot of those things. If it's a simple test and it can make a difference and the treatment is, you know, folate or exchanging their diet, why not in certain situations?

17:00Dr. Labib Ghulmiyyah:So I wouldn't say test everybody today. I mean, next year, if I come back to your podcast, I might say it differently. But today, based on what data we have, I wouldn't like screen everyone. But yes, maybe someone with multiple miscarriages, a family history of neural tube defects, we might check those, but not across the board. I would definitely supplement them and make sure their nutrition has enough folate, choline, omega-3, all these things in order to improve the outcome of the pregnancy.

17:34Gary Brecka:Yeah, I'm going to list in the podcast show notes some of the supplements or at least key nutrients that you talk about for sperm quality. Zinc, selenium, methylated B vitamins, huge fan. Methylfolate, omega-3s, antioxidants like C and E and CoQ10, and lycopene, just like in tomatoes and watermelons, bell peppers.

17:58Dr. Labib Ghulmiyyah:What's lycopene's role in improving sperm quality?

18:01Gary Brecka:That's kind of a new one for me.

18:02Dr. Labib Ghulmiyyah:They're also a very potent antioxidant. So anything that could lower your oxidation will improve how the DNA or how the sperms multiply and divide, and that will have less fragmentation. Of course, the data is not robust on just lycopene supplementation, but it comes as part of the multi-nutrient or the rainbow

18:25Gary Brecka:that men and women should eat in order to improve their gametes. I love this idea of couples going into this and coming out of this together, right? I mean, I have three children and I can tell you when we had our first child at 27 and I really did view this as really being my wife's role at the time and not really realizing the impact that I could have had. And by the grace of God, we had three very healthy children and they're all doing amazing as adults. But I wish I'd had this information then because I was already doing some of those things. It was fairly healthy. I wasn't drinking a lot.

19:04Gary Brecka:I was exercising. I was eating a pretty decent diet. But, you know, had I known this, I think, you know, it would have been a little different going through this with my wife at the time as a couple instead of it being such a unilateral journey.

19:19Dr. Labib Ghulmiyyah:Yeah, I think also to simplify things, we don't want couples to worry much about this and cause anxiety. But today, you know, we're living in a toxin, in a soup of toxins. So we have to be more careful. Maybe, you know, our ancestors didn't worry much about this because they were having healthier food, less processed food, less toxins. But today there is some there's an enemy that's hitting us. So we have to be careful. Men and women before, during and then especially after the pregnancy. I think the support from the man helping, you know, raise the kid, all the habits that we have. There's a lot of studies if the father is athletic and he likes sports, your kids automatically will mimic and will see things that you do at home.

20:06Dr. Labib Ghulmiyyah:Yeah, isn't that amazing?

20:07Gary Brecka:It's like some kind of genetic programming that, you know, where characteristics are passed on. And even though you can't point to this gene causes you to have this outcome. If you have this gene, you're going to like sports. if you like to have this gene, you're gonna be more cerebral or left-brained or right-brained. But it is kind of fascinating how characteristics are passed from generation to generation. And I've actually been reading and studying about trauma even being passed from generation to generation embedded in our genetics,

20:42Dr. Labib Ghulmiyyah:which is really fascinating. Yeah, trauma, stress, all these change how our genes are expressing. And if you're pregnant during that time and you're under so much stress, then this could affect you know because for for me i always say health span starts in the womb so it even starts before birth so whatever the mom is feeling if she's chronically stressed and she's not happy this will reflect into the blood flow to the placenta and therefore nutrients will be less you know given to the baby and then their genes are going to be expressed in a different way so when they're born they might be born at a lower weight than they're supposed to be and this is going to lead to other chronic maybe diseases later on.

21:23Dr. Labib Ghulmiyyah:So yeah, everything is related. And the more you read, the more you learn, the less you know. It's so complicated how the genes interact among each other. We are what our environment is. So I think it goes both ways. Whatever we give our environment, it gives us back. And I think that relationship we should control because the maternal environment is what the fetal environment is. And it's going to be your early stages of life and then eventually your adult diseases. Today, we talk a lot about trying to live longer or healthier, better. And most of people start in their 40s or 50s. Oh, today I want to start living better.

22:07Dr. Labib Ghulmiyyah:And whatever I've done in the past, forget it. No, I mean, I know we have to prepare for our last 10 years or marginal decades that a lot of experts talk about. This is important. but I think starting early and I see a shift

22:21Gary Brecka:the new generation

22:22Dr. Labib Ghulmiyyah:the new generation are more health conscious than what maybe we were so I'm happy that there's more awareness of that but simplifying things not complicating things not causing anxiety empowering women and men and couples anybody that wants to have a kid even if you're going through IVF or egg freezing you want to freeze your eggs to maybe later on use them Also, you have to go through that process, make sure your gut is healthy. Before you start freezing your eggs. Yes, of course, of course.

22:52Gary Brecka:You know, I really love this concept. So, you know, prepping for the pregnancy, then you conceive. And where do you fall on supplementation during the actual pregnancy? Methylated multivitamins or, you know, methylated prenatals or non-methylated prenatals. I don't want to put words in your mouth. So, you know, for a woman to be supplementing with during that time of pregnancy for adhesion and healthy fetal growth, where do you fall in that?

23:22Dr. Labib Ghulmiyyah:Well, there's a couple of, you know, nutrients that are super important, you know, including iron, for example. I think that's the number one metal that, you know, people think about because the placenta needs iron. The baby needs iron. You can see it in the color of the placenta. Exactly. And the woman's blood volume almost doubles, you know, during pregnancy. So she becomes a little bit anemic or what we call hemodilution. So you're going to need, you know, more iron for multiple things in pregnancy. So iron is number one. If you are iron deficient or you have an issue with your iron absorption or metabolism, you will have a higher risk of developing a smaller baby, what we call fetal growth restriction.

24:00Dr. Labib Ghulmiyyah:So iron is key, especially if you don't get it in your diet or you're not absorbing it well. And then, of course, you have the B vitamins, which are basic frameworks for DNA synthesis. You have to have those. Vitamin D, there's a lot of data about vitamin D levels and developing diabetes in pregnancy, preeclampsia. Of course, it's important for the bones. So vitamin D is actually it's considered like a hormone. So vitamin D is super important. But again, you know, you have to supplement the right amounts. So checking labs, supplementing them with the right dose, with a good quality supplement.

24:35Dr. Labib Ghulmiyyah:If you can give them those through a diet, it will be even better absorbed. But unfortunately, the diet is not always available for everyone to have the optimal levels in pregnancy. So that's why we have to supplement. So yeah, good prenatal vitamins that have those including choline, DHA for brain development. All of those are important today. To take the right supplement, I think in the very near future, And I think there's a couple of companies now working on like very specific, tailored prenatal for every single patient. So, for example, a woman might not need that much vitamin D, but she needs more iron.

25:15Dr. Labib Ghulmiyyah:She needs more chlorine. So based on testing on nutrigenomics, we can tailor a specific supplement for, you know, Mrs. X and Mr. X instead of us taking the same multivitamin across the board.

25:27Gary Brecka:Yeah, yeah. That's another thing. I think this is coming very soon. I think I'm a huge believer in that. It makes sense. Yeah, it makes a lot of sense.

25:32Dr. Labib Ghulmiyyah:If you don't have, for example, the MTHFR mutation, you might not need, let's say, that much folate versus someone who has it, for example. Yeah, that makes a lot of sense.

25:42Gary Brecka:So, you know, I've read a lot of literature around vaginal versus cesarean section delivery. And I know there's confusion around this, just people that fall into both camps, people say it doesn't matter at all. There are OBGYNs like the one that was, or is our clinic director, that's a big believer on trying to have a vaginal birth to the extent that you can. And a lot of that has to do with how the fetus is inoculated, you know, through the vaginal canal. Where do you fall in that, you know, conundrum of cesarean versus vaginal birth? And if there was a preference, you know.

26:19Dr. Labib Ghulmiyyah:Well, my straight answer is the way we're supposed to be born is vaginal. That's how God created us. but of course with advancement in science c-section became available and they do save a lot of lives they can make a huge difference in certain situations but the goal is always to try to have a normal delivery as long as it's safe for the mom and safe for the baby this is the way to go because there's a lot of benefits from the way the baby you know moves in the canal all these cardinal movements of labor and then eventually the inoculation from the vaginal flora the skin to skin touching that happens.

26:58Dr. Labib Ghulmiyyah:There's definitely a lot of benefits. Otherwise, I don't think God would have created us to deliver that way. Right, right. I mean, but the C-sections have a role. And I think, like I said, they save lives. But the problem is like everything in medicine, people abuse them. And I think a lot of - Use them more for convenience. For convenience for the patient. I'm not talking about doctors. I mean, I've done plenty of C-sections, but those were done for indications. But a lot of times the patients would come to you, I want the C-section because I don't want to go through labor. It's a long process.

27:30Dr. Labib Ghulmiyyah:I want to keep my pelvic floor healthy because I heard vaginal delivery can cause damage to my pelvic floor. And we know if it's done the right way, the right timing, it will not cause sexual dysfunction or other things. And yes, it is a stressful time. You will rehab eventually your pelvic muscles through special treatments and therapies with specialists. but it's way less risky than a C-section. At the end, a C-section is a surgery. So there is bleeding, infection, you could injure organs. So we keep C-sections when it's needed. And my message to people, don't abuse it.

28:08Gary Brecka:Not just because you want to deliver on a certain day of the year. Yeah, I want to pick the birthday. I want to deliver on the 16th at two o 'clock in the afternoon. And you can now.

28:16Dr. Labib Ghulmiyyah:Yeah, because one C-section after another, it's going to lead to more complications. Now we know after, let's say a third C-section, If you have an issue with your placenta, you can end up having what we call placenta acrita. And that can lead to death and complications. So C-sections are great when needed. But our ultimate goal is to deliver normally in a safe way for the mom and for the baby. That's I agree fully with any physician. And I think this is the oath that we swear by to make sure moms are safe and babies are safe. without being heroic and then using the C-section when needed. Right.

28:56Gary Brecka:And so you go through this birth process and then you have this brand new fetus in the world. For someone that has a birth that was non-vaginal, that was through C-section, are the things we can do to mitigate some of those consequences of having not had a vaginal birth, like prebiotic or probiotic supplementation or trying to inoculate the baby's gut flora so they're not so colicky and have some of these other skin conditions and others because what's fascinating to me lately is the impact that gut microbiome has even at a fetal level. I mean, we know that adults, when they do long course of antibiotics or other things that actually destroy their gut flora, they have all kinds of consequences that we don't draw back to the gut.

29:48Gary Brecka:and now we know the importance of the gut microbiome. And so if they miss that inoculation period vaginally, are there ways for young parents to actually supplement these kids with probiotics?

30:04Dr. Labib Ghulmiyyah:I think the first step, the most important first step is to do skin to skin. Put the baby on the mom's skin and if the mom can't, let's say she's in a C-section and it's not feasible sometimes, then the dad. so even our skin flora can help inoculate there are you know few trials small trials doing like inoculating the vagin flora or smearing the babies i don't think you know there's any you know proof yet that it will make a huge difference in the long term but those are still ongoing studies but i think starting with the skin putting the baby even in the c-section they can put the baby on the mom's skin while the obstetrician is finishing the c-section that will help a lot calm the baby's nervous system because the baby will start hearing the mom's heartbeat, which he or she was hearing when they were in utero.

30:51Dr. Labib Ghulmiyyah:So putting the baby there on the skin will improve breastfeeding chances. Plus they would, of course, get inoculated by the mom's skin. And then dads can do it. So I'm sure you've seen a lot of pictures of dads putting the kids on their chest. Of course, if they have a lot of hair to, you know, shave it so that the skin but touching the skin to skin

31:14Gary Brecka:is so important

31:15Dr. Labib Ghulmiyyah:from the first minute the first minute or two minutes of life are critical so as soon as you remove the baby you put the baby on the mom's skin in a c-section or a normal delivery I think that's one of the first steps that will make a huge difference probiotics and other things I'm not really aware of any you know robust studies on that but it makes sense is to replace, you know, whatever the probiotics needed, but nothing like the probiotics of the mom. Because her vaginal flora will change based on the trimesters of pregnancy. And then at the time of the delivery, it will be exactly, the composition of her bacteria will be exactly what the baby needs.

31:56Gary Brecka:That's so wild.

31:57Dr. Labib Ghulmiyyah:Yeah, so supplementing with probiotics, I don't know which one, you know. So I don't think we're there, but maybe in the future, we can maybe test the probiotics of the mom and then tailor or create a probiotic specific and give that to the baby, maybe. So all this precision medicine, I think, is on the way. But today, I think doing the skin-to-skin immediately is probably the best thing you can do for your kid.

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32:57Dr. Labib Ghulmiyyah:Now let's get back to the Ultimate Human Podcast.

33:00Gary Brecka:So amazing. I had a Harvard scientist on my podcast actually when we were in Dubai. uh dubai and they do uh in his laboratory they do these customized probiotics where um they take a stool sample and they culture your your flora and they look at you know the different strains of bacteria and which ones you're deficient in which ones you have an excess in and what's really fascinating was how much they could predict about the person having nothing other than their gut flora their their their actual profile of their gut flora like this is somebody who gets seasonal flus more frequently than the average.

33:40Gary Brecka:This is somebody who doesn't have a lot of endurance. This is somebody who is very likely to have skin conditions like eczema, psoriasis. It was incredible the mapping that they've done from specific gut flora, both in excess and in deficiencies, to like these manifestations in the real world.

33:57Dr. Labib Ghulmiyyah:You are what you eat. Yeah. And you are what you're surrounded with, your friends, your community. You eventually blend into it. So whatever you're surrounded with, it becomes you. And I believe the gut is so important. And, you know, especially in pregnancy, because there's a lot of interaction between the gut, the vagina, the gut and the uterus. And I'm sure there's a gut placental connection somehow, which we still probably don't know about. But this is amazing to be able to, let's say, tailor a specific probiotic, maybe to give to the baby eventually. So maybe we should test pregnant patients and tailor a probiotic for them so that in case they end up with a C-section, we give it to the baby.

34:38Dr. Labib Ghulmiyyah:I mean, I don't know. I find that fascinating. It'd be a nice project, you and I, maybe. No, let's do it. We can create. All right, let's do it. So, yeah.

34:46Gary Brecka:New probiotic coming soon, guys. So I think skin to skin is the best thing you can do for your kid in minute one of life. Yeah. And then in the precious important months immediately after delivery, I think the consensus is in that if you can breastfeed, you should be breastfeeding. And for whatever reason, a lot of women can't either for anatomical reasons or other reasons they can't. And so now they fall back on having the feed babies formula. And I had the Health and Human Services Secretary, but I also had a gentleman named Kyle Diamantis, who's the head of human foods at the US FDA. And one of the big focuses and projects that he's aligned with and they're really researching right now are infant formulas.

35:37Gary Brecka:And do we really need to put pro-inflammatory seed oils in as the sole means or major means of fat, of these fatty acids? So if a woman has to, it can't breastfeed for whatever reason. I know a lot of the young pregnant women, especially in my, I've got two in my company right now. They're ordering their infant formulas from Europe. because they've gone down the rabbit hole of the research and they're like, they're just better quality formulations there. They're seed oil free. And here there's some regulatory guidelines that force different ingredients to have to be in there because it has to meet a certain profile.

36:22Gary Brecka:So where do you fall on infant formula? And is there, I've seen both sides of the spectrum, you know, Dr. Barbara O 'Neill, or she's not a doctor, but Barbara O 'Neill saying, well, goat's milk is very close to mother's milk. And then I've had other people say that there's nothing wrong with infant formula. And some people say that you should only get it from Europe.

36:43Dr. Labib Ghulmiyyah:I don't think there's anything like the breast milk. I agree with that. Because like the vaginal microbiome, for example, your microbiome, your milk consistency changes. So if you deliver, let's say at 27 weeks, the consistency of the milk that comes out is going to be different than if you deliver at term. So it's made in a way to give the baby what the baby needs at that age. Oh, wow. Yes, the antibodies that are in it. There's no way a formula can mimic breast milk. And unfortunately, yes, like you said, there might be a lot of things added to the milk to make it maybe more tasty for the baby that might be hurting.

37:21Dr. Labib Ghulmiyyah:I'm not an expert. I'm not a pediatrician. So I cannot comment that. But yes, my to-go first is milk, is breast milk. The other option, of course, to try to get the least amount of formula that is not inflammatory or causes gas. And you can know, like, for example, in my experience, my wife restfed for three months. Then she couldn't anymore. So we moved to a formula. We had to change 10 formulas in order for the kid to not have gas and colics. So, which is not normal to have, you know, colics and why that severe colics. So it might be one formula not working for that specific kid. But yeah, the world of formula is a huge problem.

38:03Dr. Labib Ghulmiyyah:A lot of hospitals are shying away from having formulas on board. Some hospitals used to give away formulas on discharge. A lot of them stopped that because they don't want to promote those formulas. So it's a difficult situation. But again, the first two years of life, if you give the baby those inflammatory components, you're going to make things worse. So try to find the most natural way. There are donor milks that women donate some milk. It could be maybe a better option. Not everybody accepts those. But yeah, breastfeeding should not be difficult. I think putting too much pressure on the woman is going to make her maybe not like to breastfeed or feed this social pressure.

38:51Dr. Labib Ghulmiyyah:By the way, doing skin to skin in the first minute will improve your breastfeeding rates. I've seen it firsthand. A patient telling me, I don't want to breastfeed. Please don't even open the subject. I don't want to breastfeed. Don't even tell me the benefits. I know I'm doing formula from minute one. And then I remember we're doing rounds and the baby was in the room and the pediatrician was talking to the woman. And she's like, can I try something and just put this baby next to your breast? And she took off, of course, her blouse and put the baby. the baby just crawled to the nipple and started sucking.

39:24Dr. Labib Ghulmiyyah:Really? Yeah, and the mom started crying. She's like, I want to breastfeed. You know, so really like before trying, you have a lot of oxytocin that comes out, which will make you calm and bond you with the baby. I'm not, we don't pressure women. We empower them to try to breastfeed. Yes, there are sometimes anatomical things that will not let you breastfeed. But if you can breastfeed, try even a month, even two weeks, even a few days will make a huge difference in the baby. But going back to formula, I really don't have an opinion about it because I know there's so many formulas out there and each one says they're the best, but they can never mimic breast milk.

40:07Gary Brecka:Yeah, yeah. You know, I'm deep down the rabbit hole of this right now. So when I come to some conclusions, I'll share them with you. I'd love to get your opinions on it. Yeah, and then maybe we can eventually, like you said,

40:16Dr. Labib Ghulmiyyah:do tailored or specific formulas for each baby depending on their gut microbiome. So maybe we need to look into that in the future.

40:27Gary Brecka:I love that. I love that concept. So now these couples are on this journey together. The man still plays a huge role. I mean, the father's presence we know, especially in young children, is critically important. Breastfeeding, critically important. But yeah, I mean, deep down the rabbit hole of this whole toxic exposure. and pro-inflammatory compounds and a lot of different infant formulas. But, you know, the sad thing is it's restricted by the regulatory guidelines. Like you have to have this and you can't have that. And so it limits the capacity to structure these in ways that might be healthier for babies.

41:03Gary Brecka:I think you're going to see a lot of that change because, you know, human foods, the US FDA is really open to widening these lanes to the extent that there's evidence, you know, to say that they should. This is priority. I think this should be, you know, the number one priority. Yeah.

41:19Dr. Labib Ghulmiyyah:Because we are what we eat and, you know, we need to have a nice, you know, clean, you know, food supply. Like you said, some people are going to other countries to get, you know, different type of food. So, no, I think this should be our priority because a lot of the diseases are related to food. We know that.

41:36Gary Brecka:And so as an OBGYN, you're not only dealing with deliveries. Obviously, you're also dealing with women's health issues. and there was a big announcement by the fda recently removing black box warnings from female hormone therapy and they corrected the narrative around the women's health initiative study uh that incorrectly was uh you know when when they they didn't most people don't read a published study and so they take the narrative and the headlines that comes from the headlines and they intentionally or unintentionally i mean i have to think that it was intentional you know redirected women away from hormone therapy and you know if you talk to marty mccary the head the commissioner for the fda he'll say that 50 million women needlessly suffered because they were told that um you know hormone therapy uh increased their risk of breast cancer when in fact it actually decreased their risk of breast cancer there was not even uh there's certainly nothing causal and there was a correlation between taking these you know having hormone therapy and increasing your rate of breast cancer.

42:44Gary Brecka:What I find fascinating is, you know, menopause for a lot of women is beginning earlier and earlier, right? It can start in their late 30s. So you start to have these weird symptoms, mood changes, weight gain, water retention, fatigue, brain fog, you know, mood and emotional issues. And immediately, I think most women look to their outside environment and go, okay, it's either my spouse or my career or my job, my kids, my stress. But very often, these are the hormonal changes going on. And it's my belief that they can benefit very often from hormone therapy. But where do you fall in that whole debate on hormone therapy?

43:28Dr. Labib Ghulmiyyah:I think today it's not a debate anymore. I think the WHI misled, not only women, but misled physicians. Yeah. Happy to hear you say that. So when the WHI came out, I was still resident that was 2001 2002 and you know we discussed it in our journal club and you know there was a robust study you know we should not be giving you know women uh you know hrt and even though like in our residency and as an obgyn we don't see a lot of menopausal women so right right add to that you know the training and and post-menopausal treatment is not as robust as it should be and i think this is changing very soon so we did not you know have a lot of experience with giving HRT plus we were like afraid.

44:11Dr. Labib Ghulmiyyah:So in my first few years of practice, I would tell women, yes, take HRT just to treat your hot flashes five years and then that's it. You would stop them because we don't know the risk of breast cancer or cardiac diseases. And if you want to continue, it's at your own risk. I used to make actually a few patients sign consents like they're taking it at their own risk because that's what the data told us and we're following evidence-based. But yeah, if you want to talk about the WHI, the type of estrogen that was used, the design of the study, the age of the woman. We can talk for two hours, but it was some sort of, it doesn't reflect what the real problem is.

44:48Dr. Labib Ghulmiyyah:Now women are going into menopause maybe a little bit earlier. Yes, they would benefit from hormone replacement, especially the newer bio, or I call them body identical because they're identical to the body. They're still, you know, manufactured in a way. Sure, they come from yams and yeast. Yeah, yams and other things, But they're chemically very similar to their own estradiol and progesterone and testosterone. Yes, women will benefit on multiple levels, you know, from their skin all the way down to their organs and bones and vaginal health, sexual health, mental health. Mental health, yeah. So there's a lot of benefits, you know, for HRT.

45:27Dr. Labib Ghulmiyyah:But also I think we should always kind of, you know, personalize things. Right. The dosages, who should benefit, when to start, when to stop. Work on the pillars initially, their inflammation, their gut, their toxins, before throwing in hormones without thinking. And it becomes like a recipe. It should not be a recipe. It should be a tool that we have to give women those medications that I think are just replacing what they lost. We're not giving them super physiological dosage. just you know bring them back where they are because they deserve to be functioning you know the work the workforce today is almost 50-50 men and women you have CEOs that are women so imagine a CEO in a meeting and she's sweating and she forgot what she thought about I mean it's so important well it's happened to my wife

46:19Gary Brecka:we just did a podcast on it I mean I lived it day to day I mean like it just over a period of slowly over a period of several months my wife was becoming kind of a different person and and um what really drew my attention to it um was when she got frozen shoulder she got adhesive capsulitis and it's typical so yeah i didn't realize how typical it

46:41Dr. Labib Ghulmiyyah:was and there's not a lot of literature on it and so i started going deep down the rabbit hole of it

46:47Gary Brecka:and and you know all of this the symptomology including the frozen shoulder was linked back to menopause and then of course then when she started having hat flashes that was the big flashing red light and we did a test called a dutch test it's 24-hour urine test and it gave us so much information um that her ob-gyn was able to tailor her hormone uh treatments and and uh if you're a woman and you want to see that podcast we actually give sage's exact hormone dosages on there we go through the the dutch test in detail what was astounding to me so you became a different person i'm sure in three weeks a completely different human being it was like the woman i met you know 10 years prior i mean mood improved sleep improved uh libido came back of course thank you very much of course um and uh that was a that was a nice plus uh libido came back like a freight train her um you know her waking energy improved she she would tell me she's like i'm sitting down to send a wire from my bank to pay this bill.

47:53Gary Brecka:And I've done this a dozen times and I literally can't figure it out. Yeah, yeah. She's like, I feel stupid. I hear this all the time.

48:00Dr. Labib Ghulmiyyah:It's not me. Like, I feel I'm a different person. Yeah, yeah, she would say that too. So, yeah, definitely hormones play a role. But even the frozen shoulder.

48:06Gary Brecka:Yeah. Which I was like, you know, she went from being able to only raise her arm to here to went straight up in the air.

48:13Dr. Labib Ghulmiyyah:And of course, you know, it's not only, you know, your musculoskeletal system, your cardiovascular system, your skin, which is so important for women and their beauty. They start aging very fast if they're without HRT. I see a lot of women undergoing, let's say, facelifts. And the ones that are not on hormone replacement, their results are usually weaker and last less. So it can help on all levels. And I'm so happy that they removed this stigma on estrogen-causing cancer because I think we're in the right directions. using them the correct way for the right patient, the right dose, the right route is what's important.

48:53Dr. Labib Ghulmiyyah:And that's where physicians and healthcare workers, midwives, those are the people that can help those women. And at least the help is there now.

49:04Gary Brecka:You know, I try not to get my information from TikTok. I mean, Instagram, I try to get it from clinical studies and then put it on Instagram and TikTok. But I've been reading a lot lately about, because we struggled with this when we were young parents, you know, with having the kids sleep with you, right? And it's the best. I mean, let's just be honest, having your baby in the bed with you or your young child in the bed with you and they're all snuggled up. You do not want to just get up and go dump them in the crib or give them away. but now there seems to be some evidence emerging that you know kids that actually do break that law and sleep with their parents early on i mean you don't want your 50 year old sleeping with you but you know yeah that's look weird yeah yeah yeah it's a little weird when they're your size but um you know that there's some evidence that um this bond and this unity actually creates um children and adolescents that have less incidence of anxiety.

50:04Gary Brecka:Absolutely. I saw that study.

50:06Dr. Labib Ghulmiyyah:It was out a few weeks ago. Yeah, a few weeks ago. Yeah. Yeah, because our son is like six. He sleeps in our bed. There you go. Just like that. But the problem is that a lot of nights he comes in, he sleeps in his bed, but then I would say every night he would come. Yeah. A lot of nights he would kick me out. I mean, I wake up very early. Your wife kicked you out or did the kid kick you out? No, it's him. It's him. At 3 a.m., 4 a.m. is like he starts, you know, giving me up. No room for you, dad. But yeah, and then we thought, oh, we need to break this cycle, keep him in the room. But when I saw the study, it makes sense.

50:39Dr. Labib Ghulmiyyah:But like everything, you have to have a balance. Yeah, sure enough, forever. There should be a point, yeah, a point where, you know, he has to have his independence. He will probably or she will probably won't want to sleep in your bed anymore. They want their own room and blah, blah, blah. Exactly. But definitely this bonding, this connection, there's some chemistry that goes on, pheromones. I don't know what they are or the energy that goes between humans when they are sleeping next to each other that could, you know, maybe help the kids have less anxiety. They would feel safe.

51:06Gary Brecka:So it's all connected. My wife used to accuse me of being lazy because, you know, we would take turns when our firstborn, my daughter, would wake up in the middle of the night and start crying. And my solution was go pick her up, bring her back to the bed because I was so exhausted. Just lay down and she would go back to bed.

51:22Dr. Labib Ghulmiyyah:I'm like, this is working, right? the easy way the easy way but the little chair

51:29Gary Brecka:next to the crib and I'll try to you know get her back to sleep and sneak her back into the crib she'll start crying again I'm like but if you think about it

51:35Dr. Labib Ghulmiyyah:you know the baby was connected to the mom through the umbilical cord they were in their uterus suddenly putting them alone in a crib is weird like same thing with twins you know they were used to being you know close to each other there's a lot debate whether you should separate them and at what age you should separate them or keep them sleeping next to each other I think it's important to keep the internal environment kind of the same when you're out and slowly, you know, disconnect them from each other, for example, disconnect the kid from you. So it's okay if your, I guess, kid sleeps in your bed.

52:09Dr. Labib Ghulmiyyah:I'm sure a lot of people comment on this saying yes, no, it's controversial. But at the end, whatever works for you.

52:15Gary Brecka:I think, yeah, I think you should just make the decision as a parent and quit worrying about the rest of it. you know, it's mother nature has a way of kind of taking care of itself. You know, one day your kid's not going to wake up and just come running into your bed. You know, I used to, I used to hear the, like the pitter patter of the feet come down the hallway.

52:33Dr. Labib Ghulmiyyah:Or the running sometimes. Yeah, yeah, sometimes they run.

52:35Gary Brecka:Because, you know, kids that wake up alone, I mean, if they've got high catecholamines or something, they go right to worst case scenario. You know, there's an alligator under the bed, there's a monster in the closet, and they beeline for your, for your bed. And it's, it's kind of hard to just carry them back.

52:49Dr. Labib Ghulmiyyah:Like I said, the body will adjust. You know, the nice thing about the body, it puts priority to what it needs to fix first. So that's why I tell people to try to fix one thing at a time. Because if you overwhelm the body to fix everything in different directions, it's going to get overwhelmed. But the body knows. Like now my priority is, let's say, sleep. So it will fix your sleep in a way. Now my priority is to reproduce. So you will fix your gonads. So yeah, the body is an amazing machine, I would say.

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54:04Gary Brecka:Now let's get back to the Ultimate Human podcast. I've also heard you talk about a topic that might be somewhat controversial. about migration as a health disruptor. And because we have such mixed cultures and mixed migratory patterns all over the world. And it's, you know, that migration, adapting to a new culture or language, new social norms has its set of stressors. Absolutely. And you talk about some of the statistics in migrant population, right? And I wonder if you might touch on that for, you know, what does that look like for people that are either relocating to a new country, new culture?

54:54Gary Brecka:What does it look like for people that are coming from another culture and trying to assimilate it?

54:59Dr. Labib Ghulmiyyah:I mean, today there's around 300 million people around the world that migrate. Some of them migrate across borders. Some people migrate in the same, you know, country, but different regions. So but humans migrate in search of food, career, family safety. Some are forced to, let's say, migrate. Some just do it by choice for other, you know, more opportunities in life. So migration is common and it's increasing today because it's easy. It's easy to migrate today. But yes, I think migration is not only, you know, changing geography, it's changing your physiology. and honestly I learned this from myself, from my own experience because I migrated a few times in my life and it takes time for your body to adjust.

55:44Dr. Labib Ghulmiyyah:Your microbiome changes from one country to another. Really? Because it's the water you're drinking, the food you're eating. Like for example now when I go back let's say to Lebanon in the summertime, if I eat something there I might have an upset stomach because my flora changed living in Miami and using the water of Miami for example. So your physiology changes. That's not that good, by the way.

56:05Gary Brecka:Yeah, I know. Don't get me started on that municipal water here.

56:08Dr. Labib Ghulmiyyah:Yeah, I just saw your reverse osmosis system. So I think this is also another message to people clean their water before drinking it. So yeah, your physiology changes by migrating. Not only your geography, your physiology, your friends might change, a new job. So I think it's always a good opportunity to use migration in a positive way, not to make it dramatic. Even if you had to be forced to migrate, but your circadian rhythm will change but the body like I said is amazing and it will adapt to this migration and people need to be aware of it if you're migrating it might take you 3-4 months to adapt to your society

56:48Gary Brecka:would you refer to it as the healthy immigrant effect yes

56:52Dr. Labib Ghulmiyyah:and you need to be positive about it and even if you've lost everything and you move to a different country it should be an opportunity to start from scratch any bad thing that happens, I think, in everybody's life should be taken in a positive way and try to build on it. And this all reflects in your physiology and your energy will change. Your sleep patterns will change. So, yeah, I think migration is a topic that not many are talking about, but it plays a role in our health because we are constantly migrating and traveling around the world.

57:29Gary Brecka:You know, it wouldn't be the Ultimate Human podcast if we didn't talk about some of the fixation that people have on longevity and anti-aging and not just for women, but for men as well. Knowing what you know, experiencing what you've experienced as a physician, everything from delivering babies to managing female hormone therapy to, you know, your lens on migration. What are just some of the must-haves or must-dos that society, men and women both, need to be engaged in on a regular basis?

58:10Dr. Labib Ghulmiyyah:Yeah, I think first, you mentioned the obsession with, let's say, longevity and healthspan. I think we should not have this obsession. Unfortunately, people now are so obsessed on doing everything at the same time. and this is what's causing sometimes more anxiety. Sometimes doing more labs can cause more anxiety. So I think we should use labs more as a framework to help us improve things, not to do so many labs because this is going to make you more anxious. You mentioned in the beginning basics, your sleep, your food, and your stress levels. I think those are the first thing that we need to do because being obsessed with longevity, you might miss things in life that you need to enjoy.

58:59Dr. Labib Ghulmiyyah:So you have to have a good balance in improving your health, enjoying life, but at the same time living in a healthy way so that you can function, have good energy and transmit this to your kids and to your environment. So yeah, the first thing is not to obsess about longevity and living longer. just obsess about living healthier now. I think that's, and if you like to do this certain hobby, do it in a healthy way. If you like to play paddle or you like to play tennis or soccer, do it, but in a way that you will enjoy it. And don't obsess about, you know, hacks that might not work for you, might work for some other people.

59:40Dr. Labib Ghulmiyyah:And like I said, sleep is so important. I mean, I'm discovering this every day because I have issues with sleep And I'm trying to fix that because the nights I sleep well, I'm so productive and I feel so. And the nights I don't, I'm in debt for sleep and my whole concentration, my whole energy collapses. So focus on sleep because there are people who say, oh, I'll sleep when I die. I hear this all the time. You know, you live once. Sleep is for losers.

1:00:09Gary Brecka:Sleep when you die. Take the hill.

1:00:11Dr. Labib Ghulmiyyah:I think the hours you are awake will be so much more fruitful if you have slept the night before. Yeah. So I think that's the main message. And of course, we know sleep improves your fertility, improves your weight control, your gut microbiome, your brain. It's unbelievable, you know, how important sleep is. And then food, like we talked about, is what we are because it's going to affect our hormones, which in turn will affect our life.

1:00:41Gary Brecka:Yeah, I would totally agree with that. I mean, I think that you can get paralysis of analysis very quickly by just going out there, just Googling around about a good supplement, Googling around about the best biohacking modalities. And I think very often we just forget that we have data on this already. We have big data, we have blue zone studies. And there is not much that matters if you don't get sleep, whole food dieting and mobility just making exercise kind of non-negotiable and these are this doesn't matter if you make two dollars an hour two million dollars an hour it's not a socio-economic thing it's just a human thing and movement is cheap i mean movement yeah movement's cheap and and and and you know what's interesting is you know you you you want it to be this one special thing you know like i was always fascinated when i would look at like blue zone studies and it was like the goat herders and sheep herders and yeah that were they were living the longest life because you know like sheep wanders down over the hill they walk over and get the sheep they're bringing the sheep back up then they brought their lunch with them and they ate out in the sun you know or ate out under a tree and they have fresh air and and um you know casey means was talking about how we spend 97 and a half percent of our time indoors now yes um and i'm conscious about trying to force myself out outside and and i will say that of all the biohacking you know you walked around here i mean of all the biohacking modalities that i have um and all this you know fancy fancy equipment nothing really makes me feel better than getting silently on my skin in the morning doing a round of breath work going for a grounded walk or i mean when i'm in colorado i have this little four mile uh loop that i do with a weighted vest and i come back and i'm like i feel really

1:02:28Dr. Labib Ghulmiyyah:good like i feel like spiritually good absolutely yeah yeah yeah the connection with nature yeah all

1:02:34Gary Brecka:these uh yeah western medicine they do or eastern medicine they do forest bathing for the bit yeah you know um somebody actually sent me a a slide of some of the uh hospitals in the 30s and 40s and they had sunbathing balconies hospital beds yeah on rooftops rooftops yeah yeah and we just

1:02:54Dr. Labib Ghulmiyyah:lay the patience out in the sun it tells you you know like uh our ancestors knew a lot uh yeah but we just had to prove it uh with you know with studies but there's a lot of things that are done that are really you know basic that our ancestors did without even maybe noticing that they are you know beneficial and you know with time they uh we lost those skills i guess yeah but yeah nature walking outside is amazing. But yeah, unfortunately, because of work and because of people want to succeed all the time and there's so much pressure on us that we're stuck inside on our laptops and on phones.

1:03:33Dr. Labib Ghulmiyyah:With junk lighting. Yeah, you just have to go out and walk. And I think what you've done here is almost like nature. Yeah, I'm trying to bring the outside. Yeah, your air is so clean and everything is amazing. But like you said, going outside is key. Still no replacement for you. No replacement. Yeah, yeah, yeah.

1:03:50Gary Brecka:I mean, I think the more disconnected we get from other nature, the more isolated we become. You know, I don't think that we were genetically programmed or ancestrally designed to be endorsed this much in artificial lighting and artificial temperatures. You know, our bodies are so adaptive. It's incredible how resilient we are. You know, that's why I love the application of some of these hormetic stresses like sauna and cold plunging. and you don't have to be obsessive about it, but those things make a difference. They actually build resilience.

1:04:18Dr. Labib Ghulmiyyah:And of course, if you do it with friends, it'll be even better because also the community is so important. Yeah.

1:04:27Gary Brecka:That community, that sense of connection. That community is huge. Yeah. So in your practice, where are you going? How has your actual practice evolved? like the way that you look at your patients now have you zoomed out now and you actually start to consider lifestyle diet stress whereas maybe i'm not putting words in your mouth when you got out of med school first started seeing patients it's sort of a by the numbers kind of thing i

1:04:56Dr. Labib Ghulmiyyah:think you you're not putting words in my these are my words okay that's exactly what i want to say yes yeah um you become you know after training uh you know you become a bit kind of a robot and you do the right things. You save lives. You do C-sections. You do hysterectomies. And so you're doing the right things. But yeah, that zoomed out, you know, 360 view of lifestyle. I'm starting to appreciate it maybe in the last four or five years how important it is. Yes, we used to be told lifestyle is important, but we never dug into, like a patient would come in for 10, 15, 20 minutes. Yeah. I wouldn't know much about her life.

1:05:34Dr. Labib Ghulmiyyah:Right. You can't really dig in. Yeah. So but I think digging in into every person's lifestyle, the way they sleep, what they eat, when they move, what are things happening in their life as far as stresses, the relationships. I mean, those take time to know a person. You can't know a person within five minutes. But yes, definitely my view on pregnancy. Whenever I see a woman that has a baby, a small baby, I start thinking the things she ingested. Is it the food? Is it, you know, her blood pressure? Why is her blood pressure high? Is it, you know, related to, you know, her stresses in life? Where does she live?

1:06:09Dr. Labib Ghulmiyyah:So, like, yes, my view to things have changed, no doubt.

1:06:15Gary Brecka:Have you seen patterns in your practice?

1:06:18Dr. Labib Ghulmiyyah:A few patterns, yeah. A few patterns. Stress and lifestyle. Yes, yes. I mean, definitely women that have a very hectic lifestyle with, you know, very high demanding jobs. you would feel sometimes their pregnancies, they might end up with more IVF sometimes. I mean, again, those are just observations. I'm not saying anyone who's a high achiever will need IVF. But yeah, you have those patterns that you are seeing. People that don't have access to food, they only have access to junk food. They end up being overweight, having preeclampsia, preterm labor, emergency C-sections. Yes, there is a pattern, no doubt.

1:06:56Dr. Labib Ghulmiyyah:I know that. But now just the way I think about a pregnant patient is different than what I did, you know, five, six years ago. Yeah.

1:07:04Gary Brecka:Yeah. Just amazing. I'm so glad that you came back so we could run this podcast. I'm so happy you had me for round two. Yeah. And it still strikes me that we had to meet halfway around the world and we had to finish it and you're right up the street. dumb. You know, I have a group of folks that are my VIP clients and, or VIP members. And so we're going to go into the VIP group and now have a little private podcast because I let them know who's coming on the podcast and they have some questions for you. If you're actually interested in becoming a VIP, just go over to theultimatehuman.com forward slash VIP and you can get it, take advantage of the private podcast.

1:07:43Gary Brecka:You can ask Gary anything. You can get my AI, you can be at labs, you can be at a genetic testing, you can ask at anything. It's an incredible community of like-minded people that's going to change the world. But before I end every podcast, I ask my guests the same question. And if you watch the podcast, you know it's coming. There's no right or wrong answer to this question. And that is, what does it mean to you to be an ultimate human?

1:08:10Dr. Labib Ghulmiyyah:I think being, you know, I did not, I knew you were going to ask this question. I didn't want to prepare it. I wanted it to be, you know, to come out from what we're we're discussing. I think an ultimate human, you should be a person who is connected to yourself, connected to the people around you, give as much as you take from others so that, you know, the day you are not here on earth, people remember you that you were someone who impacted their life in a positive way. And then at the same time, being a human is, you know, enjoying life, not to take things all the time seriously. And then, you know, being able to live in a healthy way and then not dying suffering.

1:09:05Dr. Labib Ghulmiyyah:I think that's how I see an ultimate human. Meeting lifespan. Yeah.

1:09:10Gary Brecka:No, that's amazing. Dr. Labib, you're amazing. I'm glad that you came back and gave us... Thank you for having me.

1:09:15Dr. Labib Ghulmiyyah:Round three is going to be trying the biohack gadgets you have. For sure.

1:09:21Gary Brecka:We'll do a whole podcast episode on it. You're welcome back anytime.

1:09:24Dr. Labib Ghulmiyyah:You should do this.

1:09:25Gary Brecka:Yeah, you're my neighbor, so you're welcome back anytime. So thank you for coming on. And until next time, guys, that's just science.