by DND | Mar 22, 2023
Medical Advice from the Military Elite | Dr Bryan Stepanenko
Dr. Stepanenko recently retired from the military after completing seven years as an active duty Army family physician and was a firefighter/paramedic in South Florida prior to his military medical career. He recently joined Gabrielle Lyon’s medical practice as the lead physician and is an ambassador for the Institute for Muscle Centric Medicine. He practices Lifestyle & Performance Medicine with specialty training in Functional Medicine (IFMCP) and is teaching staff for the military’s only Functional Medicine training pathway. He lectures internationally on Warfighter Human Performance & Wellness, focusing on ways of identifying and mitigating threats to health and performance in the military Operational Environment and every day life.
In this episode we discuss:
– What it’s like to jump from active duty to practicing medicine
– What is functional medicine, and who can practice it?
– How we can start treating our Special Operations Forces (SOF) Operators better immediately.
– How to live your best life from a muscle centric perspective.
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Dr. Stepanenko, Dr Lyon
Dr Lyon 00:01
Welcome to the Dr. Gabrielle Lyon show where I believe a healthy world is based on transparent conversations. In today’s episode of The Dr. Gabrielle Lyon show, I sit down with Dr. Brian Stepanenko, who recently retired from the military after completing seven years as an active duty Army family physician. He was also a firefighter paramedic in South Florida prior to his military medical career. Now I have worked with Dr. Stepanenko in the military sector for the last six years, and I’m thrilled to announce he recently joined the practice as the lead physician and is an ambassador for the Institute for muscle centric medicine. Dr. Stepanenko practices lifestyle and performance medicine with specialty training in functional medicine, and his teaching staff for the military’s only functional medicine training pathway. He lectures internationally on warfighter human performance and wellness, focusing on ways of identifying and mitigating threats to health and performance in the military, operational environment and every day life. I’m thrilled to be able to bring this to you. And in this episode, we talk about what functional medicine is how you can understand the key pillars to your own health, how to get to the root cause of any dysfunction that you may be encountering. Dr. Stepanenko is one of the finest physicians I know. He’s full of integrity passion is incredibly articulate. Please take a moment to share your thoughts on this episode. Like Subscribe, comment, share, we are so grateful for your time and attention. Dr. Brian Stepanenko
Dr. Stepanenko 01:54
Dr Lyon 01:55
Welcome to the show. I am so excited to introduce you to the world you are my lead physician in the practice. And the truth is I’ve been recruiting you for five years,
Dr. Stepanenko 02:09
and finally made the jump I’m ecstatic to be here ecstatic to be part of the team. I can’t say enough amazing things about your leadership and the team of unicorns literally that you’ve assembled. Just amazing high performers and just happy to be part of that.
Dr Lyon 02:24
Well, the truth is you is you are no slouch. You recently retired from the military, you’ve had a incredible career. And I think that the listeners and of course the practice, we are so lucky to have you please share a little bit about yourself.
Dr. Stepanenko 02:41
Sure. So yeah, first off, I have a very clear mission and purpose in life. And that is to bring the best of what’s possible to just amazing high performers. And I originally thought it was going to be a full career military only. You definitely helped me understand and expand that that thought process that I’m able to serve my mission and purpose, and treating any and all high performers. And I’ve just been blown away by the patient population that we attract. That our practice that I get to treat day in day out. I mean, so many times I’ve texted you already say listen, I love my, our job, and been blown away by the opportunity to join you and your mission and purpose. It just aligned with me phenomenally. So me personally, I’ll go all the way back
Dr Lyon 03:30
Oh we want tohere at all everybody wants to know who is Dr. Brian!
Dr. Stepanenko 03:32
My origin story. Yeah, beautiful. So I’m a cancer survivor. I had leukemia when I was three until I was five. So I was too young to really remember that portion of the experience. But through my family’s experience, I understood, you know what that impact was on the family. But that definitely lined my family up and my mom in particular to really focus on integrative strategies for health, supporting health, because I was lucky as hell to come out of that, and was a happy go lucky kid, energetic and I was able to start school at the same time as my peers, so five years old in remission, but food is medicine exercises, medicine, integrative and holistic modalities was definitely part of how she thought. And that translated to a lot of what I found important growing up. So in general, that resonated with me from extremely young age, and I went on to become a firefighter. And one thing that I don’t get to tell often is that they actually granted us a wish Make A Wish Foundation granted us a wish and sent my family to Disney World. But the face of the Make a Wish Foundation, the person that interacted with us was a firefighter. And he later he lost touch with our family for about 15 years or so maybe even 20 but when I graduated the and got hired at the fire department, he actually pinned the badge on me. So when I when I became a firefighter, so I was a firefighter for five and a half years firefighter paramedic career. And the guys that I worked with literally raised me. And I actually got put into a leadership position very early. So a young buck 21-22 put in charge of people that were literally retired from other departments. It was a fantastic growth opportunity to learn how to lead when you’re not the highest authority individual when you’re not the most seasoned person and when you don’t know it. All right, so it was a phenomenal growth experience. I jokingly say that they literally raised me, you know, I grew facial hair while I was there. I hope that never happens to me. So, firefighter paramedic, the medical stuff just really came easy to me. And I enjoyed distilling complex concepts to be able to teach it in a way that was just super simple and easy to understand. And I think that in particular, really set me up for awesome patient care, really good educational experiences. So that that that really created a strong foundation for me when I ultimately went to medical school got a military scholarship to go there
Dr Lyon 06:15
How did you decide? So you were a firefighter for five and a half years and a paramedic. So do they train all firefighters to become paramedics or you can choose how does that work?
Dr. Stepanenko 06:24
right, very different depending upon state depending upon region. So down in South Florida, they, they do hire you in a career role as dual firefighter and medic or firefighter and EMT. So medical and fire work in the same building. And the same individuals are duly trained. So I worked for Seminole Tribe Fire Rescue, and that was working for Seminole Indians. And that in itself was a really unique experience, because we had rural areas that we served as well as urban areas that we served. So we were duly trained as wildland firefighters and structural firefighters, and did a lot of public service activities as well. But fantastic experience. And yeah, the military seemed just to be more experiences and opportunities. Basically, in my mind, I was equating it to a bigger Fire Department. So the Brotherhood the the ability to serve a higher mission and purpose and to live a servant life and really kind of protect the health well being of others. That 100% resonated with me. So I just saw it as all opportunities, no obligations, it was just an exciting opportunity. So got the scholarship, went to the University of Miami for medical school. And in my first month of medical school, a mentor of mine that I had been chasing for a while he was a leader in the exercises medicine initiative with the American College of Sports Medicine. He knew I had an interest in integrative modalities and holistic care. So he’d said, Hey, there’s this lunchtime lecture that I think you should go to. And lo and behold, it was Mark Hyman talking about functional medicine at the University of Miami in Florida. And they were just initiating a partnership with my medical university that ended up being the entire four years that I was there. The there was every two weeks, diverse professionals coming to learn about functional medicine from some fantastic leaders at the time, and even still currently at the University of Miami. So come hell or high water on a Saturday, even if I was celebrating an exam being done and you know, hungover from the bar,
Dr Lyon 08:33
not that you’re ever hungover.
Dr. Stepanenko 08:34
I don’t drink. So I would I would make sure my book was in seat for the the every other Saturday, learning about functional medicine and having these professionals that were at different parts of their career, looking at me and saying, you’re gonna do good things because you’re just learning about this now, like your brain is really open, wide open. And I really felt like I was training to brains. I was training brain to pass the test and conventional medical care. It’s it’s excellent for urgent care for emergent care. And even internal medicine, like when when things go wrong, and you need life saving measures. Now, by all means, like I learned that part. But then I was learning this whole concept of what’s possible with lifestyle medicine, integrative modalities, personalized medicine to a degree that I’ve never heard outside of those, those educational opportunities and outside of those professionals, so picked up some fantastic mentors in that area to that put me put me in front of an opportunity to go to Loma Linda University. They had an elective rotation for medical medical students in their fourth year to learn about functional medicine there and I had four years of exposure to functional medicine so they loved having having me over there and they actually let me follow a few practitioners in the local area that had their, their clinical, they had their their clinic setup and I got to go shadow, learn about their functional medicine care delivery model. And by the time I was graduating, I’ve had that exposure and knew what’s possible. And now I was going into conventional military medicine, rotation and military medicine, Medicine Residency.
Dr Lyon 10:25
So, how does that work for the for the listener to understand, you go through med, so you went into medical school on a military scholarship?
Dr. Stepanenko 10:34
Dr Lyon 10:35
That is that essentially am Igetting that right?
Dr. Stepanenko 10:37
Yeah Once you get accepted, you show them the acceptance letter, and they allow you to apply for the military scholarship, which I was awarded, which
Dr Lyon 10:46
is incredible. And was that already? Were you designated to go into the army? Did you get to pick your branch? How does that work?
Dr. Stepanenko 10:55
we designate beforehand, so you apply for an army scholarship.
Dr Lyon 10:59
I won’t hold that against you
Dr. Stepanenko 11:00
Yeah So I figured, Family Medicine is where I saw myself and the most locations and opportunities to serve in very diverse roles. The army was was that solution for me. So I just wanted to maximize opportunities and maximize locations and various jobs that Army family physician can do. So picked army got scholarship, went to medical school, got that exposure was thinking very differently than the average first year family medicine resident in the army. And throughout the residency experience all three years in Fort Benning, Georgia. I was chasing additional functional medicine education opportunities, getting my advanced practitioner certifications to where I when I graduated residency, I also graduated Advanced Functional Medicine Practitioner got certified as that so one or two years into my actual clinical practice outside of residency.
Dr Lyon 12:02
Where did they station you?
Dr. Stepanenko 12:03
I got to Fort Bragg and I was Fort Bragg, North Carolina was my my first location for for clinical practice. So my first big boy job and
Dr Lyon 12:15
Were you nervous?
Dr. Stepanenko 12:16
I was very nervous but extremely excited. No longer being in residency. I know Shane, your husband is just starting residency and we’re comparing some notes of what his experiences and how excited he is right now. And I remembering you know, when I was starting residency, but the job that I rolled into was a blessing in disguise, it really was because I was replacing a geriatrician trained family medicine doc that was at the end of his career. And he had the most complex panel of veteran. So veterans and chronic pain patients. And I kind of compare this to some of your geriatrician training background to where when you have complexity, early in your career, you’re either gonna sink or swim
Dr Lyon 13:07
Dr. Stepanenko 13:08
Yeah. And I found a way to swim and I had to swim fast. And I was very open to training up and teaching, the end, empowering the rest of my support staff finding out who all was part of my team, how can I leverage everybody to the to the maximum of their capability and scope? How can I even train them beyond their scope, to where they can help me make good decisions, and then I have confidence that they can gather the right info, make great decisions, and that I then trust them. So 100%, I loved the fact that I had that complexity to start off with. And I look back on that and say that that was a fantastic springboard to just get me comfortable with being uncomfortable, and making hard decisions with partial information. So that that was how I learned to start incorporating functional medicine. I had, I had to because once you learn these things, you can’t unlearn them and you start, you start thinking very differently. So I was working with people on the polypharmacy part of the equation, getting very comfortable with scary medication lists and helping people rethink utilizing their their pain meds in combination with other modalities, some self care skills, how to incorporate that. And I was learning how to practice a version of the functional medicine, while seeing 16 to 22 patients a day.
Dr Lyon 14:35
Ah, so many!
Dr. Stepanenko 14:37
that’s why, honestly, the role that I have right now in the practice that we have, I mean, we get to spend 90 minutes with an initial patient, I really get to know the person that I’m that I’m engaging. And I’m just so grateful for that opportunity and that time. So, the experience now is extremely different than how I had to practice a version of functional medicine in the military. Healthcare System. And so I got comfortable with uncomfortable, fantastic opportunity. I was treating Special Operation veterans as well as conventional veterans, family members, chronic pain patients, complex comorbid patients, and was still figuring a way to practice a version of functional medicine, especially with lack of access to some of the advanced specialty labs that I’m now comfortable with,
Dr Lyon 15:26
yeah which we get toorder now. So lucky,
Dr. Stepanenko 15:30
right? Right. Honestly, if I had the ability to look at the things that we look at, in our practice, now, I feel like I would have been practicing a very different version of the functional medicine, but I was doing the best with what I had doing the best with what I what I had access to. Not only that, once I started doing that, and picking up some additional mentors in the military functional medicine space, which there was only a few of us, right,
Dr Lyon 15:55
so there’s like what Dave LeMay? Dr. Dave LeMay, right.
Dr. Stepanenko 15:58
So, he’s a civilian contractor, and he is essentially sought out for some high level care.
Dr Lyon 16:07
very high level,
Dr. Stepanenko 16:08
and he was being sought out outside of the system. So the question is, who inside the system was doing a version of what I was trying to do and learning to do, and I found some individuals, Mi-Lin Whin, is a fantastic friend, mentor, she is Air Force, she was Air Force and at the end of her professional career, about to transition to veteran status and retire. And she saw in me the potential and pulled me under her wing. And we started co lecturing and educating together in the military, functional medicine space, really building up a foundation of professionals that were like minded. So we had the lifestyle medicine individuals, we had integrative medicine, individuals, people that wanted to practice a better version of personalized care. And we, we expanded the network and the Institute for Functional Medicine ended up pairing up with a Walter Reed organization called the National Capital Region pain initiative. And they started a military functional medicine training pathway that’s been active for the last, this will be the fifth year running. And it’s paid for by the military. It’s the only military pathway where you can learn functional medicine and it’s up at the best institution, a center of excellence, Walter Reed, yeah. So they pulled me in as teaching staff and faculty. And it’s been a blessing and honestly, such joy and fulfillment in that training role. And I never thought I was going to do education. I assume
Dr Lyon 17:36
I’m surprised about that, because you are such a good speaker. And you are so charismatic, whether it’s at the military Special Operations conferences, or you know, the these tactical Naval Special Warfare is I mean, everybody gravitates towards you so to me, appreciate lecturing and speaking would be a no brainer for you.
Dr. Stepanenko 17:57
I’m passionate. That’s that’s the easy, that’s the given. And that ability to translate kind of concept, complex concepts down to really easy to digest and understand that came natural for me because I had to when I was at the fire department, and I really think that was a foundational experience for me. I literally had to make it easy to understand for firefighters who had attention span, extremely small. I know you
Dr Lyon 18:23
Nothing against firefighters. But Dr. Stepanenko is a firefighter, was a firefighter.
Dr. Stepanenko 18:27
I know, becauseI am, right, there you go. So I had to think of how would I teach this to myself if I was as distracted as I am, as I was.
Dr Lyon 18:37
I don’t know. You crush those battle ropes this morning. So we’re
Dr. Stepanenko 18:40
that workout this morning was awesome. Yeah. I appreciate that. Every time we get together, we work out in the morning. And that’s an opportunity for us to catch up and resonate before the day before the workday. So that’s fantastic.
Dr Lyon 18:50
Our team is non negotiable. Anyone on our team is fit.
Dr. Stepanenko 18:54
Dr Lyon 18:54
they have to live what they are talking about.
Dr. Stepanenko 18:58
I think all of us have done the 75 hard before all of us workout regularly and that
Dr Lyon 19:04
Not Shane, what a lazy dude.
Dr. Stepanenko 19:07
husbands. He’s by by proxy by association. He’s awesome. And yeah, he’s put in his time. So forget where we’re at?
Dr Lyon 19:19
No, you were talking about how you implemented and was able to begin to lecture and speak and became sought after to talk to and right, these things.
Yes. So that experience those three years at Fort Bragg got me comfortable in figuring out a way of doing a version of functional medicine in the Military Health System that allowed me to teach others some of what works and what doesn’t work, especially in constrained environments. So it was even nicer to be able to teach some of these concepts to the people that were then specialists who had 60 point 60 minute appointments maybe even longer, because they could do a better version of what I did. So if anything I helped tell them, hey, this is what’s possible. Here’s some tools, resources, this is knowledge transfer, here’s lessons learned.
Dr. Stepanenko 20:15
And we created documents, templates, and made ourselves extremely available to support mentor, what you know, whatever’s necessary. Because this became a life mission and purpose for me. I remember being at a functional medicine conference, it was an energetics, energetic, bioenergetic Advanced Practice module. And Dave Rakel, was on on the stage. And he did a group activity where we sat back to back all of the attendees. And he asked the question, what do you want your health for? And he had us ask each other that in succession three times, what do you want your health for? What do you really want your health for? What do you really, really want your health for? And what became clear to me was a mission and purpose that I wanted to bring functional medicine to the military. And there was such an opportunity and a gap, and that became a fire in my belly. And that still to this day, is is a huge part of the fire in my belly. But I gotta tell you, I felt that once again, when you were lecturing to our military functional medicine community, I had made sure that we got you on the docket and said, you know, she needs to, she needs to share her version of functional medicine that she’s practicing. And when you started talking about the science behind the muscle centric medicine and the approach, and it was such a wake up call, and I felt that fire in the belly again, and I remember immediately reaching out to engaging you. I remember our conversation too, because it was in part about having young kids at home and how we were both
Dr Lyon 20:15
Yeah. by the way, you have three I have two
Dr. Stepanenko 21:54
Yeah. Yeah. Our kids around about the same age. I just got one more.
Dr Lyon 21:59
Dr. Stepanenko 22:00
Yeah. So yeah, I remember engaging you and just being so darn excited, because I’m saying, Listen, I mean, this makes too much damn sense. Nobody’s talking about this, the sciences here, why aren’t we doing more with this, like, you need help getting this message out. And, and like, this resonates completely with me. And then even more recently, I was thinking about that, like, the muscle centric approach to care and the version of functional medicine that you practice with this muscle centric medicine, it and that we get to do is, is a it’s applying the Pareto law, the 20-80 principle to human performance and performance optimization and wellness optimization. And I make it a point to say that it’s the performance optimization component to because you need to be living your best life and functioning well into your old age. And not only your old age, but right now. And how can you narrow the focus and keep it simple, but use evidence based practices to have wellness and health as a byproduct. And that made it like crazy simple, and, and that’s why your was your message with the muscle centric medicine, and the science just resonated completely with me. And that’s when we really picked up conversations. And you were saying that’s after, you know, four or five years of knowing me. And I was really starting to make some hard decisions saying, do I continue on a path where my next professional roles will be more administrative and removed from clinical care? Or do I want to continue to be the thinker doer and learn a version, that a version of of medicine and practice a version of medicine that I that I will be excited about every day, and that’s what I get to do with you. And the the muscle centric medicine, functional medicine approach to care, the way that we’re able to provide care for people is nothing short of just joyful fulfillment, completely gratifying. And I, you know, I, I’ve literally Thank you, and I’m very appreciative. My whole family all sees like the the joy that I get from being able to come to work and engage you and the patient population that you attract. So just genuinely, you know, thank you,
Dr Lyon 24:16
Oh thank you!
Dr. Stepanenko 24:17
for letting me chase you around and join your practice. And yeah, I’m ecstatic about the version of care and the the quality of care that we’re able to provide. And part of my experience has been, you know, directly seeing the results of Yeah, of your patient care, and now my patient care and the patient experience in general. If you’re out there, and you’re thinking about it, and you’re on the fence, get in the door, get in front of us, we have the opportunity to just achieve some amazing results for people that have been hitting the wall time and time again gets so frustrated with the clinical experiences in the conventional setting. And we take the time and We get the time to really dive deep understand you in context over time, figure out why certain treatments in the past haven’t worked, even other functional medicine practitioners that they’ve seen. And the issues haven’t been fully fully resolved we get after that.
Dr Lyon 25:15
Yeah. And we get, though, you know, I think that one of the things, there’s many things that I really appreciate and love about you, and you are a savage, right? I mean, it’s true, you are an absolute a player, you know, I’ve had this practice for, let’s see, I’ve been in practice, I’ve been seeing patients since 2006. I’ve had a version of my own practice since 2016. And I am very protective of my patients, any of my patients listening, you know, we don’t take everybody we take the people that are the right match for the practice and on the same wavelength. With that being said, I don’t want anybody less than the absolute best interfacing with my people. And I, that’s what you bring, not only in clinical knowledge, which you’ve had a tremendous amount of clinical knowledge, and we’re going to talk about your work and special operations. But your ability and leadership is incredible, and who you are, as a person is outstanding. You know, one of the things I think is really important as a provider is it’s not just about the algorithmic approach, like, Hey, you want to lose weight, Hey, you want to build muscle, that’s great, you need a physician that is going to step in that fire with you, and stop at nothing to be able to get you where you want to go.
Dr. Stepanenko 26:45
I was at a very professional conference yesterday. And, in general, it came time to relay a concept that is getting after exactly what you’re talking about. And I couldn’t help but say it in a way that ended up saying a curse word. So I had to apologize ahead of time. And I’m like, listen,
Dr Lyon 27:06
you’re allowed to curse on this show
Dr. Stepanenko 27:07
Yeah, hey, I gotta apologize. And I need to say plain English. But your ability to resonate and create a trusting cooperative relationship with that patient, they need to feel a high give a shit factor. And you’re giving should factor needs to be high, and caring for the population that we get to care for. And the special operation community, even the elite entrepreneurs that you attract, and just the the people that are ready to get after it, the super motivated patients that end up in front of us that just want to be better, and they’re ready to tear the world down to make it happen. That’s that person motivates me to try and match their their energy. And I’m 100% ready to jump in the ring with them?
Dr Lyon 27:53
Dr. Stepanenko 27:54
And that’s, that’s it, we do it together. So the ability to form that alliance, that trusting cooperative relationships get to a shared understanding what’s happening, why and what will make it better. That’s literally the first two parts of the process of healing. Yeah, you know, so the gearshift factor has to be high. And it is so easy. And just an energizing to be able to treat the patient population that you do. And we do.
Dr Lyon 28:22
We do, we do. We are We are a team and we have a great team behind us. What, When was your interest in special operations? When did that kind of evolve? Because the truth is you’re you’ve always been incredibly driven. You’ve always been a servant leader, which is actually what makes a phenomenal person and a phenomenal, phenomenal physician, it is about it is about this servant aspect and then actually stepping up as a leader for those people. The Special Operations community is a very unique community.
Dr. Stepanenko 28:56
I had no understanding of what it meant to be special operations warfighter until my the end of my second year of military residency, I was at Fort Benning, Georgia, that’s the location of the rangers and in general, there’s some of the most fantastic tip of the spear elite warfighters. But I had no direct interaction with while I was there. Really, my interaction first started through Master Sergeant Jeff Dardia, the director for Task Force Foundation, special operation force Health Initiative, and I met him while I was on an elective rotation to Cleveland Clinic center for functional medicine. So I was up there, spending some time with Mark Hyman, Patrick hanaway. And I also was learning about Shared medical appointments and group visits. And in general, that was a mind blowing experience. But while I was there, one individual had pulled me to the side while I was at the Center for functional medicine clinic, and he said, Hey, you know, we’ve got this pathway that every Thursday we save a slot and we have elite warfighters, some green berets and special operation community members come for care. So we save this spot. And it’s a pathway that this one guy Jeff Dardia created. Do you know Jeff Dardia? And I’m like, Well, you know, the Army is pretty big. We don’t know everybody. So they introduced me to Jeff Dardia and our first phone conversation. If you’ve ever just resonated so hard with somebody on the first conversation that was it was like that movie stepbrothers, where you’re like you want to go to? Oh, my gosh, it was it was amazing how how quickly he and I resonated about what’s possible, and the fire in our bellies, but from totally different perspectives he, he had broken in every way that you can break and was hitting the wall, getting the wrong answers, answers that he wasn’t accepting with conventional military medicine, and knew there was something more, and he had pursued different avenues for care. For trying to understand, there’s got to be more than what they’re saying, it’s not all in my head. So he found his way to the Cleveland Clinic center for functional medicine, and got fixed, but through functional medicine, and he said, it was for him, it was one of these never again, episodes. You know how you’ll have some of those events in your life where you’re like, nobody should ever have to go through this again. And that was his motivation to initiate a care pathway that saved a spot at once a week for Green Berets, special operation community members, anyone that needed that level of care, was now able to get it. And he and I started educating together and started doing workshops and lectures and briefings to varieties of audiences about threats to health and performance in the military operational environment. And we, we did our first lecture with Meilin, when the other mentor that I meant to mention, and two other amazing practitioners, Kara Parker, she’s a functional medicine certified educator with the IFM as well. And we did a joint lecture for Military Family Physicians in 2018. That solidified, like our mission and purpose and really showed me that this education, like it starts with education. And in this needs to happen more. And we took that concept, those that content and took it on the road and did lectures and briefings for military spouses. We did it for special operators. We did it for command teams, and we’ve talked about it for Gen Gen pop and some of the military nonprofits as well. So we’ve been in the space of educating on threats to health and performance in the military, operational environment. But those that content that framework translates to anybody, everybody, everybody. So in terms of the things that we landed on as a way of teaching and communicating to others, how you can think about things differently. And you don’t have to wait and be a victim. And it’s not a question of if but it’s a question of when and how you’re going to get exposed. You’re going to get these burdens, and how can you identify check engine lights early, assess early and intervene early, starting with self care first. So we’ve got some fantastic content that we built out, iterated and improved. And we’re actually have, we actually have a military medicine article coming out, and a great academic military journal, about the lectures in the briefs that we do the force Health Protection briefs. So that content really resonates with any, any audience, because we can, we can massage the concept as needed to educate different, different audiences. But once again, the framework itself, it translates to the work that we get to do with anyone. So it’s been fantastic to develop, to help share that thought process to help build that community and to create that educational content that we can then help enlighten any, any audience.
Dr Lyon 34:10
That’s so valuable. And you know, we do have a team, we have a great team, and we have certain mission values, you want to actually have access to our stuff, the phone
Dr. Stepanenko 34:24
I do, I got the our team, Team document pulled up which we for any listeners, we use this to start off all of our team meetings. So whenever we touch base as a team, the team of unicorns that you’ve assembled, once again, we we remind ourselves and we start off by reminding ourselves of the mission, the vision and our core values. And I’ll read them off for the audience so everyone can understand a lot of time and thought process went into this. As as you had these new team members join, like we figured this out together. So our mission is that we’re Changing the arc of public health by shifting the perspective from pathology to optimal health through muscle centric medicine. And our vision is Gabrielle Lyon and Institute for muscle centric medicine serve as a leader and a beacon for patients and professionals of any age striving to optimize their wellness and performance in a personalized integrative and evidence based way by focusing on muscle as the pinnacle of health hell yeah.
Dr Lyon 35:24
Dr. Stepanenko 35:25
So our core values and these I resonated with fantastically when I saw them in your creative work slides, and I was like this needs to be front center. And this needs to be reminded like we need to start our meetings with this. So we do now. First value science matters. Take a scientific evidence based approach to health. Next one, be credible. Know your stuff and stay current. Next one honorable service, act with integrity and earn the trust of those in our care. Don’t settle. Be tenacious and give your all no matter the obstacle, show compassion, respect the dignity of others through kindness and empathy. question the status quo question for understanding at with an question for understanding with an open mind don’t blindly follow the herd
Dr Lyon 36:22
Heck yeah. love that
Dr. Stepanenko 36:24
those just really set the tone for me. And for our team, we set the tone at the beginning of each meeting. mission vision, those core values, fantastic way to jumpstart any meeting.
Dr Lyon 36:36
Yeah, we know exactly what we’re trying to do in the world. And thinking about muscle as the organ of longevity. And what does that mean? You know, you and I were talking on the way to the gym this morning about how muscle is the easy lever to pull? Yeah.
Dr. Stepanenko 36:53
Yeah. We talked about content function and context. And I, I always have like, fun or categorical ways of thinking about things. So when, when you and I have been having our conversations about muscle centric medicine and the evidence behind it, I tend to mentally categorize these things into content, content, function, and context. And in general, focusing on each of those three areas of skeletal muscle allows you to create the foundation and the signals for muscle muscle to be in its optimal state of health and integrity and function and the context. And that context is really the functional medicine component layer to that whole experience. Because if you’ve got inflammation, if you’ve got gut bugs, parasites dysbiosis, if you’re not digesting, and you’re mal absorbing, and you’ve got your micronutrients all over the board, then that context is suboptimal, and you’re never going to fully achieve the full muscle health potential.
Dr Lyon 37:02
Dr. Stepanenko 37:04
so muscle health potential is that other area that we’ve been really thinking on is, you know, we already do a fantastic job of quantifying muscle health potential and acknowledging we can do so much better in this, this, this and that area. And I, we get to focus on that with every patient. We said, What’s your true muscle health potential? Where are you hitting some roadblocks? What are the things that you already know that are that are blocking you? How can we make it simple and easy to address those, but then what are the things maybe you haven’t even thought about that are driving the bus that are creating complexity for you when you don’t need it? So really removing barriers that people didn’t even know were barriers? That’s the real exciting part of the job that we get to do.
Dr Lyon 38:44
Yeah. Do you want to touch on some of the barriers that I mean, again, it is about muscle as his pinnacle of health. And exactly what you’re saying is how do we Well, number one muscle is the easiest Oregon to influence. There’s no fat tissue, that’s pathology, but skeletal muscle, you know, when we think about the concept of muscle centric medicine, which you guys, we will be doing more episodes like this that will outline, you know, what are the medications that can potentially affect skeletal muscle health in a negative way? What are the medications that can protect and potentiate skeletal muscle health? You know, there’s there’s all ways in which when we focus on muscle as the pinnacle the levers that we can pull to drive health and wellness and this trajectory of aging and just being a stud your entire life, right? It’s, you know, or studet, whatever begins with this incredibly powerful organ system, which is skeletal muscle, and you were saying that we’re working on tools, we’ve just created a new assessment for how we can identify muscle health, we could talk about that. I would also love for you to mention some of the roadblocks and things that we treat on a daily basis.
Dr. Stepanenko 39:56
Right? muscle health assessment questionnaire, we’re trying to figure out and create something that didn’t exist, which would be a yardstick something that anyone can take to understand where they at with their muscle health potential. And to create a bit of a composite metric or a score to where you can take our questionnaire that we’ll make available in due time. Just need a little more refinement, and you’ll be able to understand where you’re at with your muscle health potential. And that will highlight you know, the the opportunities for improvement. So I’m super excited about that. And other educational material ebooks and whatnot, we’ll be talking about some of these hidden, hidden things, HIDDEN stressors that are preventing you from achieving your optimal muscle health potential. Yeah, and that’s medications, like you touched on hormonal axis derangements or dysfunction. And that can be thyroid, adrenal, that can be sex hormone. But there’s so many ways of optimizing that and so many ways that people are suboptimal, and even symptoms that you can easily identify that we say are check engine lights at home to where if you’re experiencing these check engine lights, you know, look for this in the ebooks that we come up with, but if you’re experiencing these these check engine lights, then you should get them evaluated, or you can maybe take the steps for self care first.
Dr Lyon 41:16
Dr. Stepanenko 41:17
So hormonal axis is one dysbiosis mal digestion malabsorption. So really focusing on the gut, another huge area
Dr Lyon 41:25
Dr. Stepanenko 41:26
Yep. And we we definitely do deep dive with every patient on that.
Dr Lyon 41:30
You have to. Yeah, I mean, special. Now again, our practice services elite military warfighters. But we also serve as anyone ready to get after it. I mean, if you vibe with what we are talking about, and the way in which we are, you can bet your bottom no pun. How’s my mom jokes? Mom jokes are coming in hot!
Dr. Stepanenko 41:49
That was a good one
Dr Lyon 41:51
that everybody had, you know, it’s interesting. Everybody has some gastrointestinal exposure. I really think it’s almost the elephant in the room. And here’s why. A couple reasons why. Let’s say you deployed you went to x y&z Right, so do you go to Afghanistan? Did you go to Africa, anywhere you went, you’re gonna pick something up. I truly believe that. Listen, 100% of our patients who have traveled to these countries come back with things that maybe they don’t initially realize that are that’s creating gut inflammation malabsorption, you know, when we do nutrient testing, but the other thing is that we eat foods from all over the world, we now live in a global world, we are not just eating local, locally sourced foods, you might get an avocado from Ecuador, right? My dad lives in Ecuador, you’re eating foods that are coming from all over. So yes, we do a very deep dive into gut health, which actually includes infectious disease right now do the standard,
Dr. Stepanenko 42:53
I’m amazed at the amount of resolution people will get from just looking and then addressing the infectious disease component, intestinal related. And that’s something I was not on my radar, at least to the degree of what I’m aware of now as being part of your practice, to how to test how to look and you’ve definitely established some best practices that I’m honored to have access to now on how to really get after true gut health, intestinal integrity function dysbiosis and the parasites and worms like we we get to learn things about people that nobody else like, knows
Dr Lyon 43:33
and they also don’t want anyone to share.
Dr. Stepanenko 43:35
Right right, 100%,
Dr Lyon 43:36
Do you want me to send you a picture? No, thank you not want to see a picture of that.
Dr. Stepanenko 43:41
Right. So the the the population that we end up serving, especially the fact that they’ve, they’ve hit the wall with conventional approaches to care, it ends up being some of the things that people don’t normally test don’t normally look for that we do on the regular, and that’s thinking about things like mold exposure, thinking about things like the potential for Lyme, thinking about things dysbiosis, or parasite, a worm related, and supporting simple things like supporting digestion, literally the correct use of things like prebiotics, probiotics, digestive enzymes, betaine, HCl and an ox bile support. So those things are not common tools in the toolbox for conventional training, and we get a chance to use that every day. For the patients that need it. Right. So yeah, the those hidden drivers that are taken away from your muscle health potential, we address them all the time. That’s part of that context. And that’s like the special third component of the the muscle health framework is the content, the function in the context and the context really allows us to get after that functional medicine component of this approach. And that’s the beauty that I found In our approach to care now is that we get to layer in the best of kind of both focuses. And I’ll tell you that fire in my belly is hot for the muscle centric focus, because it’s the Pareto law. It’s the 20-80 principle, it’s keeping it simple. And then we get to remove all these hidden barriers that are preventing you from focusing small and getting big results.
Dr Lyon 45:22
Yeah, I love that focusing smaller and getting big results. If someone is listening and thinking, Okay, well, how do I know if I’m reaching, you know, my potential or one’s potential. And I will say that no matter what, you can do better, no matter what, and you can’t settle. Life is so short. And you don’t want to wait until there’s an issue or a problem before you begin to address it, which I think that, you know, again, we service a lot of people that are very aggressive in nature and in their own life, and individuals with that mindset will continue to push at the expense of their health. till it becomes a cap, right, you can only show up in your life as, as high and as robust as your health Period, end of story. I was just recently at Operation black site, Dan Fleischman, and Beatrice Cooley, and it’s their ranch, this this ranch, and it’s a was a group of Tim Kennedy was there as a group of really Alpha dudes, alpha entrepreneurs, and they’re all fit, jacked tan probably all have good testosterone, you know, they’re, you know, they are just beasts of humans. But the one thing that individuals fail to understand, and I talked to them about this is that the drive to do more and be more comes at a cost. And at the peak, is when you’re most vulnerable, when you’re at the height of your success, when you are crushing it, because all of that dopamine and all of that drive, and all of that motivation is addictive. And once you’re at that peak, you better believe that you will fall below baseline, you will not hit your normal baseline, but you will mirror that peak will be as low as any entrepreneur as any get after a human will go. And at that peak, and that trough, those are the points of vulnerability when it comes to really diminishing one’s potential because the natural tendency will be to push harder. Now I got this, I’m gonna take more Adderall, maybe a little bit of Modafinil, or, I don’t know, some kind of stimulant, extra caffeine, whatever it is
Dr. Stepanenko 47:37
Dr Lyon 47:38
energy drinks, bang,
Dr. Stepanenko 47:40
oh, boy, yeah,
Dr Lyon 47:42
anything to bring an individual back up to that pinnacle, but that is not sustainable, that is not sustainable.
Dr. Stepanenko 47:50
Not at all. So we talked about that as allostatic load and specifically Allostatic overload. So Aloe stasis in general is a stressor that is either known, but can also be known, unknown and hidden. But the total Allostatic burden on somebody that’s running full throttle wide, open, aggressive in nature, is is extremely high. And like you’re saying, the overload component comes when you don’t get back to baseline. And you’ve been going so hard for so long, that it now has resulted in maladaptive behaviors. And you know, stimulant use, shorten yourself on sleep, shorten yourself on the relationships of the people that surround you. Even self medicating behaviors, like that’s where it can become extremely problematic. And that’s where actually we’re gonna get a lot of knowledge transfer from this military Special Operation community and the approaches that are now being shown to like work, and the work that we get to do with that community fixing some complex comorbid issues that that we’re seeing some of the veterans now who are transitioning in a picture and I’ll use the term operator syndrome.
Dr Lyon 49:09
I was just thinking about that,
Dr. Stepanenko 49:11
right. So operator syndrome, is not an ICD 10 diagnosis and in the research and academic setting, Allostatic overload is definitely a I’d say a more appropriate term. But the there was a descriptive paper that came out in 2020. Chris Free, fantastic friend, mentor, awesome, dude, amazing human being. And he along with five other clinicians, psychologists, therapists, were seeing a pattern of special operation veterans that had way more than just PTSD and depression. And there was a pattern that they were identifying of sleep disorders, mood disorders, social dysfunction, existential crises, and have experienced An extraordinary loss and extraordinary trauma. And it was this constellation picture of social dysfunction, physical issues, mental issues, and neuro endocrine and metabolic conditions. And they said, this needs a term, this needs a term because we’re seeing it so consistently that we need to be able to talk about it. And we need to have a shared understanding of what the hell it means. So operator syndrome, came out of that paper, that script of paper. And this was 2020. And we had a Jeff Doherty and myself, we’d already had been educating on threats to health and performance in the military operation environment for two years already by this time. So we didn’t know that term, we didn’t use that term, not once in, I’d say, six to 10 of lectures that we had done. But it was a beautiful opportunity for us to have a shared understanding about a potential end state. And, hey, that’s just a potential for an end state where the wheels have fallen off. right, you’ve had check engine lights, you were putting tape over them, or not getting them addressed, or you didn’t have confident that confidence that people could address them appropriately. Regardless, the wheels have fallen off. All right. So that’s the the sense of mission and purpose that I feel about the education educational component for what we what we talk about and what you educate on what what I educate on that operator syndrome, and how we can do better, and how we can do different? And it’s the conversation of the path there? And how do we reverse that path there? And how do we empower you with understanding of what those check engine lights look like? What the hell should I look for, because when you know better, you do better. And we’re talking about treating a population of solution oriented, action oriented individuals that are problem solvers. And they’ll not only solve their own problem, they’ll solve the problems of the people to the left and right of them. Heck, yeah. So you, you teach those people how to think differently about the path there. And those threats to health and military performance. You teach them to understand the check engine lights, understand your exposures, and get after solving the problem, quantify it documented, if you can, early assessment, early intervention, make some better decisions about the actions that you have to do because the job because of the location that you deploy to. There’s, there’s it starts with education. And it’s going to change the curve, it’s going to change the culture, I have a strong confidence that if we do right, we’ll be changing the conversation between Special Operations individuals. So one guy to another, rather than saying, Hey, man, don’t worry, I won’t tell anybody. It’s going to be Hey, man, your shirts messed up. You know, let me let me show you. Let me show you what right looks like. And that’s going to be the conversation, it’ll be different. When they know better, they do better. And their problem solving not only their own problems, but the problems to the people to left and right of them. And that’s gonna be family members, too, because we teach them the same content. And we teach them how to see the check engine lights, what to do about it at an early point. Don’t put the tape over it. Don’t let them say I’ll deal with that another time. Or like, I don’t want to get pulled off my team. You won’t get pulled off your team if you address these things early.
Dr Lyon 53:14
That’s true mastery, no matter what,
Dr. Stepanenko 53:15
Dr Lyon 53:16
that’s been a true sheepdog, whether you’re in special operations, or whether you’re the head of your family,
Dr. Stepanenko 53:22
and they have access to amazing services and resources. And in our practice, we make sure people have access to the best possible services, resources and care. So they just need to know what to look for how to act on it, when to act on it, and what to ask for. And that’s, that’s why it starts with education.
Dr Lyon 53:43
And when you talk to the military operators, that, you know, obviously, you talk to the military operators, and, you know, we deal with civilian sector as well. What do you feel are the top threats to those outside of the warfighting community
Dr. Stepanenko 54:01
outside of the warfighting community? Well, that beautiful thing about the framework and the way that we educate on it is that it applies to Lottie, Dottie everybody. So anyone who is as part of their training pathways job or otherwise lifestyle choices, they are put into extreme environments and their allostatic load is very high. They’re full throttle wide open because they have to be or because they choose to be. The framework applies. And it’s an acronym that we’ve got developed and stained is the word but I’ll just put it down as ti sta ined and we finally have the E we actually were missing the E for years. And Dave LeMay. Thank you. He helped me remember identify that okay, there is an E. So stress, sleep snips, trauma, toxins, tablets, allergies, which includes sensitivities. and intolerances, autoimmune infections, ingestions nutritional excesses and deficiencies, and then EMF and radiation. That’s the key. That’s what we were missing for a while. And then digestion and dysbiosis. So I remember being in functional medicine training one of the advanced practice modules, where they had a version of it, I think it was stand. And it just it, it was teaching us the content of root causes of dysfunction in such a way that resonated with my brain, because that’s how I think any in any ways is like fun ways of remembering things super easy, you know, frameworks. And when we did our first lecture in 2018, teaching the military family physicians, that’s that was a handout that we ended up creating, laying out that exact acronym. But that acronym applies literally to everybody, because it is root causes of dysfunction, antecedents, triggers, and mediators. So things that are either setting the conditions for dysfunction to happen, that are triggering the dysfunction to initiate, or that are mediating the process and continuing driving the bus in the background. So antecedent triggers and mediators, stained acronym. That’s something that we teach. Diving deep and geeking out, I really get on a soapbox, if you ever, you know, wanted me to. But that’s part of what we teach in the framework of how you can think about it. Because in each of those categories, for each of those exposures, each of those root causes of dysfunction, you can figure out check engine lights, you can figure out what a clinical picture might look like, you can figure out what relevant history might be notable. And in general, when you can see those check engine lights, then you can act on him. So that framework of care will benefit everybody, that knowledge transfer and lessons learned from this work is going to make an impact. I know it it is just a matter of time, we got to figure out how to get get the heck out there. Well,
Dr Lyon 57:03
we’re doing it, because that’s exactly how we take a look at our patients. And one of the other things is what also subtly, what you said, was that taking the subconscious taking perhaps the things that are pushed under the rug and making it more conscious. And by being able to identify those things that are perhaps in the periphery, for example, you know, when you’re seeing a patient in the practice, what are some of the questions and things that you’re looking for? Like, let’s take Stephan, the producer over here, Stephan, would you like to be a potential patient in the practice, or we can take an unnamed any unnamed patient, or just putting Stephan in the hot seat.
Dr. Stepanenko 57:46
So I’ll just look at you guys, as I’m talking to you here, but
Dr Lyon 57:48
how are you sleeping Stephan? No I’m just kidding. How much protein did you eat!?
Dr. Stepanenko 57:50
this would be the generic patient, right? I mean, in general, we want to know where you’re at right now. We want to know, generally how you’re feeling. But not just about symptomatology, or collection of you know, labeled conditions that you know, you have, I want to know, walk me through your day, like literally, when you get up? How do you feel? What’s your energy levels, and we rate them from like, one to 10 to really try and get an understanding of your energy flux throughout the day, because it’ll change. And what do you eat? And what are you drinking? Tell us about those meals really break it down for me, because we are creatures of habit to an amazing degree. And I want to know what your habits are, because we’re going to tweak them. Because we’re going to start exactly where.
Dr Lyon 58:33
We’re coming for you, Stephan. you should be nervous right, you should be sweating bullets, your armpits.
Dr. Stepanenko 58:39
And we’re going to find ways of turning on your metabolism, when it needs to be turned on turning on your muscle protein synthesis when it needs to be turned on to protect the health of what you have already put to help you recover and optimize really adapt to the stressors that we want you putting on yourself regularly. We want to make sure you have enough mental and physical energy to get the heck in the gym, and to push them weights and push yourself hard, mentally, physically and show up for your team show up for your family. So we support you from like, metabolic energy hormonal standpoint, we remove those barriers that are preventing you from getting quality sleep and having optimal metabolism and having optimal Hormonal Health. Any nutrient depletions, or insufficiencies? We’re going to find those. And we love diving through some of the advanced labs that the that you bring to the table that you might have had at some of the other practices where, you know, you thought you were getting the best care possible and you’ve still been hitting the wall. So we very often we see people that have seen a variety of specialists, even other practitioners, even other functional medicine practitioners
Dr Lyon 59:47
Fourteen other doctors with so we did a poll. Yeah, you know, we’d like to collect it in a practice the average was 14 other physicians.
Dr. Stepanenko 59:54
It so fun to go through some of those labs and just show them our perspective. I read things a little differently. And it tells a very different story. And that is that is a beautiful and fun part about functional medicine is that we can even look at conventional labs and say, Okay, you see the trend here? You see, you see how, you know, this is related to that, and nobody ever connected those dots, but we do beautiful opportunity that we have, having a different perspective and looking even at the same data.
Dr Lyon 1:00:27
Yeah. And also being, you know, there’s a lot of confusion about what is functional medicine, who is qualified to do it, who is qualified to look at labs. And one thing that’s really important to us is that we are board certified medical that we are physicians, and that is critical. We are trained in patient care treatment, looking at bloodwork, I mean, we’ve been doing this for years, went to medical school passed our boards. You know, I did a fellowship. And, you know, you and I are both board certified physicians, I think that that’s a critical part. Because right now, there’s a dichotomy, you have this more holistic care, which is critical and so important. And then you have conventional care, which is really the, the gap functional medicine is trying to fill, and really doing a pretty good job at filling the gap between what is a bit more esoteric, and also what is conventional, but the magic really comes from a blending of the two. And, you know, just right off the top of my head. You know, I can think of two patients that we saw last week one in particular, and obviously, we won’t say their names unless they want us to which you can chat out my Instagram and, or our website where we have some patients that talk about their experience. But you know, one guy in particular was really interesting. This is a very successful human who is a chiropractor has many chiropractic facilities, and had gone through, you know, more functional medicine approach. And the guys did he he has vertigo, and being able to say, Hey, listen, okay, we’re gonna figure out what’s going on. But in the meantime, we’re gonna give you Antivert, we’re going to be able to prescribe a medication to you, while we are figuring out this thing that has, you know, really been ruining your life because you feel so terrible, right. And I also suspect, severe sleep apnea and a bunch of other things that are, you know, a medical provider should be looking over that that’s critical, right. And, and, again, we talked about, you know, we have multiple members on our team, and good medical care does involve nutrition does involve, you know, more integrative, you know, care a coach when, when needed, obviously, we can never get the results without having a great trainer, right? I always recommend people to, you know, a handful of trainers that, you know, I just recently collaborated with Don Saladino, amazing, one of my best friends, he’ll be on the podcast soon. We’ve got a ton of great resources, but we do need a team. You know, just going back to an example of a patient that we saw him recently, I think he was he was a firefighter. And then he was a police officer.
Dr. Stepanenko 1:03:10
He was Army four years, law enforcement for 23.
Dr Lyon 1:03:15
Amazing guy, amazing guy,
Dr. Stepanenko 1:03:16
fantastic human being,
Dr Lyon 1:03:17
and he is a leader in his community. And he came to us and he was really emotional.
Dr. Stepanenko 1:03:23
He was he was at the end of his rope at the end of his run here, he’ll tell you himself, he said, I, when I when I said our patients will often come to us and be ready to tear the wall down for solutions and ready to do anything that that that we put in front of them, because this is either last stop last ditch effort. I think he even used that those words. He’s like, this is this is like last ditch effort. You know, this is this is my Hail Mary. But people, people who I trust and and people who I believe in tell me, you do things differently. And, you know, she doesn’t mess around, she’ll, she’ll fix, you know, she’ll fix your stuff. And he he had full confidence was very happy. And just grateful to be there in front of us. And he said, whatever it takes. So he said, There’s no way we’re gonna we’re gonna fail you. Yeah, there’s no way we’re gonna fail you.
Dr Lyon 1:04:19
That’s right. We’re a team and and his case was so interesting. And the reason I bring him up is that this is a guy who never struggled with weight until he moved into a house in 2004. And then all of a sudden, he struggled with weight. His wife struggled with weight. Their dog struggled with weight
Dr. Stepanenko 1:04:39
and their kids
Dr Lyon 1:04:40
and their kids struggled with weight. Now,
Dr. Stepanenko 1:04:44
how did you make that connection?
Dr Lyon 1:04:45
You guys are thinking out, well, he probably needs to exercise and eat better and do all those things and you know, get his hormones checked. Okay, yeah, we’re working on all those things. But there’s some chemical exposure that is affecting this individual. This is what we believe that something actually got into the water, the water system, and we’re going to be testing him for all those things and actually testing the water and and his home. Because it was so unusual again, this is how do we take evidence base attributes evidence based medicine? So yes, we’re going to address his metabolic dysfunction. But we cannot discount the fact that he’s been everywhere else. And why is it that despite working with multiple nutritionists, being on semaglutide, you know, what go V being on him and still being weight loss resistant? However, being on a more Titan diet and his children and his dog? I mean, the dog is not
Dr. Stepanenko 1:05:36
And the neighbors
Dr Lyon 1:05:41
Dr. Stepanenko 1:05:42
we had him explore that thought process. And he’s like, yep, to the left of me, you know, same thing, weight issues, to the right of me. Other health conditions plus weight issues, like, yeah, there’s a common factor here. And
Dr Lyon 1:05:55
there you go. So it’s not a I think it is about really thinking outside the box,
Dr. Stepanenko 1:06:01
because it’s easy to say, hey, family members, shit, yes, they share genes. Yes, they share, you know, meals. So their dietary patterns may be similar, but they also share exposures. And when you have a common factor like that, that elevated out of just the conversation and the deep dive that we got to do, because we have the time to dive that deep. And because we ask those questions, really elevated an opportunity. So yeah, we were looking at mycotoxins, toxin exposures, and we said, hey, you know, let’s let’s assess, and we could backwards plan from whatever comes back positive. Yeah. And he, he was just so enlightened and excited about the fact that we were talking about things nobody else had brought up. And that we’re going to look in places nobody else had looked. And this is a completely new thought process after 10 to 15 years of hitting his head against the wall and not getting results from some extreme measures that he had been taking. And like you said, not really even losing a pound despite being on some of the best weight loss support medications that he was finding any way possible to get on. And to continue using. Yeah, so we were like, wow,
Dr Lyon 1:07:09
you know, we’re gonna, we are gonna get to the bottom of it for him and I, and I bring him up, because I think that there’s a very interesting asset to the military community. So the reason I think you and I think along those lines, is because of the extreme environments that war fighters have been in, right, I’ve seen it with my husband, we take care of elite war fighters, and we see their exposures. And I actually, a commander, and his family and his dog went through nearly the same thing. And what they were doing is they were spraying in the coldest act that this individual lived in, and ultimately, it was getting everybody around them sick. So there are ways in which, you know, we have to think outside the box to get to, you know, we don’t discount the issues in front of us, whether it’s insulin resistance, or sleep apnea or hormonal problems there is if you get the, if you’re asking the right question, then you will get the right answer. If you are asking and, and, and the right result, if you are operating under the wrong framework, which again, which I believe obesity operates really under this wrong framework. And that’s just an example. But if we are operating under an incorrect paradigm of thinking like this is okay, so we believe he’s overweight because of XY and Z. And then we do those things and nothing works. And then we keep doing those things. Because Oh, it’s his fault. Come on. we’re missing something.
Dr. Stepanenko 1:08:43
That’s like telling a special operation individual whose threshold for raising their hand is already extremely high. That’s like telling them that it’s all in their head. If they’re at the point where they’re actually seeking help. And your answer is, Well, you look good. And it doesn’t seem to be anything that I know of. Can’t do anything for you. It must be all in your head. That is like a death sentence. Right? That is that is an answer that will drive someone to feeling hopeless, helpless and powerless, that changes situation. And for the lifetime of problem solving. For a person who is used to being in control that is not being in control. Yeah. And that’s that’s where I feel that is unacceptable. And I know you feel the same and that’s why I’m grateful that we have the opportunity to have a different framework, approach things differently have different conversations, and the the trickle down effect of the impact that we we have of not only fixing the person in front of us, but empowering them since now they know better, and now they no different. They then share that understanding with their entire community with their family. And honestly like we’re We’re making an impact and protecting the future fighting force. Because the the individuals that enlist for the military tend to come from military families. And if you’re talking about special operation community, the kids see what Dad and Mom experience. Yeah. And if they are able to serve a full career and have good health well being. And if they understand that when mom or dad we know wasn’t quite right, not doing well, if they get better, it’s a very different trajectory for the entire family unit. Compared to if nothing worked, nothing got them better, and they got medically separated or worse. So literally, the what we do has such third and fourth order and fifth order impact, that I think I’m exactly in the right place doing exactly the right thing. And do not question my decision at all to like jump from active duty military to where I’m at right now, because of what we get to do and the impact that we’re making. I think trans generationally. So I mean, it’s a really bigger mission than either of us, and super stoked that I get to do it with you.
Dr Lyon 1:11:08
Are you kidding? Talk to somebody go, you are showing us what right looks like?
Dr. Stepanenko 1:11:14
That’s the goal, that’s the goal
Dr Lyon 1:11:15
Yes, you are showing us
Dr. Stepanenko 1:11:17
And you’re showing me you know, what right can look like I think we’ve all got a piece of the puzzle. And just the the goal should be to concentrate talent, concentrate talent, figure out what the hell right can look like figure out varieties and versions of it. What are the core components of the turkey sandwich? I got some friends out there. And some some people that have been mentoring recently, in my last professional world before transitioning to where I use this analogy of the turkey sandwich, but it’s so important to understand is that every place is going to have a different version of the turkey sandwich. But if you figure out what bread meat cheese is, core components, then you figure out what salad what garden, what sauces and seasonings like you want on it, you figure out your turkey sandwich. But you figure out the core components, you figure out what works, you figure out a model that can easily be translated or adopted or adapted for other areas. And that’s, that’s what we’re working on. And what we’re trying to show others is the bread meat cheese.
Dr Lyon 1:12:16
I love it. Yeah, the bread, meat and cheese. Although, you know, who knows, we might turn that into a wrap or I have to throw in some really bad humor, if you were to give an individual how, you know, handful of things that they could do to live their best life, what would it be?
Dr. Stepanenko 1:12:37
Before Okay, so, in general, the nutrition components so critical, and I think that the simple approach, especially with muscle centric nutrition, is such a fantastic foundation and starting point. So eating enough of the high quality protein to initiate muscle protein synthesis regularly throughout the day. So we talked about you know, your weight in pounds, match that in grams protein, or at least ideal body weight. And at minimum, first and last meal of the day and hit your threshold of at least 30 grams to per, and I call it a dose. Because meals aren’t always right least yeah are in all the meals aren’t always meals. In the most traditional sense. Literally, it might be a combination of a protein shake and a bar just because I’m getting after it. And I want to make sure I’m hitting my dose and an initiating muscle protein synthesis at that time window. So doing that protein dose, every three to five hours, like we talked about, and making sure that you are supporting skeletal muscle health because that once again is a very narrow and simple focus that health and wellness is a byproduct. So protect your muscle condition, initiate muscle protein synthesis, and enough hydration and fiber are the other two areas where I would say are extremely important. It’s easy to walk around dehydrated. A lot of individuals do it and plenty of people including myself. busy career day in day out will have a water bottle sitting on their desk and haven’t touched it by the end of the day. And I say you shouldn’t walk around with chapped lips dry mouth, or urinating infrequently, like you make it more than halfway through the day and realize you haven’t been to the bathroom once. So hydration is extremely important. Your metabolism can be bumped up by 20 to 30% just by being hydrated well enough. So in general, your weight in pounds divided by two. That’s a good starting point. So for hydration that’s another goal then fiber. If you follow the recommendations for some of the nutritional academies, they’ll say, for females it starts around 25 grams per day. For males, it’s 3040. So I generally say hey, just 25 to 40 grams per day of fiber, figure out how to get that in. Focus on veggies or high fiber foods. high fiber fruits, things like dark berries, or pears or apples. So higher fiber fruits if you’re going to do fruits and veggies eat the roughage, especially sulfur containing vegetables. Brassica and allium family in general are great prebiotics. They also support your detoxification biotransformation pathways. So your ability to detox and build your forcefield and support good healthy microbiome, so Brassica and Allium that’s broccoli, cauliflower, asparagus, brussel sprouts, artichoke, and then your, your alliums. That’s the onions, garlic, chives, leeks, that whole family. So really focusing on plenty of those, build your microbiome, create forcefield you know, detox appropriately, and
Dr Lyon 1:15:52
then throw in some urolithin A we’ve been using a lot of.
Dr. Stepanenko 1:15:54
Right, right. So yeah, I’m amazed at things that can initiate mytophogy, and we know three main signals. One being exercise, and that’s something we talked about strength, strength, training, resistance, exercise training, you got to get in the gym, you got to give the muscles the signal to grow. And then
Dr Lyon 1:16:13
Hear that Stephan? Get down and give me 20
Dr. Stepanenko 1:16:17
You got it. And then the other thing, the other tool in the toolbox is fasting practices. Anytime you go longer than 12 hours without caloric intake, while staying hydrated, does give the body a signal to purge dysfunctional cells and purge dysfunctional mitochondria. And that’s what we’re talking about with mytophogy and autophagy. Now, the other signal that that is now a tool in our toolbox, is that Urolithin A I was geeking out with Shane, your husband this morning, because he’s like, tell me more about this. And I was like, Well, it’s a post biotic. And he’s like, looking at me. And I’m like, Alright, so basically, the Alec act ends from from the common
Dr Lyon 1:17:00
30 40% of 40% of people can’t make it.
Dr. Stepanenko 1:17:05
There you go. one of three individuals have the right probiotics the right bacteria in their gut, to actually make Urolithin A, but the amount that is concentrated in this supplement that is able to achieve the metabolic benefit and the mitochondrial benefit, the mitophagy benefit, you would have to consume a ridiculous amount of pomegranate juice,
Dr Lyon 1:17:26
six cups or something crazy.
Dr. Stepanenko 1:17:28
Yep. And it’s actually part of the white pulp that that doesn’t always make it into pomegranate juice. Yeah, so that’s another tool and toolbox. So initiate mytophagy, every here and there is a big important one, so that you you minimize your chance of having dysfunctional cells that are either impairing your immune system impairing your metabolic and Hormonal Health. And that may also be setting you up for cancer. So initiate mytophagy, we talked about those three main signals, stay hydrated, hit your fiber and your protein goals and initiate that muscle protein synthesis regularly. And you do that through exercise. You do that through diet.
Dr Lyon 1:18:06
That’s right. Well done, sir. Well done.
Dr. Stepanenko 1:18:09
Felt good about that.
Dr Lyon 1:18:12
There will be a quiz afterwards. I think that those are all really good strategies. And you know, I want to mention something. You know, in the practice, we do use supplementation, and we do use medication, we use a combination, and we do our very best to only support things that are evidence based. What do I mean by evidence base, there’s a lot of talk on the internet, that evidence base is clinical experience plus practice plus science. When we when we’re talking about evidence based supplements, medications, there has to be rigorous science behind it before we recommend it. And I think that that’s important to mention, because there’s a lot of things coming out. And I think there’s a lot of promises. But for example, creatine has a lot of evidence behind it. Fish oil has a lot of evidence behind it. Vitamin D has a lot of evidence behind it. Urolithin a you know, I’ve recently really been into this company called timeline, because I love them. And I believe in the research they have over a decade of research. And I am not trying to go off on a tangent. But you had
Dr. Stepanenko 1:19:15
But you had him on the show recently.
Dr Lyon 1:19:17
Yeah, yeah. he’s actually a PhD. I think it’s really important that when you as a listener are at home evaluating where you are going to spend your money and your time and what levers you’re going to pull or push that it should be evidence based. There should be a rigorous scientific evidence behind what an individual is using. So
Dr. Stepanenko 1:19:46
I have incorporated portions of my lecture about how to how to speak about what the heck functional medicine is in the military space, where we’re somewhat open to integrative modalities, but nobody knows this. term, it’s a new term, it’s weird. And everyone understands evidence based practice is where we need to be. So it’s extremely important to understand that. And this is slightly different than just the term evidence evidence based and in the nutritional component, got it. But from an evidence based practice standpoint, it’s best available evidence that applies to the con to the situation in front of you. So best available evidence intersected with patient preference and priority, they get to choose informed consent, and clinician skill, wisdom and experience. It’s the intersection of the three. So the clinician is when they’re experienced, they have lessons learned, they know patterns, and that’s the art component is married with the science of best available evidence, and married with informed consent. And the patient driving the bus as to what they choose to do based off of the best awareness and true understanding of why things are important how it might make things better, and what they are comfortable doing. So that’s that’s where that evidence based practice comes into play. It’s the marriage of the art, the science and the informed consent. And I make sure to drive that point home because lifestyle strategies are a checkbox, and then move on to medications and other surgeries and whatnot.
Dr Lyon 1:21:23
Dr. Stepanenko 1:21:24
We live in that checkbox. And we we expand the heck out of that checkbox. And you have the opportunity to use so many other tools in the toolbox that have evidence behind it. But a lot of people just don’t know about it. And that’s where that art and the science and the art and the clinician wisdom and experience that you bring to the table that I bring to the table that that any other you know, well informed are well educated, integrative practitioner or functional as a practitioner gets to bring to the table. It’s it’s a different component of the evidence based practice.
Dr Lyon 1:21:56
Yeah, that’s really beautifully, beautifully said. Thank you. Dr. Stepanenko. Is there anything else that you wanted to add? I again, you will be on frequently as you are the lead physician. I really want people to get to know you. You are an outstanding human. Just I’m so impressed.
Dr. Stepanenko 1:22:15
Dr Lyon 1:22:16
he’s not really blushing guys. I’m not sure what he’s talking. I’m not actually blushing, though, although I’m sure we can we can get you there. Yeah. You know, it’s everyone who comes on this podcast and everybody and anyone who interfaces with our patients, they have to be the best of the best. And I believe you are the best of the best people have.
Dr. Stepanenko 1:22:45
I strive and I chase individuals like yourself, who are the beacons that have set out there what’s possible, I chase those individuals that that show us a version of what right looks like that have the puzzle piece that I that I need or need to include, or need to consider. I’m chasing greatness, and that’s what I get to do. And I get to do that every day working with you.
Dr Lyon 1:23:08
While you are a relentless human being and it took you know, I that is waiting for you. It was the reason I never hired another physician, we get requests quite frequently. And you know, you have to be able to trust your gut on certain things. And I know what’s right and you are a shooting star, the impact that I know that you are making and will make will be second to none. So, thank you so much.
Dr. Stepanenko 1:23:40
I’m gonna give you a hug right after this is great.
Dr Lyon 1:23:42
I’m out. Thank you so much for joining me and you are amazing.
Dr. Stepanenko 1:23:47
thanks for having me. Happy to be here and excited about what we get to do together.
Dr Lyon 1:23:49
So if you have been listening and you love Dr steppin Ango as much as we all do, you can contact the practice he also does frequent lectures and education. He’s a wealth of information. And I will link all the ways to find you. And there you go. The Dr. Gabrielle Lyon podcast and YouTube are for general information purposes only, and do not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no patient doctor relationship is formed. The use of information on this podcast YouTube or materials linked from a podcast or YouTube is at the user’s own risk. The content of this podcast is not intended to substitute for professional medical advice, diagnosis or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition. They may have and should seek the assistance of their health care professional for any such conditions this is purely for entertainment and educational purposes only