Extend Podcast with Darshan Shah, MD

Most people think weight loss is about discipline, calories, or finding the right medication. But what if the real issue is that we've misunderstood how hormones, digestion, and recovery actually regulate metabolism in the first place? In this episode of Extend, we sit down with registered dietitian Ashley Koff to unpack what GLP-1 medications are really doing in the body and why bariatric surgery revealed metabolic changes long before significant weight loss ever occurred. We explore incretin hormones, vagus nerve signaling, and why appetite, blood sugar, and inflammation are part of a much larger hormonal ecosystem. We also dive into the often-missed pieces of the GLP-1 conversation, including digestion, detoxification during fat loss, protein quality, and why offboarding plans matter as much as starting doses if you want long-term success without burnout or regain. Ashley Koff is a registered dietitian nutritionist and founder of The Better Nutrition Program. She has over two decades of experience supporting patients in bariatric care, metabolic health, and digestive optimization. She is the author of Your Best Shot, a practical guide to understanding weight health through a systems-based approach. What We Discuss:   (00:00) Why Weight Loss Fails When Hormones Are Ignored (05:42) What Bariatric Surgery Revealed About Metabolism (11:18) Incretin Hormones and Why GLP-1 Is Only One Piece (18:06) The Cost of Keeping Metabolic Signals Turned On (26:14) Fatigue on GLP-1s Is Not Just About Calories (34:22) What Happens When Fat Loss Releases Toxins (44:10) Why Coming Off GLP-1s Too Fast Leads to Regain (55:03) The Biggest Nutrition Mistakes During GLP-1 Therapy   Thank You to Our Sponsors: Timeline: Go to timeline.com/drshah to get 20% off your order.   Learn more about Dr. Shah: Website: https://www.drshah.com/ Clinic: https://www.next-health.com/ Instagram:@darshanshahmd   Learn more about Ashley Koff: Instagram: @ashleykoffapproved Website: www.thebetternutritionprogram.com Book: Your Best Shot  

How much control do you actually have over the toxins in your daily environment? Most people assume chemical exposure is unavoidable, but the science shows there are practical steps that can significantly reduce your toxic load. In this solo episode, we break down why environmental detoxification is a key strategy for protecting your long-term health and longevity. We walk you through the main sources of exposure, from household cleaners and cookware to synthetic fragrances and clothing materials. We explore how these toxins affect your hormones, immune system, and metabolism, and why resilience, genetics, and consistent habits determine how your body responds over time. We also share simple, actionable swaps and strategies that can be implemented gradually without overwhelming your daily life. This episode gives clear, actionable guidance for anyone who wants to reduce chemical exposure, support metabolic and hormonal health, and create a healthier living environment. Even small, consistent changes over weeks and months can have a major impact on overall wellbeing. What We Discuss: (00:00) Introduction: Why Environmental Toxins Matter for Health (01:50) How Chemicals Affect Hormones, Immunity, and Resilience (05:18) Common Household Sources: Pesticides, Cleaners, Fragrances, and Laundry Products (09:08) Kitchen and Food Storage: Plastics, Cookware, and Safe Alternatives (11:07) Home Environment: Shoes, Air Quality, Mattresses, and Furniture (14:28) Personal Care, Clothing, and Nighttime Exposure (16:27) Gradual Detox Strategies and Free Resources (18:20) Key Takeaways and Closing Thoughts   Thank You to Our Sponsors: IM8: Try IM8 today with a 30-day money back guarantee. You can get 10% off your first order with code DRSHAH at https://im8health.com/discount/DRSHAH.   Learn more about Dr. Shah: Website: https://www.drshah.com/ Clinic: https://www.next-health.com/ Instagram:@darshanshahmd  

Toxin exposure rarely announces itself loudly, yet it quietly shapes hormone balance, immune resilience, mood, and neurological health long before a diagnosis appears. The real tension lies in the fact that these exposures are largely invisible, normalized, and happening inside the very spaces meant to keep us safe. We dive deeper into this in the Extend podcast with Allison Evans. We also chat about the "toxic bucket" concept, why synthetic fragrance and harsh disinfectants can act as endocrine disruptors and neurotoxins, how asthma, fertility challenges, and chronic symptoms can be triggered by everyday products, and where to start removing toxic load without fear or overwhelm. Allison Evans is the co-founder of Branch Basics, a household and personal care brand focused on reducing everyday chemical exposure. She is an entrepreneur and health educator with a background in environmental and dietary health. Branch Basics products are sold online and at Target nationwide. Branch Basics: Use code DRSHAH20 at branchbasics.com to get 20% off from a selected list of products, including Ultimate Starter Kit, Premium Starter Kit, Cleaning Essentials Kit, Laundry Kit, Gel Hand Soap, Laundry Detergent. The offer is valid for first time buyers only through January 13, 2025. What We Discuss: (03:55) Why Toxin Exposure Is the Invisible Fourth Pillar of Health (05:10) How Everyday Symptoms Act as Early Warning Signals (17:45) The Toxic Bucket and Why Some Bodies Spill Over Faster (23:40) How Synthetic Fragrance Disrupts Hormones, Metabolism, and the Brain (29:50) Why Asthma and Anxiety Can Be Triggered by Household Chemicals (31:30) How Cleaning Products Can Make Indoor Air More Toxic Than Outdoors (38:45) Why Removing Toxins at Home Beats Expensive Biohacking (50:35) Why Laundry Detergent Is a Constant Source of Chemical Exposure (52:45) How Plastic Food Storage Disrupts Hormones and Metabolism (54:05) Why Fear Around Toxins Can Be More Harmful Than the Exposure   Thank You for Our Sponsors: IM8: Try IM8 today with a 30-day money back guarantee. You can get 10% off your first order with code DRSHAH at https://im8health.com/discount/DRSHAH. Vitaboom: For supplements you can trust and wellness solutions tailored to your health, visit https://vitaboom.com/   Learn more about Dr. Shah: Website: https://www.drshah.com/ Clinic: https://www.next-health.com/ Instagram:@darshanshahmd   Learn more about Allison Evans: Instagram: @branchbasics Website: www.branchbasics.com  

Most people think they're doing "enough" for their health, yet nearly 90% of Americans are metabolically unhealthy and don't know it. In this episode, I challenge outdated metrics like BMI, explain why sleep quality matters more than hours slept, and break down what actually moves the needle when it comes to long-term health. In this solo episode of EXTEND, I outline my five core health frameworks for 2026. I also walk through what it means to become the CEO of your own health, how to use simple biomarkers instead of guesswork, how to run personal N-of-1 experiments, and why muscle, sleep, and toxic exposure play a far bigger role in health than most people realize. What's Discussed: (00:00) How to Take Control of Your Health in 2026 (01:41) Becoming the CEO of Your Own Health Using Your Data (02:50) Why 90% of Americans Are Metabolically Unhealthy (07:41) Why Weight and BMI Are Misleading Health Metrics (11:40) The Key Biomarkers That Actually Matter (13:01) Why Sleep Quality Matters More Than Sleep Duration (16:09) How N-of-1 Experiments Remove Health Guesswork (18:09) The Hidden Health Impact of Everyday Toxic Exposure Sleep Optimization Workbook: https://www.drshah.com/sleep   Thank You for Our Sponsors: Timeline: Go to timeline.com/drshah to get 20% off your order.   Learn more about Dr. Shah: Website: https://www.drshah.com/ Clinic: https://www.next-health.com/ Instagram:@darshanshahmd  

Mental health is shaped by how well the brain produces energy, how well the nervous system remains under stress, and how effectively the mind adapts over time. When these systems begin to break down, problems often appear years before a diagnosis, showing up as anxiety, brain fog, distraction, burnout, or emotional dysregulation that are frequently treated in isolation.  This is a special Best Of episode of Extend, where I've compiled the most important insights from conversations with leaders examining mental health through neuroscience, metabolism, nervous system regulation, and mental training, including Jay Shetty, Dr. Chris Palmer, Jim Kwik, Maya Raichoora, and Gabby Bernstein.  These selected clips highlight why mental health cannot be reduced to brain chemistry alone, how metabolic dysfunction and chronic stress quietly impair brain energy, and why nervous system safety is foundational to healing. You'll hear how focus and mental fatigue are often physiological, how visualization and mindset influence neural pathways, and why regulation, meaning, and consistency matter more than quick fixes. By pulling together these key moments, this episode reflects the patterns I see repeatedly in practice and across these expert discussions, offering a clearer framework for supporting mental health early, when intervention is most effective and long-term resilience can be built.  What We Discuss: Jay Shetty, bestselling author and former monk, explores why mental health begins with inner alignment, how chronic stress is amplified by disconnection from values, and why vulnerability is a skill that deepens emotional resilience rather than a weakness. Dr. Chris Palmer, Harvard-trained psychiatrist and author of Brain Energy, explains why mental illness cannot be separated from metabolic health, how impaired brain energy drives symptoms like anxiety and depression, and why addressing mitochondrial and metabolic dysfunction changes outcomes. Jim Kwik, brain coach and author of Limitless, breaks down why brain fog, distraction, and mental fatigue are not character flaws, how modern habits drain cognitive energy, and what actually restores focus, memory, and mental clarity. Maya Raichoora, mental fitness expert and author of Visualize, explores how visualization rewires neural pathways, why the brain responds to imagined experiences as real, and how mental training can influence both cognitive performance and physical health. Gabby Bernstein, #1 New York Times bestselling author and podcast host, explains why nervous system safety is foundational to mental health, how emotional regulation directly affects inflammation and recovery, and why feeling safe in the body is essential for long-term resilience.   Thank You for Our Sponsors: NextHealth: NextHealth: Your destination for cutting-edge health optimization—from IV therapy to hormone balancing. Explore at https://www.next-health.com/   Learn more about Dr. Shah: Website: https://www.drshah.com/ Clinic: https://www.next-health.com/ Instagram: https://www.instagram.com/darshanshahmd/   Learn more about Jay Shetty: Website: https://www.jayshetty.me/  Instagram:https://www.instagram.com/jayshetty   Learn more about Dr. Chris Palmer: Website:  https://www.chrispalmermd.com/ Instagram: https://www.instagram.com/chrispalmermd    Learn more about Jim Kwik: Instagram: @jimkwik​ Facebook: @jimkwikofficial​Log in or sign up to view Twitter: @jimkwik​ YouTube: Jim Kwik Learn more about Maya Raichoora: LinkedIn: https://www.linkedin.com/in/maya-raichoora/  Website: https://mayaraichoora.com/  Learn more about Gabby Bernstein: Instagram: @gabbybernstein Website: https://gabbybernstein.com/ Book: 7 Habits of a Super Attractor: Effortlessly Attract Your Desires