Welcome back to Resiliency Radio with Dr. Jill Carnahan, where we bring you cutting-edge conversations with leading experts in longevity, regenerative medicine, and whole-body healing. In today’s episode, Dr. Jill sits down with Dr. Khoshal Latifzai, a Dartmouth-trained, Yale-residency Emergency Medicine physician and co-founder of Rocky Mountain Regenerative Medicine, to explore the future of personalized healthcare.

This powerful discussion dives deep into regenerative medicine, innovative longevity therapies, and the systemic challenges doctors and patients face in today’s healthcare system. You’ll learn how advanced treatments—like hyperbaric oxygen therapy, ozone therapy, and cellular therapies—are transforming lives, improving recovery, and helping people optimize their vitality at every stage of life.

Key Topics You'll Discover with Dr. Khoshal Latifzai

① Regenerative Medicine
⇨ Dr. Khoshal Latifzai shares insights into the field of regenerative medicine, emphasizing the importance of personalized care and innovative therapies like hyperbaric oxygen therapy and ozone therapy.
⇨ Discussion on the integration of cellular therapies and the potential benefits observed in patients with severe conditions.

② Challenges in Healthcare:
⇨ The conversation touches on the systemic issues within the healthcare system, such as the limitations imposed by insurance companies and the need for more effective diagnostic tests.
⇨ Dr. Khoshal Latifzai discusses the disenchantment among doctors and the potential for reinventing medical careers through mentorship and innovative practices.

③ Patient-Centered Approach:
⇨ Emphasis on the importance of understanding patient needs and building strong doctor-patient relationships.
⇨ Dr. Khoshal Latifzai shares experiences of using data-driven approaches to tailor nutritional advice and therapies to individual patient profiles.

④ Future of Medicine:
⇨ The potential of liquid biopsies and advanced biomarkers in predicting and managing health risks.
⇨ The Dr. Khoshal Latifzai's vision for a more supportive and collaborative medical community that prioritizes patient well-being.

🔑 Key Takeways:

📌 Regenerative medicine offers promising solutions for complex health issues, but requires a shift towards more personalized and integrative approaches.
📌 Systemic changes in healthcare are necessary to overcome current challenges and improve patient outcomes.
📌 Building a supportive medical community and fostering mentorship can inspire new generations of healthcare professionals.

🔑 CONCLUSION: The episode concludes with a call to action for healthcare professionals to embrace innovative practices and support each other in the journey towards better patient care. Dr. Khoshal Latifzai expresses gratitude for the opportunity to share their experiences and insights.

About Dr. Khoshal Latifzai

Dr. Khoshal Latifzai is a Board-Certified Emergency Medicine physician who discovered the profound impact of regenerative medicine while caring for critically ill patients and serving on humanitarian missions abroad.

A graduate of Dartmouth Medical School with a residency at Yale University, Dr. Latifzai realized early that preventing chronic disease and maximizing lifelong wellness could make as much difference as life-saving procedures in the ER. This insight led him to co-found Rocky Mountain Regenerative Medicine, where he combines stem cell therapy and non-surgical orthopedics to help individuals heal from pain and injury while optimizing cognitive function.

Today, Dr. Latifzai serves not only elite and amateur athletes but also busy professionals seeking to preserve and enhance their vitality. An affiliate of the Cell Surgical Network and author of several published articles, he champions cutting-edge interventions—ranging from advanced biologics to comprehensive hormone and nutritional strategies—so his patients can thrive at every stage of life.

🌐 Website: https://rmrmco.com/
⇨ Instagram: https://www.instagram.com/rmrmboulder/
⇨ Facebook: https://www.facebook.com/RMRMBoulder/
⇨ LinkedIn: https://www.linkedin.com/in/khoshal-latifzai-53415047/
⇨ Tik tok: https://www.tiktok.com/@rmrmboulder

Dr. Jill Carnahan, MD – Leading Functional Medicine Doctor

Dr. Jill Carnahan, MD, ABIHM, ABoIM, IFMCP is internationally recognized as one of the most respected leaders in functional and integrative medicine. She is dually board-certified in Family Medicine and Integrative Holistic Medicine, and the founder and medical director of Flatiron Functional Medicine in Louisville, Colorado.

Widely known as a pioneer in environmental toxicity, mold-related illness, autoimmune disease, and resilience medicine, Dr. Carnahan combines cutting-edge science with compassionate, root-cause care. Her clinical approach integrates precision genomics, epigenetics, microbiome research, peptide therapy, and lifestyle interventions to transform health outcomes for patients worldwide.

She is the author of the best-selling memoir Unexpected, which weaves her personal journey through cancer, Crohn’s disease, and mold-related illness with her professional expertise. Dr. Carnahan is also the executive producer of the award-winning documentary Doctor/Patient and the host of the popular podcast Resiliency Radio, which reaches over 500,000 global subscribers.

As an international keynote speaker, Dr. Carnahan has been featured at leading medical conferences including A4M, IFM, EPIC, and IPM Congress, and her work is frequently highlighted in major media outlets such as NBC, CBS, Fox News, Forbes, Parade, People, and MindBodyGreen.

With a reputation as both a scientist and a healer, Dr. Jill Carnahan is regarded as one of the top functional medicine doctors in the world, offering a unique blend of evidence-based research, innovation, and deeply personalized care.

The Podcast with Dr. Khoshal Latifzai

The Video with Dr. Khoshal Latifzai

The Transcript – Overview

• Shift to Regenerative Medicine: Transition from ER to regenerative practices enhances patient connections, boosting provider satisfaction with longer visits.
• Custom Health Assessments: Unique lab panels track critical biomarkers, improving cardiovascular and metabolic health through targeted, personalized plans.
• Holistic Treatment Options: A variety of therapies, including cellular and hormone treatments, focus on safe, biological alignment for healing and longevity.
• Advanced Cancer Screening: Innovative liquid biopsy technology aids in early cancer detection, helping tailor proactive health strategies for patients.
• Empowering Women's Health: Nearly 50% of patients are women, with specialized programs addressing hormonal health and education, filling gaps in care.
• Growth and Education Focus: Plans for digital outreach and mentorship aim to expand the clinic's impact on regenerative and longevity medicine.

Notes

Transition from Emergency Medicine to Regenerative Practice

The shift from emergency medicine to a regenerative medicine practice was driven by a need for deeper patient connection and sustainable career satisfaction, as explained by Dr. Khoshal Latifzai, who now spends up to 90 minutes or more per patient, compared to the 5-15 minutes typical in ER settings (08:15).

• After private equity acquisition cut physician hours and increased mid-level provider use to reduce costs, patient wait times in the ER extended up to 10 hours, reducing quality and fulfillment for providers.
• Dr. Khoshal Latifzai and his wife launched Rocky Mountain Regenerative Medicine to restore meaningful patient care, enabling longer visits and personal engagement, which has improved provider happiness and team growth to include a fourth or fifth nurse, an office manager, and a new PA.
• This model rejects the corporate-driven “hamster wheel” approach, focusing instead on personalized, integrative care that fosters long-term patient relationships and community ties.
• The transition reflects a broader physician disenchantment with corporate medicine, highlighting the importance of mentorship and entrepreneurial support for doctors looking to reinvent their careers with patient-centered care.

Data-Driven Functional and Integrative Medicine Approach

Dr. Khoshal Latifzai emphasizes building a health foundation with precise biomarker tracking and lifestyle integration before introducing advanced regenerative therapies (22:35).

• He developed a custom panel of advanced labs beyond standard insurance-driven tests, focusing on apolipoprotein B, lipoprotein(a), homocysteine, fasting insulin, and hemoglobin A1C to better assess cardiovascular and metabolic risk.
• Body composition analysis through DEXA scans informs tailored goals, including visceral fat reduction and basal metabolic rate measurement, allowing patients to track progress data-driven rather than generic advice.
• Nutrition and exercise prescriptions are personalized and hands-on, with partnerships for meal prep services and coordinated physical activity such as bike rides combined with lab reviews, reinforcing adherence and engagement.
• This approach integrates conventional and functional methods, overcoming limitations of insurance constraints and fragmented care by building local provider partnerships for imaging and physical therapy, ensuring a holistic patient ecosystem.

Regenerative and Longevity Therapies Portfolio

The clinic combines cellular, peptide, hormonal, ozone, and hyperbaric therapies to address aging, injury, and chronic conditions with a focus on safety and biological alignment (37:17).

• Autologous cellular therapy involves liposuction to harvest fat-derived regenerative cells, expanded ex vivo by thousands-fold, banked, and reinjected to promote healing and tissue regeneration.
• Platelet-rich plasma (PRP) is used primarily for orthopedic injuries, complemented by various peptides targeting weight loss, immune optimization, and musculoskeletal restoration.
• Hormone replacement therapy (HRT) is deployed judiciously for men and women, addressing age-related declines in testosterone, estradiol, and progesterone to reduce cardiovascular risk and improve muscle and bone health.
• Ozone therapy, including the 10-pass autohemotherapy, is employed to enhance immune function, antioxidant capacity, and reduce pathogen load, with examples of its success in autoimmune disorders and as a conservative alternative to surgeries like spinal fusion.
• Hyperbaric oxygen therapy is recognized as an underused mitochondrial and neurological recovery tool, showing promising results especially in post-concussion syndrome and stroke rehabilitation.
• Dr. Khoshal Latifzai stresses the importance of true informed consent, explaining the current lack of large-scale randomized trials while offering these therapies safely and transparently.

Advancements in Biomarkers and Cancer Screening

Modern biomarker panels and liquid biopsy technologies are key tools for early detection and risk stratification, improving personalized intervention strategies (29:09).

• Apolipoprotein B (APOB) is prioritized over traditional cholesterol tests for cardiovascular risk, reflecting its stronger predictive power.
• Lipoprotein(a) is genetically determined and challenging to lower, but emerging mRNA-based drugs show promise, currently under early clinical use.
• Homocysteine levels are regularly measured and treated with methylated B vitamins to reduce cardiovascular risk.
• Metabolic health monitoring includes fasting insulin testing, which predicts diabetes risk up to a decade in advance, supplementing glucose and HbA1c tests.
• Cancer detection uses liquid biopsy to identify circulating tumor DNA, which guides further imaging and biopsy to confirm diagnoses, representing the forefront of non-invasive cancer screening.
• These advanced tests are often not covered by insurance, requiring motivated patients with resources, but they enable proactive and precise health management.

Focus on Women’s Health and Hormonal Balance

Recognizing the historical neglect in women’s health, the clinic launched targeted educational and treatment programs to close gender gaps in longevity medicine (52:48).

• Female patients now represent near 50% of the clinic’s population, up from about 25%, reflecting the impact of female providers and specialized outreach.
• Hormone replacement therapy is carefully managed with female providers leading consultations to improve comfort and disclosure of symptoms, which often go unspoken in male-doctor interactions.
• The clinic’s women's health program includes a webinar education series covering hormonal cycles, symptoms of deficiencies, and long-term risks, emphasizing prevention of morbidity and mortality.
• Dr. Khoshal Latifzai points out the shortage of endocrinologists managing women’s hormones and the lack of prioritization in conventional medicine, highlighting the clinic’s role in filling this gap.
• This focus addresses not only individual well-being but also family dynamics, as untreated hormonal issues in women affect household health and quality of life.

Future Vision and Growth Plans

The practice is expanding its educational footprint and digital presence to lead in regenerative and longevity medicine locally and beyond (58:11).

Transcript

00:00
Dr. Jill Carnahan
Hey everybody. Welcome to Resiliency Radio, your go to podcast for the most cutting edge insights integrative and functional medicine. I'm your host, Dr. Jill and with each episode we dive into the heart of healing and personal transformation. Join me as I interview medical leaders, innovators, thought leaders and people of all types of background, helping you to understand more about your own health and to achieve optimal wellness, longevity and high performance. That that's what we're all after all. Today my guest is no different. He's a local doc that I've known for a long time and I can't wait to introduce him. We're going to talk longevity secrets and wellness and some of the cutting edge treatments you can expect and I will introduce him in just a moment. 

00:45
Dr. Jill Carnahan
Before I do, I want to make sure you know that you can get all products and services carefully curated things like Epstein Bar Treatment Pack, Detox Essentials, my favorite Mitovite, which is an incredible multivitam for optimal wellness and so many other things. You can find them at Dr. Jill health.com again Dr. Jill health.com all products and services there for you. You can also find products we love on my website jillcarnahan.com and in that products we love is all the things I mentioned on the podcast that I use myself, my PEMF mat, my air filter, my you name it, the stuff that I use on a regular basis is all listed there. My favorite air filters at Products we love link is also below if you're on YouTube. 

01:33
Dr. Jill Carnahan
And also one of the things I want to mention today that's been a favorite and I've gotten lots of requests lately for is it's kind of hard to see with the lighting here, but it is the Dr. Jill Beauty Collagen. This product when I have women or men coming in saying their hair is thinning, their nails are more brittle and they're having trouble especially with the scalp. The two things I recommend are hair growth serum which is again@doctor Jill health.com it's a DHT blocker. It really works. That's the best thing, right? The patient. Does it work? Yes, it works. After I had Covid about four or five years ago, I had real significant hair thinning on my scalp and I used it and it has come back better than ever. But I always love to add this beauty collagen. 

02:13
Dr. Jill Carnahan
It's loaded with the kind of collagen, all the different types, the collagen peptides and then a couple of patented materials, silicone and loose driva that are incredible at building those fibers for healthy hair, skin and nails. So I'm such a huge fan. Check it out again. Dr. Jill Beauty Collagen@doctor Jill health.com It's just a scoop a day. I throw it in my coffee and the other question I've been getting lately is are you accepting patients? And I want to be sure and let you all know that yes. Our clinic, Flat Iron Functional Medicine in Louisville, Colorado, we are accepting new patients. So you can call us at 303-993-7910. You can email info@FlatIron Functional Medic or you can go to the website and check out my providers. 

03:01
Dr. Jill Carnahan
I have a pa, Fawn Elwood, who is fantastic in complex chronic disease and my nurse practitioner, Hannah Vanderwater, who is also fabulous with hormone replacement and complex chronic infections. And they're both available. So you can go ahead and go to jillcarnan.com check them out. You can give us a call. And we are accepting new patients, so we'd love to see you. If you're looking for a functional, integrative, problem solving detective kind of doc and we would love to see you. So give us a call. Okay, without further ado, I want to be sure and introduce our guest. Dr. Koshal Latifsa is a board certified emergency medicine physician who discovered the profound impact of regenerative medicine while caring for critically ill patients and serving on a humanitarian mission abroad. 

03:50
Dr. Jill Carnahan
A graduate of Dartmouth Medical School with a residency At Yale University, Dr. K realized early that preventing chronic disease and maximizing lifelong wellness could make as much of a difference as the life saving procedures that he was used to doing in the er. You'll hear his story today and I just love how he took that information and really transformed medicine the way he's doing medicine. He works with his wife who's also a nurse practitioner in their clinic in Boulder, Colorado. Today he serves not only as an elite and amateur, he serves not only elite and amateur athletes, but also busy professionals who want to preserve and enhance their vitality. He uses cellular therapies and all kinds of things. You'll hear about that today. But let's get to the show and welcome Dr. K. Hey, Dr. K. My neighbor. 

04:36
Dr. Jill Carnahan
We're in the same town basically just down, down the road from one another. I've heard amazing things about your clinic and what you're doing, but today we get to dive deep and talk a lot about that. But I always love to start with my guests a little bit about story. So you were in emergency medicine Originally. Tell us a little bit about your journey to what you're doing now. 

04:55
Dr. Khoshal Latifzai
Well, like many physicians, you know, after graduating from undergrad, I went to medical school at Dartmouth. And then after graduating medical school, I went to residency. I was a resident in emergency medicine, as you said, at Yale University. And after completing my four years as a resident, I became an attending. And that's pretty typical of doctors. There's some physicians who choose to do a fellowship. But I became an attending and moved with my wife from the east coast to Colorado, and I began working in the er and because like many physicians who were just newly minted new emergency physicians, you sort of start out at the bottom rung on the ladder and there's, you know, you're kind of the junior partner. So you're pulling a lot of shifts, seeing a lot of patients. 

05:50
Dr. Khoshal Latifzai
And I took great pride in seeing the sickest of the sickest patients, seeing them in great volume, working more shifts than my peers. And for the most part, I loved it. And at some point, our group was bought out by a private equity group, and there were elements of business that were introduced into the medical side of it that, to be honest, I never really was trained on as a resident, as a medical student. And I think a lot of doctors, a lot of physicians can probably say the same. We, like, we don't really receive a lot of training on the business side of it. And here's private equity saying, look, you know, physicians are the biggest drain on our bottom line, and we need to cut your hours, we need to cut compensation. 

06:41
Dr. Khoshal Latifzai
And they brought in a lot of mid levels, and nothing against mid levels. My wife is a nurse practitioner here at our practice currently, so she's considered a mid level. Nothing against them. But were. Our hours were cut in favor of bringing in mid levels because the private equity groups had to pay less. They're less compensated. What did that all translate into? Well, it translated into really long wait lines in the waiting room. So patients went from waiting a couple hours before being seen by a provider to sometimes they'd be in the waiting room for 10 hours. And so imagine being in the waiting room, coming to the er, expecting to be seen emergently. And by the time you see a doctor or you see a mid level, you're probably not the happiest, and understandably so. 

07:33
Dr. Khoshal Latifzai
And so those interactions with patients went from pretty brief. Like, you know, I would spend routinely 15 minutes with a patient, and that was a long time, believe it or not, down to seeing, you know, having that interaction with patients cut down to five minutes. And so from a fulfillment standpoint, you know, it's not really what I signed up for. And I wasn't really happy with the trajectory of my career. And it led to a lot of introspection for myself, for my wife. Luckily, she didn't work in the same with the same group. But, you know, I really started to consider, you know, what options I had. And it really came down to a really basic question. 

08:18
Dr. Khoshal Latifzai
If you had to redo, you know, your medical training and which path you went down, how would you devise a career, A practice that I could see myself, you know, continuing on into my 80s. And, you know, it sounds like a really basic question, basic thing that I should have considered early on. But I told my wife, look, I really want to practice where I'm spending a lot of time with my patients, where I'm able to take the advice that I'm giving to my patients. And by this time, you know, working the hours that I was working in the er, looking at my general overall satisfaction, I had put on a lot of weight. I really unhealthy. And instead of just sort of feeling sorry for myself, like I had to start somewhere. So we established this practice, Rocky Mountain Regenerative Medicine. 

09:11
Dr. Khoshal Latifzai
And we sort of did away with a lot of things that I think impede that patient, doctor relationship. And currently, you know, we're at a stage where I'm easily spending 90 minutes at a time, two hours at a time with patients. I'm able to go out and do like a mountain biking ride with my patients or go out on a hike when I'm picking up my kids. I have three little ones in elementary school. I see a lot of the other parents who happen to be my patients. And I would say in general, it's a lot more fulfilling where I am currently compared to where I was. Where I was, even though I was this newly minted grad, I was really excited about seeing patients putting in my hours. 

10:02
Dr. Khoshal Latifzai
That sort of dark cloud that came over us that I refer to as private equity. It turned out to be there turned out to be a silver lining. And that was born out of that was our clinic, Rocky Mountain Regenerative Medicine. And where I am now, I'm a world's. World's happier compared to where I was. You know, we hired our fourth or fifth nurse recently. You know, we have a office manager, my wife, who's the nurse practitioner at our practice. We just launched a program designed for women's health. We just hired a pa so Our practice is growing, and I love the family that I'm with now. 

10:46
Dr. Jill Carnahan
So it is so interesting because I hear in your story, and I hear this with a lot of guests and even my own journey in medicine in our allopathic medical training. It's so sad to see how the training actually takes some of the humanity out. And then when we mint off physicians into the world, like, we, most of us go in because we want to help patients, we want to be healers, we want to connect with people. Like, there's this deep, like, sense, at least for me and you, it sounds like, of really wanting to understand people and understand the human body and that. And then sadly, our system so often squeezes out all of the joy and all of the ability to really spend time because of this financial wheel that you described so well. 

11:24
Dr. Jill Carnahan
And sadly, if we look at statistics of even physician offices, I think, I don't know, 20 years ago, there was majority still privately owned by a couple physicians or a group, whereas it has shifted so dramatically to be more corporate. And it really does make a difference because their bottom line is all about the financials and not about the humanity. And how do we show up? And so you and I are out in the world, like, doing our own thing and, you know, creating this space to really. And patients are hungry, too. I. I'm sure you've seen this. I have seen literally every single day almost a patient or a friend or someone talking about their brother or this or that, or they went to the ER and. And again, nothing against, there's still need for this trauma and acute care medicine. 

12:03
Dr. Jill Carnahan
But so often the stories I hear are, the doctor didn't touch me, like, how are we going that we don't have a physical exam anymore, that we don't know how to actually look, you know, and touch. And even if it's just like a touch on the shoulder, even if there's no, like, what kind of medicine are we practicing? Right. 

12:21
Dr. Khoshal Latifzai
Yeah, yeah. These basic things that we learned about in medical school, sitting down when you enter the room, you know, talking with a patient, letting him talk without interrupting, you know, doing a basic exam, explaining and educating the patients. You know, again, if you're spending five minutes with a patient, some of those things have to be sacrificed. 

12:44
Dr. Jill Carnahan
Right? 

12:46
Dr. Khoshal Latifzai
Product is so poor. So to your point, you know, a lot of the terminology that you use, I have to smile because it definitely resonates with me. You know, you feel like you're on the hamster wheel. And once you jump on, you do feel a little bit out of control. Like you're going to be running forever and you just cannot stop. And I think a lot of doctors are disenfranchised, you know, with the profession in general, for all the reasons that you just alluded to. And the, you know, I want them to know if they're, you know, in your audience, like there is a better way out. And I know it's scary because, you know, you don't get a lot of training on how to establish your own practice, especially as an ER doctor. 

13:29
Dr. Khoshal Latifzai
The expectation is you're going to show up to an already established practice group and you're going to hit the ground running and you're just going to be another employee, another cog in the wheel. But if you take that leap, there's plenty of mistakes to be made along the way. But there are plenty of individuals there to hold your hand. And I've gone to sort of mentoring, funnily enough, some of my older, some of my prior attendings when I was in training, because they're seeing the writing on the wall that's the brand of medicine and that's going to end careers and end it in a really sad, disappointed kind of way. And wouldn't it be great to sort of completely reinvent yourself, your career in the way that you had envisioned when you were that medical student in training? 

14:18
Dr. Khoshal Latifzai
And it can be done and you need a good mentor and people like you who've been doing it for decades. I know that there's a lot of doctors out there looking for to individuals like you in a podcast like this for guidance. So hopefully this is going to inspire some people to take the leap. 

14:36
Dr. Jill Carnahan
Hey everybody, let me just pause for a quick moment to remind you that you can find products and services that have been carefully curated for your health, optimal longevity and performance@drjillhealth.com a lot of times I mention things in Today is one of my very favorites. You've seen mention this before. This is the Advanced Retinol with Bakuchiol, an absolute game changer for aging skin without the dryness and cracking that you sometimes get with retinols. I just love this product. It works so well. I only use it a couple times a week and get incredible effects for skin collagen and longevity, the fine lines and wrinkles. And it's again, advanced retinol 5x with bakuchiol. And you can get that@drjillhealth.com okay, let's go back to our show. 

15:21
Dr. Jill Carnahan
Yeah, I love that you say that because, again, we do have a lot of physicians who listen and professionals in that. And I think it is a. And I actually love that you also said, I mean, I remember when I first moved to Boulder and I had been with a hospital system. I was doing integrated medicine, but still under the auspice of the hospital. And that wasn't a good situation either because they were still talking about the hamster meal. There was this productivity idea that I had to see, still see 30 patients a day and an integrated, functional, regenerative medicine. Just like you said, you can't do that because you really. The medicine is getting with the patient, understanding them, getting to know them. It's a relationship at the core. Right. Which we'll talk about a little bit. 

15:55
Dr. Jill Carnahan
And then from that relationship, you know, giving a wider toolbox of options of what they have available to them and all of that. But anyway, I went from that medical system to Colorado, started completely over, kind of like you out here in the west. And that's the biggest thing when you first start and no one who knows who you are and how do you get the word out there? And so, and for me, it was trial and error. And it's so interesting because I do also, you know, mentor business physicians and that. But it's hard. It's not. I think I went 18 months without taking really any sort of salary before I started, you know, shifting that. So you have to kind of go in knowing, okay. But in the end, like, the joy I have with what I do. 

16:32
Dr. Jill Carnahan
And like, you just, I love that you talk about your team. Because for me, I go in the office and my front office staff and my office manager and my mid levels, I have a nurse practitioner and a pa and I love them so much. Like, I love talking to them about cases and I love, you know, helping them with whatever they're doing. And it's so, it's kind of this environment that's actually like, yes, we get to care for patients and we all love that. But, like, we actually really love one another and we love going to work. 

16:57
Dr. Khoshal Latifzai
Absolutely. And the nurses, you know, most of them have been with us right from the outset. So that speaks to them also seeing and getting a lot of value in this brand of medicine. And I can say the same about our patients. They really like, are like our families. We see them, you know, living in Boulder, it's a pretty small town. You're going to run into the same people over and over again. And it's. That's a great feeling compared to the way it was when I was working in the er. So I know we spent quite a bit of time on that, but it's. 

17:27
Dr. Jill Carnahan
It'S, it's worth kind of the framework because then like, and honestly this is the future of medicine. There is zero doubt in my mind what you're doing and what I'm doing in the combination. I was just in Switzerland and I was doing. It was a longevity conference and all of these, you know, amazing clinics are popping up. Germany, Switzerland, UK etc and the world is starting to see this trend as well. And they're still looking to the US because I think most of us in the US have had a little bit more experience in some of this. So let's for. So you er, and then that you moved from the east coast to here. 

18:00
Dr. Jill Carnahan
Maybe just take us a little bit through just a little bit of the startup and then how you started like what you started offering and then we'll dive into all the amazing things you're doing currently. 

18:10
Dr. Khoshal Latifzai
Yeah. When we first started, some of our first patients were individuals from a gym that I used to go to and they were looking into a lot of biological therapies like cellular therapy or something called platelet rich plasma or PRP therapy for musculoskeletal injuries. And then as I got to know these patients on a medical level, you know, some of them were sort of unhealthy in other ways. So for instance, they were maybe on the verge of type 2 diabetes and instead of just kind of diving in and instituting some form of biological therapy, I had to explain to them like, look, I really don't think this is the right form of therapy for you right now. 

18:59
Dr. Khoshal Latifzai
Ideally, you know, with these biological therapies you want to reintroduce, whether it's cells or PRP or what have you into an environment that is going to be healthy, that's going to really foster those types of interventions. And so it would behoove us to address your, your diabetes or your borderline diabetes first. And the more research that I did into that, it turned out that some of the biomarkers that were trending, that were following in conventional medicine had some shortcomings. In other words, they weren't adequately reflective of somebody's risk of whether it's cardiovascular dise or diabetes or what have you. And so it sort of took me down this path of like, why are we doing these tests and why have we been doing these for decades if there are better tests out there? And this is where insurance comes in. 

19:51
Dr. Khoshal Latifzai
And a lot of patients aren't aware that insurance dictates the types of tests, the types of interventions that a doctor is going to introduce to that patient. I can't tell you how many times when I was working in a really busy shift in the er, for instance, a pharmacy would call me and say, hey, remember that medication that you prescribed for this patient? It turned out, it turns out that a month supply is $1,000 versus this other medication that'll cost the patient $10. Do you want me to just change the prescription for this patient? And for me, it wasn't that big of a deal. It was either option A or option B and it ultimately didn't make a difference. But that was the insurance company's way of telling me, hey, we want you to prescribe this, but not this other medication. 

20:35
Dr. Khoshal Latifzai
And that type of, you know, those types of nudges from the insurance companies are all over the place that, where the doctor is being directed to prescribe. Certainly, because after you receive three or four of those phone calls, again on. 

20:48
Dr. Jill Carnahan
A busy ER shift, go to the 1. Right. 

20:51
Dr. Khoshal Latifzai
I can't even bother. You're going to go, you're going to learn really quickly to prescribe one thing and not, I think the same thing pertains to some biomarkers like the conventional lipid panel that looks at one's total cholesterol, or vldl, ldl, triglycerides, et cetera. You know, some of these panels were devised in the 80s and the test really hasn't changed all that much since then. But there are better biomarkers these days that are more reflective of one's actual risk of cardiovascular disease or diabetes or what have you. And so as I kind of went down that rabbit hole, we sort of devised a panel of labs that we still use today and we still add to, we've been adding to it since inception of our clinic that again, are much more reflective of the actual risk profile of the patient. 

21:45
Dr. Khoshal Latifzai
And then you can sit down with them and sort of explain what their risk profile looks like. And then we started going down the imaging route. These days there are really good tests called DEXA scans that historically used to tell us just about bone density, but these days they can tell us about body composition and they can tell us about your basal metabolic rate, meaning how many calories you're burning, just to sort of keep the lights on a day to day basis. And then so I could sit down again with a patient and explain to them hey, this is what your visceral adipose tissue mass looks like. And this is how you compare to age and gender match controls. 

22:24
Dr. Khoshal Latifzai
And then if the objective based on those results is to lose a certain amount of weight and the right type of weight, that's where their basal metabolic rate sort of comes in. You know, it's not enough to just tell a patient, eat less and exercise more. I want to be able to explain to them this is, these are the benchmarks that we're chasing and these are the tests that we're going to repeat in a few months and we'll see where things are. And we're going to be, you know, you're going to be following your waistline, you know, almost on a daily basis or your weight on a daily basis or what have you. So we want to set, we want to take a really data driven approach to things. 

23:03
Dr. Khoshal Latifzai
And if we're going to give them advice on nutrition, for instance, you know, I just spoke with one of my patients today and she said, hey, remember that company that you recommended that prepares foods, you know, we didn't want them to do three meals a day. We just wanted them to kind of bring a little bit more structure to how we snack. And so that's all that company does for that particular family is once a week they show up and they fill up the fridge with snacks based on what the patients and that family's food sensitivity profile looks like, what the overall objective is. So we took this really hands on approach to nutrition. 

23:42
Dr. Khoshal Latifzai
And then when it came to exercise and the right type of exercise, zone 2 exercise or strength training, you know, some of my patients, not the ones that I met through the gym, you know, but other ones, they hadn't exercised. And so it wasn't enough to just sort of tell them, this is what I want you to do. We needed to kind of get out there and if I was going to recommend running or hiking or cycling, what have you, I needed to do it with them. And so we would hold our lab reviews, you know, while we're, you know, taking a bike ride. 

24:16
Dr. Jill Carnahan
That is amazing because in this world of functional medicine it's, I feel like that's the missing piece that most functional doctors don't know how to prescribe exercise. And you, if you look at the data, there is no. Yes, it's harder for most people. They could say that, although you and I agree probably it's not true. But it's foundational, this movement that we've forgotten. Right. So you're prescribing and integrating it is so impressive. 

24:41
Dr. Khoshal Latifzai
Yeah, Yeah. I mean, it's. And, you know, I tell I patients this. I feel like I get more out of those relationships than the patients do because, you know, I don't think most of them realize, like, my background in emergency medicine and how bad things had gotten and how out of shape and miserable my health had become. And, you know, I'm a world away from where I had started. So I really feel like this brand of medicine, as fulfilling as it might be, my patients, it's even more so for me to be engaged in their, you know, in their wins or my wins. And so then, you know, we started this conversation around some of the biological therapies that we do. 

25:27
Dr. Khoshal Latifzai
But once you have your house kind of straightened out, as far as, you know, those, your risk profile for the most common causes of death and disability in this country, once you have everything sort of teed up, then we can turn the page and say, okay, now we can address your knee pain because you're in a far better place compared to where you were. And sort of this ecosystem that we've built. I've mentioned a few of them. You know, one of them is a company that we partner with that does the meal prep. And patients don't have to sign up for that. It's totally up to them if they, you know, if they want to hire somebody to do that. We, you know, there's a company here locally that provides physical therapy services, and they're very skilled at what they do. 

26:15
Dr. Khoshal Latifzai
But not all of our patients need it. But when they do, I have, you know, those are, that's who I refer them to. And we partner with someone who does VO2 max testing. 

26:27
Dr. Jill Carnahan
I was going to ask about that with a dexa. Do you do DEXA in house or do you send them? 

26:30
Dr. Khoshal Latifzai
We don't do DEXA in house. We work through other local companies here. And so you are sort of at the mercy of, you know, who you refer these patients out to, because once you kind of enter the house of quote unquote, conventional medicine, you know, you're again, prone to all the shortcomings of that system. And my patients realize that, you know, when they have a hard time scheduling something or somebody calls and not all of their questions are sufficiently answered, they. 

27:00
Dr. Jill Carnahan
Realize what a good job you and your wife and your team have been doing. The same thing is like, oh, we call you for the prescriptions, not a primer, because you're quick. 

27:08
Dr. Khoshal Latifzai
Right? So, so we don't do tests like that, you know, but, you know, it's. It's like a whole new skill set. Can we learn it? Yes, but there's already people doing a great job. 

27:18
Dr. Jill Carnahan
I would agree on some of those things. You just find the really good people, you know, and trust. That's amazing. And I really love that you're thinking about the physical fitness and activity and again, just thinking about just being in Switzerland. All these docs are talking about the amazing regenerative therapies, which we'll get to that as well. Which you and I agree there's some phenomenal things out there. But one of the things that I went and lectured on was the immune system and immune resilience and this metabolic dysfunction, because no amount of injectable, whatever regenerative cellular therapies is going to overcome if you aren't doing the basics. So I really love that and I just want to speak it out. 

27:51
Dr. Jill Carnahan
The fact that you're so starting there is so critical because it's that foundation of a healthy metabolic system, immune system movement, good food, and then we can do all this really fun stuff. 

28:03
Dr. Khoshal Latifzai
Yeah, that's it. Yeah. I mean, you know, because even though in medicine, and I'm sure your training was the same way, you know, we kind of divvy up people's health into different segments. So this is their endocrine health, this is their cardiovascular health. And I think even the course, during the course of this discussion, I'm kind of using that same categorization. But ultimately in the body, it's everything sort of working together. So we use it as. As an aid to sort of organize our thoughts about somebody's health and making sure that we don't miss anything. But ultimately, you know, the person is more than the sum of all those individual parts, and we just need to appreciate that. So. 

28:40
Dr. Jill Carnahan
Yeah. Now you mentioned biomarkers in your own lab tests. And I mean, I'm sure we could talk about hundreds of the panels of different things, but I'm just curious because I'm sure people are thinking, what would you say are the top two or three or four like. Like thing markers that you're just like, whether it's like a LP or a HSCRP or whatever you. You name them. But what would you say for you are like, these are really critical to my assessment. 

29:03
Dr. Khoshal Latifzai
Yeah, I mean, the way that I think about it is, you know, what are the most common causes of death in this country as. As a person gets older? And luckily the CDC tracks this and they break it down by decade of life. And so for instance, you know, in these do change by decade of life, but it's usually some permutation of cardiovascular disease. So to that end, apolipoprotein B is I think, a really important biomarker, certainly more important than total cholesterol or LDL cholesterol, something commonly referred to as bad cholesterol. So apob is really important to your point, LP or lipoprotein A. And the reason that's important is it's sort of genetically predetermined, so it's kind of baked into the genetic cake and there's not a whole lot that can be done about in terms of lowering that. 

29:52
Dr. Khoshal Latifzai
So if that is a strike against you, it's a challenge to lower that. Now having said that, there are some drugs on the horizon, one of them got approved recently that supposedly is promising in lowering that. For what it's worth, it's an MRNA based medication, so but it holds some promise. So maybe there's something on the horizon that may work. Well, I currently have a couple of patients on it, but it's really too early to tell how effective it is in lowering lp. So APOB is the first important one with respect to cardiovascular disease. LP is the other one. Homocysteine is also really important and it's really easy to lower that strike against your cardiovascular health using methylated B vitamins and that sort of thing. So but that's often overlooked one when it comes to cardiovascular disease. 

30:43
Dr. Khoshal Latifzai
And then in terms of most common cause of morbidity and mortality, metabolic disease is up there, including diabetes especially. So to that end, historically we've only checked people's serum glucose level in conventional medicine and if it's less than 100, then usually people don't pursue it any further. Maybe they'll check a hemoglobin A1C, which gives us a sense of your average serum glucose over the prior three to four months. But if that's normal, meaning less than 5.7, which is the threshold for either prediabetes or diabetes, is a little bit higher at six and a half percent. You know, we don't check anything else, but I would add to that your fasting insulin is probably an important biomarker for gauging your metabolic health because it's able to predict your risk of diabetes up to a decade in advance. 

31:38
Dr. Khoshal Latifzai
So of the three that we talked about just now about metabolic health, glucose, hemoglobin A1C and fasting insulin. Fasting insulin is probably one of the more important ones. But if you have the ability to check all three for sure. And then cancer is also one that's up there. And you know, there are a couple of tests on the market currently that are based around what's called liquid biopsy. So the thinking is, you know, there's a certain level of cellular turnover in our bodies and this happens with all cells, healthy or otherwise, where there's a, you know, they have a finite lifespan, they're born and then at some point they die. When cells die, it's a little bit of a messy process where they release their contents, be it proteins or genetic material like DNA. And to that end, cancer cells are no different. 

32:32
Dr. Khoshal Latifzai
And if anything, they have a really high cell turn, cellular turnover because they're born en masse very quickly. And the thinking with liquid biopsy is some of that DNA from cells that just died, cancerous cells will make their way into the bloodstream and you can draw a sample of blood and look at it and see if it contains cancerous DNA. And the test is not just a simple thumbs up, thumbs down, where yes, there's some sort of cancer, but it's able to identify and sort of narrow down what type of cancer somebody might have. And like most tests out there, it's not a perfect test, but you can layer these imperfect tests on top of one another. So if the liquid biopsy is pointing in a certain direction suggestive of cancer, maybe you can pursue that with some sort of imaging modality. 

33:28
Dr. Khoshal Latifzai
So this is where full body MRIs perhaps come in. That is, and if those results concur with one another, then maybe it is the real deal and we need to pursue that, be it through biopsy or some other more invasive means, some sort of imaging modality that kind of pins down if this was a true positive or a false positive. So I think those are some of the tests that are really important. You know, there's no shortage of tests. There's so many tests out there that, you know, even for someone who's interested not just in longevity, but maybe, you know, something that's really close to your situation. You know, what you experience is if, you know, I have several patients who were maybe exposed to mold at some point, or maybe it's an ongoing issue and they're very symptomatic as a result of it. 

34:23
Dr. Khoshal Latifzai
You know, there's really good tests that can pick up on, on some of those toxins that are in the body. And then as we're instituting various types of therapy, be it ozone therapy or, you know, antioxidants or elimination therapy, that we can follow those biomarkers and see how they're changing. So hopefully that answered your question. I mean, there's tons of tests. 

34:47
Dr. Jill Carnahan
Spectacular. And what I heard too is just like the most people, if you just ask the man on the street, 55 year old male, and say, what are you most afraid of dying from? They're going to say heart disease, cancer. You know, they may or may not know about diabetes being up there. But like, you just hit the nail on the head and you just really gave a nice concise summary of, I would agree, some of my very favorite tests. I love that you talked about the circulating tumor, kinds of liquid biopsies. And because I think that the future of medicine, we really are going to be able to check and know more ahead of time what our risk are. And so it's as long as you're a motivated patient and you have some form of resources, because that's the other thing, right? 

35:24
Dr. Jill Carnahan
This isn't cheap, some of these tests, and they're not always covered. However, there are ways to really get a good snapshot and then the best thing is the interventions. So let's shift now because you've got so many neat things that you offer and really profoundly shifting. So I love this terrain work where you're really working on the exercise and the fitness and the percent visceral body fat and all that. And I'm so impressed. And so I respect what you're doing because like I said, there's a lot of regenerative longevity kind of medicine that forgets the basics. So now that we've established that, let's talk about ozone hyperbaric cellular therapies. What are some of the things that have been just like the groundwork of your clinic? And then what are some of the up and coming? 

36:06
Dr. Jill Carnahan
Especially I want to go to mitochondria at some point. 

36:09
Dr. Khoshal Latifzai
Yeah, yeah. I would say, you know, the thing that we started out with, which was cellular therapy. And look, there's different types of cellular therapy. The way that we do it is we want to stay true to your own biology as much as possible. So in other words, we don't want to use anybody else's cells. And so what we do is a liposuction procedure where we remove a small amount of fat from the person's own body. Usually it's from the lower back or the upper buttock area. And we do that under just local anesthesia using lidocaine. And then we take that fat and we isolate the cells that we're after, the cells that are tasked with healing and regeneration in the body. The cells that are going to decline both in number as well as quality as a person is getting older. 

37:04
Dr. Khoshal Latifzai
And we replicate those cells outside of the body in a lab to thousands of times the number of similar cells that are occurring naturally in the body. And then those cells are banked, they're frozen for future use. And then at some point in the future, if somebody sustains some sort of an injury, be it orthopedic or otherwise, we reintroduce those cells in high numbers compared to what's. What's present all over the body. And then those cells are alive. They are able to interact in the micro environment that we reintroduce those cells in and interact with the tissue that's injured to try to figure out, you know, which cells need to be weeded out and undergo apoptosis, where they get eliminated from that environment because they're not contributing in a constructive way to the tissue, to the organ. 

38:04
Dr. Khoshal Latifzai
And some of those cells also transform into the type of cells that are required to restore function to that tissue. And so we. That's one form of therapy that we institute in our clinic. I mentioned the other one, which is prp. Again, there's a lot of a big role for PRP in the context of orthopedic injuries. I've recently gone to using peptides, and I think most of your audience have probably heard about the peptides that are all over the news, and they are primarily weight loss peptides, the GLP1s, et cetera, and certainly those work. 

38:51
Dr. Khoshal Latifzai
But there are a plethora of other peptides that are meant for optimizing your immune system, for instance, or working alongside your immune system to eliminate the pathogens that need to be eliminated or to restore function in a way where your own immune system is not turning against your body and destroying your own tissue in the form of an autoimmune condition. There are other peptides that are aimed at, you know, musculoskeletal restoration. We use hormone therapy. And, you know, in the case of men, one of the things plaguing, you know, sort of medicine in general is there's testosterone clinics on every corner. I feel like, you know, I constantly get text messages and emails like advertising testosterone therapy. So there's definitely, I think, a way where that sort of form of therapy is being misused and it's probably doing more harm than good. 

39:51
Dr. Khoshal Latifzai
You know, sometimes I'll get 20 year olds walking in here saying, hey, I used to get testosterone down in Denver and I want to come to you now. And I'm like, well, you're 20 years old. 

40:02
Dr. Jill Carnahan
I know, right? And do you realize that what are you doing over time? 

40:06
Dr. Khoshal Latifzai
And yeah, and it's like, you know, these therapies do have, you know, there's some nuance there. Not everybody needs to be on it. But, you know, one of the things earlier you ask, what are some of the, the labs that you recommend checking? You know, especially in older patients, both men and women, I think it's really important to assess their hormone levels because that's something else that succumbs to aging. And in men, the testosterone levels decline. In women, it's their estradiol, their progesterone, their testosterone levels, also that decline, that makes them more susceptible to cardiovascular disease and to thinning of their bones, loss of muscle mass, amongst other symptoms. And so, you know, both in men and women, we institute hormone replacement therapy. Again, you have to do it in a judicious sort of way. But those are some of therapies that we do. 

41:02
Dr. Khoshal Latifzai
Other, other therapies include ozone therapy, where there's different forms of ozone therapy. The way that we do it is something called a 10 pass or major autohemotherapy, where you place an IV in the patient's arm, you take some blood out, and then under pressure, you introduce ozone gas into the liquid, into the blood, and reintroduce that back into the body. And there are reasons for doing that form of therapy to eliminate pathogens. But there's also ways to augment one's immune system, to augment their antioxidant capacity, to limit cellular damage from the sick cells to healthy cells. And this form of therapy is used pretty commonly in Switzerland, in Germany, both in the way that I described it, as well as direct injection into different parts of the body if it's injured. 

42:01
Dr. Khoshal Latifzai
I was just at a conference not that long ago where they were talking. There was a spine surgeon from Europe saying, look, in Germany, before the surgeon agrees to do a discectomy or some form of an invasive surgery like spinal fusion, they'll usually try ozone therapy first to see, you know, what kind of mileage they get with that. And sometimes it works well enough where it negates the need for surgical intervention. But we've used ozone therapy for autoimmune conditions like discoid, lupus, for instance, for mold exposure to beef up the body's antioxidant capacity. So those are some of therapies that we do. You mentioned hyperbaric oxygen. That's something that we invested in recently. And I, you know, the first few times I went into the chamber, I think five days in a row, and I was really proud of myself. 

42:55
Dr. Khoshal Latifzai
And then the chamber just got booked wall to wall. 

42:58
Dr. Jill Carnahan
Hey guys, just a reminder. If you haven't yet got a copy of my book unexpected, you can find it anywhere. Books are sold on Amazon or Barnes and Noble or wherever. It's been a bestseller and garnered rave reviews for the last three years. But if you haven't yet read it, you will find all kinds of practical advice and wisdom for treating complex chronic illness, including cancer, mold related illness, Crohn's and colitis, and many more. And if you want a signed copy personally by me, you can purchase this on our store@drjill health.com I will personally sign the book and send it out to you. Okay, let's get back to our show. Man, you're like so great. I do think that's one of the, and I'm wondering with. 

43:39
Dr. Jill Carnahan
So I had an experience with cellular therapies and hyperbaric and I felt like the hyperbaric really augmented the effectiveness. Do you feel like there's data there to show that? 

43:47
Dr. Khoshal Latifzai
Yeah, I mean, look, this is all anecdotal. So from my personal experience is, you know, we've had, you know, there was a patient here locally, a family who was going to go abroad for cellular therapy. And the kid had anoxic brain injury. And every time that he underwent cellular therapy abroad, there was an improvement in their neurologic function. But the kid was now 10 years old. And according to the parents, it was a big deal to have to travel abroad to seek these forms of therapy, you know, just from a sort of a logistical standpoint, you know, and so they asked for our assistance in doing that form of therapy here. And this was at least five years ago. And I said no. 

44:38
Dr. Khoshal Latifzai
Look, I, you know, I, I, it's one thing to have a conversation with a patient and explain the pros, the cons, the risks, the potential benefits, the alternatives. But, you know, with experience, kid, I can't really do that. And so, you know, we said no. And finally, you know, after several back and forths, we agreed to have the kid undergo cellular therapy. And the results were so remarkable that they began to tell, you know, they were part of a support group Online where other parents were asking like, hey, what did you do? And so they, they discussed this on that forum. And then were inundated with phone calls from parents and for a lot of them, we turned them away. And I had, you know, just because I didn't feel comfortable. 

45:29
Dr. Jill Carnahan
Yeah. 

45:29
Dr. Khoshal Latifzai
You know, and there was. And so I finally said, look, let meet with their neurologists, you know, and these neurologists were all over the country and some of them, you know, from academia, they were totally on board and they said, look, I've kind of reached my limit as to what I can offer, you know, these kids. 

45:47
Dr. Jill Carnahan
Yeah. 

45:48
Dr. Khoshal Latifzai
And if you think that this is going to work, even if it's anecdotal, you know, explain that to the patients, make sure that, you know, the parents are on board and then you can do it in, you know, that feedback. At the other end of the extreme, you know, there was neurologists saying, look, there's no large placebo controlled, double blind, multicentered, multi year studies. And so I have a hard time recommending this and I don't think there's a wrong answer. 

46:18
Dr. Jill Carnahan
Yeah. 

46:18
Dr. Khoshal Latifzai
You know, and what I realized is if you're the patient and your doctor tells you, what I've told these parents is like, look, there are no double blind placebo controlled studies. These studies are probably going to take many years to do. And so right now we don't know how effective this therapy is going to be for you or for your child. So if you want to wait, that's okay, you know, but if you want to undergo it, like, let's talk about that. And you know, there's plenty of parents who say, like, look, I don't want to wait for those. 

46:53
Dr. Jill Carnahan
Right, right. 

46:54
Dr. Khoshal Latifzai
By the time they kind of sort of come out, you know, I don't want to miss out on any potential good that might stem from these forms of therapies. So let's do something about it. And so, you know, we've done, that's true informed consent. 

47:09
Dr. Jill Carnahan
Like, like, let's just go there because that is truly like you're saying. I really just wanted to pause there because I think that so important I do the same thing in some things that I'm like, we don't have a lot of evidence, but I do feel like this is likely safe and it's always that balance. Right. If it's something super risky, you're going to take a lot more precaution and say, huh, this could actually be dangerous for X, Y and Z. But if you've had some experience, you can say it's likely safe. We've not seen cases of harm anecdotally, and the potential is pretty great, but we just can't promise anything. It's, I mean, right. That's the true informed consent. 

47:43
Dr. Jill Carnahan
Like, and then someone can decide, but how wonderful would be to offer it because so many places would not even offer, you know, we know. 

47:50
Dr. Khoshal Latifzai
Right, right. And, you know, in conventional medicine, and I don't think a lot of people realize this, and maybe if they're in your audience, you know, given your own story, maybe they do know this just from you personally. If, you know, there's a ceiling to what conventional medicine has to offer. And when you know, I don't think most patients know that. You know, just from my own experience, I think a lot of patients, for example, they'll regard surgical intervention as the ultimate, like, answer, right? Where they say, hey, if I need a knee replacement, like this knee replacement at age 40 is going to last me the rest of my life. Right? And it's like, no, actually, you know, you're probably looking at several revisions and, you know, another implant at least, you know, at some point in your life. 

48:40
Dr. Khoshal Latifzai
And that's assuming that the surgery goes well, you know, even then you might not have the return of function that you think you're going to have. Like, there is this ceiling that you're going to run up against at some point. And I think that was the big feedback from a lot of these neurologists where they said, hey, all I can. 

49:00
Dr. Jill Carnahan
Offer, we've done everything we can, so go ahead and try as long as the patient knows that there's. 

49:05
Dr. Khoshal Latifzai
Exactly. 

49:05
Dr. Jill Carnahan
And yeah, I really love that though, because I feel like you and I are on this edge of really trying to push medicine into a new frontier. And the only way you can do that is be open minded and say, what else is possible and how do we keep our patients safe? Like, we do the look at every last piece of data and say, okay, this is what I can say is true. This is what we don't know. But only those physicians who are willing to go out there and be curious about what else is possible can really, like, we're, we can move the needle, but if you're not being curious, and then there's some things, you know, 10 years ago we felt were great and we're like, you know what? I don't think that's all that. Right, right. 

49:41
Dr. Khoshal Latifzai
Absolutely, absolutely. And there's tons of those examples where, you know, we prescribe a medication, we think it's going to do X. And then it turns out, you know. 

49:51
Dr. Jill Carnahan
It'S, it's Celebrex. Right. I mean, you name it, like, it. 

49:55
Dr. Khoshal Latifzai
Increases your risk of stroke. 

49:56
Dr. Jill Carnahan
Yeah. So let's talk a little mitochondria. One of my favorite topics, because I just see so much power when we really, I mean, whether it's a cell danger response or whether it's the mitochondrial peptides or what do you think is up and coming? What do you feel like is some of your favorites? It might be something as simple as ala, but like basic mitochondria, what is cutting edge and what do you see as future of mitochondrial medicine? 

50:18
Dr. Khoshal Latifzai
You know, something that is really underutilized is hyperbaric oxygen therapy. You know, and I have had so many patients with, you know, fatigue, and certainly it's not the only thing that we used to sort of help them out. There was a lot of other things. But once we started doing the hyperbaric oxygen therapy, you know, a lot of those patients saw a positive. You know, I had several patients with really severe concussions. These are athletes who sustained, you know, bike accidents or maybe they were playing football or wrestling or some sort of contact sport. And in their symptoms from the post concussive syndrome were just so overwhelmingly limiting in terms of, you know, what they do on a day to day. These are like CEOs that can't like show up to work, you know, for months after, you know, their index injury. 

51:13
Dr. Khoshal Latifzai
And we started doing, you know, what they do at some academic centers for stroke. So somebody sustains a stroke, they, you know, they undergo hyperbaric oxygen therapy. And, and it's been a real game changer for a lot of our patients. But you know, ozone therapy can also help with mitochondrial function things like glutathione and other antioxidant RLA or ALA. You know, that's really excellent stuff. 

51:42
Dr. Jill Carnahan
Are you doing IV ALA or sorrel? 

51:46
Dr. Khoshal Latifzai
Yeah, we do IVs here, but as much as possible, I want the patient to have sort of control over it. So if there's an oral alternative that they can potentially use at home, that's great. And you know, we don't make any of our own peptides, we don't sell our own peptides, but there's really great. I know you've partnered with, you know, a few of them and some of them are located here in Colorado. That, you know, we. We prescribe and. And they do great on, like, the oral formulation. But for those patients who, for whatever reason, maybe they're not responding to the oral formulation and they want to come into the office, absolutely. We can definitely do it here in the office. 

52:26
Dr. Jill Carnahan
Awesome. What? It's so much fun to talk to you and just get to know what you're doing better because it feels so aligned, and I really respect, you know, going to the foundations and all of that, and then also on the top offering what you're doing. Is there anything that you've just seen in the last year or so that you think is, like, up and coming in the next phase of longevity medicine? 

52:48
Dr. Khoshal Latifzai
You know, as is true for, you know, conventional medicine in general, it, like, I really feel like women's health has. Has historically taken a back seat. And I know I'm probably preaching to the choir here, but I remember, you know, being in med school and thinking about, you know, being in. In. In class about reproductive health, for instance, and then you take your, you know, ob gyn, you're on your OBGYN clerkship, and you're looking around and you're like, yeah, this is kind of the forefront. Like, I'm glad, you know, this discrimination against women is in the rearview mirror and, you know, moving forward, like, things are totally different. But even now, I think, you know, women's health has taken a backseat. And it's funny, because now everybody else, and I'm the only male in this office, which is. 

53:42
Dr. Khoshal Latifzai
And I feel perfectly fine with that. But, you know, I've had female patients for years now, you know, some of them for, like, eight years. And I'll say, hey, it really looks like your hormones are in a place where you would benefit from hormone replacement therapy. And what I'd like to do is to ask a female provider, either Colleen, my wife, or Sarah or Pa, to come in and sit in on this part of the meeting and sort of talk to you about hormone replacement therapy? And they go, well, you don't need to do that. If you think I need something, just tell me what I need. And I say, like, look, just humor me for a second. Let them kind of sit in. And I'm going to be a fly on the wall and just kind of listen to this conversation. 

54:26
Dr. Khoshal Latifzai
And within, like, five minutes of them meeting, you know, they'll talk about stuff that has never come up during the conversation for years. And I. I think there is value in that. Female provider, female patient. Even though, like, look, I don't take it personally. You Know, I'm just kind of a fly on the wall listening to this conversation. But you appreciate that it's really, like, it's really difficult to know the ins and outs of what somebody is going through. And just that easy, like, gender difference turns out to be a big deal, you know, because within five minutes, they'll start opening up that you're like, you know, this is. You know, this is. This is kind of weird because, like, this never came up during the course of discussion. 

55:14
Dr. Khoshal Latifzai
And so, you know, something that Colleen launched along with, you know, as part of her sort of outreach to female clients is an educational program where she teaches them about, you know, it's just kind of a webinar. It's video recorded, but it has PowerPoint slides. It kind of goes through, like, a woman's cycle and what to expect during different parts of different phases of the cycle. What different hormonal deficiencies can mean, both in terms of symptoms and in terms of things that you might be completely oblivious to. But they're equally important because at some point down the line, they can turn into morbidity and causes of mortality. So you want to pay attention to those things in the here and now to avoid a bad outcome at a later time. 

56:03
Dr. Khoshal Latifzai
So I think as far as this clinic goes, I think that's been a huge game changer, where, you know, our patient mix previously was like, 75% men, 25% women, because I was seeing all. 

56:16
Dr. Jill Carnahan
The athletes from the gym and everything. 

56:19
Dr. Khoshal Latifzai
Yeah, exactly. And now I'm glad that it's starting to close in on that 50 mix. And, you know, and Colleen and Sarah have been really instrumental in that. So I'm really excited about that. 

56:33
Dr. Jill Carnahan
That's amazing. And, yeah, you can't go anywhere without hearing about menopause and women's health now. And I agree with you. Twenty plus years ago, Women's Health Initiative came out, and it was such a scam about what were told. And then obviously, now the door is open to really help these women. And if we're talking cardiovascular, there's nothing better that we could do, so. 

56:53
Dr. Khoshal Latifzai
Yeah, yeah, absolutely. Absolutely. But, you know, just kind of like, as a male, I'm sort of disappointed by how backwards we are still. And I didn't have that perspective back in medical school where I thought this was, like, the better than this. And I've had so many discussions with OBGYNs where, you know, I've said, like, look, I think this patient would benefit from hrt. And they asked like, well, isn't that the Purview of an endocrinologist. I usually refer these patients out. 

57:26
Dr. Jill Carnahan
Yeah. And you're like, no. 

57:27
Dr. Khoshal Latifzai
And it's like, well, good luck getting in with an endocrinologist, because here in Colorado, and I'm sure it's the same way across the nation, and it's really difficult to get in with an endocrinologist because they're accustomed to treating complex diabetes or, you know, complex thyroid diseases. They don't want to be managing a woman's hormones. That really is the purview of either primary doctor or an obgyn. And I just think there are a lot of women sort of suffering with their symptoms, and by extension, this should really appeal to men. I think there's a lot of families and men suffering because their. Their wives, like, you know, their partners are suffering. And so it kind of like, really limits, you know, the entire family. 

58:11
Dr. Jill Carnahan
So amazing that you're having that. So this is so cool and so great to go deep and hear about all the great stuff you're doing. If people want to know more about your clinic or want to reach out, what is the best website or place for them to go? 

58:25
Dr. Khoshal Latifzai
Yeah, the company URL. Our clinic's URL is rmrmco.com and RMRM, the acronym for our practice, Rocky Mountain Regenerative medicine. Color like colorado.com and pretty soon here I'm going to be starting a substack account and starting to publish and print, and we'll see where that goes. So I think the clinic website is probably going to be the best resource. 

58:55
Dr. Jill Carnahan
We'll be sure. And if you're driving, wherever you're at listening to this, you will get the links on the show notes wherever you listen, whether It's Spotify, iTunes, YouTube, whatever. So we'll have all that there. Thanks for being a great neighbor. Thanks for doing the work that you're doing. And it's just encouraging to talk because the world needs more of this kind of medicine, and the more we can support each other, the better, because I really think all patients need to see you or me or someone like us. Right. 

59:20
Dr. Khoshal Latifzai
Yeah. Well, thank you so much for having me and thank you for being an inspiration because your. Your story is amazing. And, you know, before the podcast started, I told you that I recently heard one of your talks, and I've heard that one before, and every time I hear it gets better and better. 

59:35
Dr. Jill Carnahan
So thank you so much. Thanks for coming on the show. Hey, everybody. Hope you enjoyed that amazing episode with Dr. K on longevity trends in medicine. It was really fun to talk through all the similarities and just going to the root cause of immune resilience and longevity, checking for risk of cancer, heart disease and all that. And then on top of it, some of the amazing therapies that we have available to us. So hopefully you learned something there. As you well know, we're out every week with a new episode. You can catch us on itunes, Spotify, wherever you listen to podcasts, and on YouTube, where we now have over 700,000 subscribers. I hope that if you aren't yet a subscriber, you will click to join and click that bell to be notified of future episodes. 

01:00:21
Dr. Jill Carnahan
And I will see you again next week for another episode of Resiliency Radio right here.