Health Optimization Medicine Podcast

In this episode of the Health Optimization Medicine Podcast, Dr. Scott Sherr sits down with Dr. Dominic D'Agostino, the premier researcher in ketogenic metabolic therapies. Moving past the mainstream fads of keto ice cream and internet trends, they break down how exogenous ketones actually impact cellular energy, cardiovascular health, and environmental stress.
From the liver toxicity associated with certain high-dose ketone esters to the hidden vasodilatory superpowers of L-BHB, this discussion separates the biohacking hype from the physiological reality of ketone supplementation.
Join us as we delve into:
Fad vs. Science: Why serious researchers use the term Ketone Metabolic Therapy instead of Ketogenic Diet, and why peer-reviewed science is growing exponentially despite Google trends.

The Metformin VO2 Max Penalty: Exploring recent data showing metformin can blunt VO2 max adaptations to exercise by 50% and acts as a weak mitochondrial toxin.

Mitochondrial Hydraulic Efficiency: How ketones physically tighten electron flow in the mitochondria, reducing superoxide (ROS) production and enhancing endogenous antioxidant capacity.

The Danger of 1,3-Butanediol: Why relying on high doses of certain ketone esters and diols can trigger dizziness, liver abnormalities, and dependence, and how to formulate them safely.

The L-BHB Advantage: Why the lesser-known L-enantiomer of BHB acts as a potent vasodilator, significantly increasing cardiac output and brain blood flow through adenosine signaling.

Performance vs. Recovery: Why exogenous ketones might underwhelm a healthy athlete looking for a power boost, but shine in extreme stress environments like hypoxia, hyperoxia, and recovery.

This episode is for you if:
You want to know the difference between a nutritional ketogenic diet and simply taking exogenous ketone supplements.

You are concerned about the side effects, liver stress, and acidic load of pushing your blood ketone levels too high.

You are interested in the synergistic effects of Hyperbaric Oxygen Therapy (HBOT) combined with ketone therapies for traumatic brain injury and mitigating oxygen toxicity.

You can also find this episode on…
YouTube: https://youtu.be/sU-ZNinqqgg
Find more from Dr. Dominic D'Agostino:
Website: https://ketonutrition.org/
Metabolic Health Initiative: https://www.metabolicinitiative.com/
Instagram: https://www.instagram.com/dominic.dagostino.kt/
LinkedIn: https://www.linkedin.com/in/dominic-d-agostino-156014b/
Find more from Health Optimization Medicine and Practice (HOMeHOPe):
Website: https://homehope.org/
Instagram: https://www.instagram.com/homehopeorg/
HOMeHOPe Conference 2026: https://homehope.org/homehope-conference-2026
Use PODCAST10 to get 10% OFF your purchase of the Clinical Metabolomics Module at https://homehope.org/products/clinical-metabolomics
Find more from Troscriptions:
Website: https://troscriptions.com/
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Use POD10 to get 10% OFF your Troscriptions purchase at https://troscriptions.com/collections/our-products

In this episode of the Health Optimization Medicine Podcast, Dr. Ted Achacoso, Dr. Scott Sherr, Dr. Allen Bookatz, Jodi Duval, and Dr. Jup Kuipers take a deep dive into the shocking new 21-year pre-diabetes follow-up study (DPPOS) published in the Journal of the American Medical Association on June 15, 2026. Moving past the mainstream longevity hype surrounding Metformin as an anti-aging cure-all, the faculty breaks down why chemically poisoning your enzymes is a profound mismatch for healthy, active individuals.
From the bioenergetics of exercise to the clinical application of precision metabolomics, this roundtable shifts the conversation from off-label drug prescriptions to cultivating true cellular safety and mitochondrial hormesis.
Join us as we delve into:
The Metformin Illusion: The long-term results of the DPPOS study proving Metformin completely failed to outperform a placebo for reducing multimorbidity risk, while intensive lifestyle intervention reduced multiple chronic disease risks by over 20%.

Mitochondrial Blockade: How Metformin's inhibition of Complex I of the electron transport chain chemically throttles your cells, cutting cardiovascular fitness gains (VO2 max improvements) in half compared to exercise alone.

The mTOR Obstacle: Why daily off-label Metformin use actively blunts muscle hypertrophy and strength gains in response to resistance training by blocking key adaptation pathways.

The Rating of Perceived Exertion (RPE) Spike: How chemically throttling your mitochondria drives up lactic acid, leaving active biohackers with nagging, unexplained fatigue during workouts.

Pathogenesis vs. Salutogenesis: Why functional and preventive medicine remain trapped in disease-centered thinking, and how Health Optimization Medicine shifts the focus to detecting and correcting cellular imbalances.

The 3-Phase Metformin Transition Protocol: A step-by-step clinical sequence using early morning circadian anchors, urinary organic acid testing, targeted orthomolecular cofactors, and pulsed phytoceuticals strictly on rest days.

This episode is for you if:
You are currently taking Metformin or berberine off-label for anti-aging but feel like your gym gains and recovery have plateaued.

You want to understand the exact biochemical mechanisms of how daily chemical inhibitors block the cellular stress signals required for exercise adaptations.

You want to learn how to transition off chronic metabolic blockades and restore biological peak quality of life naturally.

You can also find this episode on…
YouTube: https://youtu.be/v1e132gqY_k
Find more from Health Optimization Medicine and Practice (HOMeHOPe):
Website: https://homehope.org/
Instagram: https://www.instagram.com/homehopeorg/
HOMeHOPe Conference 2026: https://homehope.org/homehope-conference-2026
Use PODCAST10 to get 10% OFF your purchase of the Clinical Metabolomics Module at https://homehope.org/products/clinical-metabolomics
Find more from Troscriptions:
Website: https://troscriptions.com/
Instagram: https://www.instagram.com/troscriptions/
Use POD10 to get 10% OFF your Troscriptions purchase at https://troscriptions.com/collections/our-products

In this episode of the Health Optimization Medicine Podcast, Dr. Ted Achacoso, Dr. Scott Sherr, Dr. Allen Bookatz, Dr. Jup Kuipers, and Jodi Duval take a deep dive into the gut-brain-microbiota axis. Moving past the simplistic, pathogenic "pill-for-an-ill" approach of conventional psychiatry and the mainstream hype around over-the-counter probiotics, the faculty breaks down why establishing enteric safety must always precede biochemical optimization.
Join us as we delve into:
The Tripartite Axis: How the enteric microbiota, gut barrier, and central nervous system communicate at a molecular and metabolomic level to dictate brain state and mood.

Epigenetic Signaling: How gut microbes act as active metabolic factories, fermenting dietary fibers into short-chain fatty acids (SCFAs) like butyrate that cross the blood-brain barrier to upregulate BDNF and support synaptic plasticity.

The IDO Serotonin Hijack: How gut-driven inflammation activates indolamine 2,3-dioxygenase (IDO), shunting tryptophan down the kynurenine pathway to produce neurotoxic quinolinic acid instead of serotonin and melatonin.

The Microglial Fire: How circulating cytokines cross the blood-brain barrier at the circumventricular organs, placing the brain's microglia into an active defense state that triggers cognitive fatigue and brain fog.

The 3-Phase Gut-Brain Protocol: Why seeding probiotics into inflamed soil fails, and how to logically sequence clearing overgrowth, rebuilding mucosal integrity with L-glutamine, and seeding validated strains.

This episode is for you if:
You are running on high-dose over-the-counter probiotics for mood issues but feeling no relief or worsening symptoms.

You want to understand the exact cellular and biochemical mechanisms connecting leaky gut to leaky brain and psychiatric distress.

You want a practical, clinically sequenced blueprint to restore gut barrier safety before attempting to optimize your neurochemistry.

You can also find this episode on…
YouTube: https://youtu.be/AX-Mt1crayc 
Find more from Health Optimization Medicine and Practice (HOMeHOPe):
Website: https://homehope.org/
Instagram: https://www.instagram.com/homehopeorg/
HOMeHOPe Conference 2026: https://homehope.org/homehope-conference-2026
Use PODCAST10 to get 10% OFF your purchase of the Clinical Metabolomics Module at https://homehope.org/products/clinical-metabolomics
Find more from Troscriptions:
Website: https://troscriptions.com/
Instagram: https://www.instagram.com/troscriptions/
Use POD10 to get 10% OFF your Troscriptions purchase at https://troscriptions.com/collections/our-products

In this episode of the Health Optimization Medicine Podcast, Dr. Allen Bookatz, Dr. Ted Achacoso, and Jodi Duval tackle the widespread trend of supplement fatigue.
As biohacking becomes a mindset of treating symptoms with heavy stimulants and endless pills, the faculty breaks down why forcing adaptation on an exhausted system only drives the body deeper into a chronic state of inflammatory defense.
From the biophysics of the Cell Danger Response (CDR1) to practical parasympathetic upregulation, this roundtable shifts the focus from treating disease to establishing true autonomic safety.
Join us as we delve into:
The Cell Danger Response (CDR1): How a sympathetic fight-or-flight state physically stiffens cell membranes and halts aerobic respiration.

The Vagal Superhighway: How sympathetic dominance halts gut motility, triggers dysbiosis, and blocks neurotransmitter synthesis.

The Autonomic Safety Protocol: The critical importance of chronobiology, early morning sunlight, and circadian anchors.

Vagal Upregulation & GABA Support: Utilizing transcutaneous auricular vagus stimulation (taVNS), L-theanine, and Kava to quiet the central alarm and exit CDR1.

The Myth of Extreme Hormesis: Why intense stressors like ice baths and strict fasts act as active threats, not adaptation triggers, when your cells are already depleted.

This episode is for you if:
You are running on a continuous cycle of intense workouts, strict fasts, and multiple wearables, yet feel more exhausted.

You want to understand why your cells cannot use nutrients for energy production when they perceive an active attack.

You want to learn how to pulse carefully calibrated hermetic stressors only after restoring baseline energy reserves.

You can also find this episode on…
YouTube: https://youtu.be/uE3LhioxwZQ
Find more from Health Optimization Medicine and Practice (HOMeHOPe):
Website: https://homehope.org/
Instagram: https://www.instagram.com/homehopeorg/
HOMeHOPe Conference 2026: https://homehope.org/homehope-conference-2026
Use PODCAST10 to get 10% OFF your purchase of the Clinical Metabolomics Module at https://homehope.org/products/clinical-metabolomics
Find more from Troscriptions:
Website: https://troscriptions.com/
Instagram: https://www.instagram.com/troscriptions/
Use POD10 to get 10% OFF your Troscriptions purchase at https://troscriptions.com/collections/our-products

In this episode of the Health Optimization Medicine Podcast, our faculty, Dr. Scott Sherr, Dr. Ted Achacoso, Boomer Anderson, Dr. Allen Bookatz, and Jodi Duval, tackle the recent trend of therapeutic plasma exchange and "blood washing". Moving past the mainstream marketing of plasmapheresis as a longevity cure-all, the team breaks down why mechanical filtering is only a surface-level fix for microplastic toxicity.
From the autonomic anxiety caused by biological lockdown to the clinical application of precision metabolomics, this roundtable shifts the conversation from invasive procedures to measurable, cellular safety signals.
 
Join us as we delve into:
The Protein Corona: How circulating microplastics masquerade as pathogens, triggering localized purinergic signaling and the release of extracellular ATP.

The Cell Danger Response (CDR1): Why the body halts oxidative phosphorylation and locks down the cell membrane when invaded, and why blood washing can't touch toxins stuck inside tissue matrices.

The Problem with Plasmapheresis: The clinical realities and physiological costs of invasive vascular filtering, including the removal of essential immunoglobulins and clotting factors.

The True Detox Protocol: Utilizing organic carbon binders (humic and fulvic acids), phase two liver conjugation (glucuronidation/sulfation), and barrier integrity support to properly excrete microplastics.

Pulsed Antioxidant Support: When and why to use targeted NAD, alpha-lipoic acid, NAC, and ubiquinol to transition cells out of a defensive lockdown.

 
This episode is for you if:
You are considering expensive therapies like plasmapheresis to clear environmental toxins.

You want to learn how to test your cellular metabolomics for organic acids and brain inflammation.

You want to understand how your unique exposome interacts with your cellular safety mechanisms.

 
You can also find this episode on…
YouTube: https://youtu.be/5b4jWqByRAU
 
Find more from Health Optimization Medicine and Practice (HOMeHOPe):
Website: https://homehope.org/
Instagram: https://www.instagram.com/homehopeorg/
HOMeHOPe Conference 2026: https://homehope.org/homehope-conference-2026
Use PODCAST10 to get 10% OFF your purchase of the Clinical Metabolomics Module at https://homehope.org/products/clinical-metabolomics
 
Find more from Troscriptions:
Website: https://troscriptions.com/
Instagram: https://www.instagram.com/troscriptions/
Use POD10 to get 10% OFF your Troscriptions purchase at https://troscriptions.com/collections/our-products