Don Colbert's Blog

A widely shared electron microscopy study found that the brain’s own housekeeping cells begin consuming synaptic material after even one night of lost sleep, and that chronic sleep restriction activates the brain’s immune cells in a way that may leave lasting vulnerability. Here is what the research genuinely established, and where the popular retelling overstates it.

I have spent decades telling patients that sleep is not a luxury. Most nod politely and go on treating it as the one thing in their schedule that can always be shortened. So when research emerges showing measurable structural changes in brain tissue after sleep loss, I pay close attention, because it turns an abstract warning into something you can see under a microscope.

The claim circulating online is dramatic: your brain starts eating itself when you do not sleep. The study behind it is real and important. The framing needs some care. Let me give you both.

First, A Correction Worth Making

Getting the citation right

The post that spread this finding attributes it to Nature Communications, volume 8, page 1787. That is not where this study appeared.

The correct source is Bellesi, M., de Vivo, L., Chini, M., Gilli, F., Tononi, G., and Cirelli, C. (2017). Sleep Loss Promotes Astrocytic Phagocytosis and Microglial Activation in Mouse Cerebral Cortex. Journal of Neuroscience, 37(21), 5263 to 5273. It comes out of the Center for Sleep and Consciousness at the University of Wisconsin, and Giulio Tononi and Chiara Cirelli are among the most respected sleep researchers working today.

I mention this not to be pedantic but because it matters. When a health claim travels with a wrong citation attached, it becomes impossible for a careful reader to check. And the actual paper is strong enough that it does not need embellishment.

What The Researchers Measured

8 hrsof sleep deprivation was enough to increase astrocytic phagocytosis~5 daysof sleep restriction before microglia showed activation3D EMserial block-face electron microscopy of mouse frontal cortexMeet The Two Cell Types At The Center Of This

Most people know about neurons. Fewer know that neurons are outnumbered by support cells called glia, and two types of glia drive this story.

Astrocytes

Star-shaped cells that supply neurons with nutrients, regulate neurotransmitters, maintain the blood-brain barrier, and prune worn synaptic components. Think of them as the maintenance crew that keeps the wiring in good repair.

Microglia

The brain’s resident immune cells. They patrol for damage and infection, clear debris, and engulf dying cells. Useful in short bursts. Damaging when chronically activated, which is a hallmark of neurodegenerative disease.

Using serial block-face scanning electron microscopy, which reconstructs brain tissue in three dimensions at extraordinary resolution, the Wisconsin team examined the frontal cortex of mice under four conditions: normal sleep, spontaneous wakefulness, acute sleep deprivation of about eight hours, and chronic sleep restriction over roughly five days.

What They Found

Astrocytic phagocytosis increased after both acute and chronic sleep loss. The astrocytes were consuming synaptic components, predominantly the presynaptic portions of large synapses, meaning the biggest and most heavily used connections.

Microglial activation was different. It appeared only after chronic sleep restriction. Those microglia showed morphological signs of activation and increased engulfment of synaptic elements, and notably this occurred without obvious markers of neuroinflammation in the cerebrospinal fluid. The immune cells were stirred up before any conventional inflammatory signal would have flagged it.

The Authors’ Actual Conclusion
Sustained microglial activation from prolonged sleep disruption may predispose the brain to further damage. The concern is not that sleep loss directly destroys the brain but that it primes the immune machinery, potentially leaving tissue more vulnerable to a second insult later.

Where “Eating Itself” Goes Too Far

Here is the nuance the viral version leaves out, and it changes the picture meaningfully.

The astrocyte activity is not straightforwardly destructive. Cirelli, one of the study’s authors, has noted that this pruning of large, heavily used synapses may partly represent appropriate housekeeping, clearing worn-out components from connections that have been working hardest. Synaptic pruning is a normal and necessary process. The brain does not maintain every connection indefinitely, and it should not.

So astrocytes ramping up after sleep loss is not automatically the brain cannibalizing itself. It may be the maintenance crew working overtime because you gave them more wear to repair and less time to do it.

The genuinely worrying finding is the microglial piece, and specifically that it required chronic restriction rather than a single bad night. Sustained microglial activation is associated with neurodegeneration. That is the signal that deserves your attention.

Three limits to keep in view

These were mice. Mouse sleep architecture differs substantially from human sleep, and human brains have not been examined this way for obvious reasons.

This study did not measure Alzheimer’s risk. It measured cellular behavior in cortex. The connection to dementia is a reasonable inference from other lines of evidence, not something this paper demonstrated.

One rough night is not the concern. The findings that alarm researchers came from sustained restriction, not from a single late evening or an occasional broken night of sleep.

“I do not need to frighten you about one bad night. I do need to be honest with you about ten years of five-hour nights, because that is the pattern I actually see in my practice.”

Dr. Don Colbert, MD

Sleep As The Brain’s Cleaning Cycle

This research sits alongside another body of work that I find equally compelling. Researchers have described a waste-clearance network in the brain called the glymphatic system. During deep slow-wave sleep, the spaces between brain cells expand considerably, allowing cerebrospinal fluid to flush metabolic debris out of brain tissue.

Among the substances cleared is amyloid-beta, the protein fragment that accumulates in Alzheimer’s disease. Studies have found that even a single night of sleep deprivation can raise amyloid-beta levels in the human brain on imaging, and that chronic short sleep in midlife is associated with higher amyloid burden years later.

Put the two lines of evidence together and a coherent picture emerges. Sleep is when the brain performs both maintenance and sanitation. Cut it short repeatedly and you compromise both. There is no supplement, no energy drink, and no productivity technique that substitutes for it, because nothing else opens those channels.

A Word Of Encouragement

“It is vain for you to rise up early, to sit up late, to eat the bread of sorrows: for so he giveth his beloved sleep.”

PSALM 127:2

That verse has always struck me as one of the most practical in Scripture. It names the anxious striving that keeps people awake, and it calls rest a gift rather than a weakness. Many of my patients do not have a sleep disorder. They have a trust problem that expresses itself at eleven o’clock at night. Learning to lay the day down is spiritual work with measurable physiological consequences.

How To Protect Your Sleep

Eight Steps I Recommend

1Hold a consistent wake time, seven days a week. Your circadian rhythm anchors to when you wake far more than to when you go to bed. Sleeping in on Saturday undoes much of the week’s progress.2Get morning light within an hour of waking. Ten to twenty minutes of outdoor light sets the timing of melatonin release that evening. This is free and remarkably effective.3Get evaluated for sleep apnea if there is any suspicion. Loud snoring, witnessed breathing pauses, morning headaches, or waking unrefreshed despite adequate hours all warrant testing. Untreated apnea fragments deep sleep badly.4Cut caffeine by early afternoon. Caffeine has a half-life of roughly five to six hours, and longer in some people. A three o’clock coffee is still working at nine.5Be honest about alcohol. It helps you fall asleep and then suppresses REM and fragments the second half of the night. Many people who believe they are poor sleepers are simply evening drinkers.6Keep the bedroom cool and genuinely dark. Around 65 to 68 degrees suits most people. Core body temperature must drop for deep sleep to consolidate.7Build a wind-down that is not a screen. Thirty to sixty minutes of dim light and low stimulation. Scripture, a paper book, prayer, quiet conversation. Give your nervous system a runway.8Treat chronic insomnia properly. Cognitive behavioral therapy for insomnia is the first-line treatment and outperforms sleep medication over the long term. Ask your physician about it before reaching for a prescription.The Bottom Line

A carefully conducted electron microscopy study found that sleep loss increases astrocytic consumption of synaptic components and that several days of sleep restriction activates microglia in ways that may leave the brain more vulnerable. That is real, it comes from an excellent laboratory, and it should be taken seriously.

It is also mouse research, some of the astrocyte activity may represent normal maintenance rather than damage, and the study did not measure dementia risk directly. The alarming shorthand about your brain eating itself outruns the data.

What holds up without any exaggeration is this. Sleep is when your brain repairs and cleans itself, that process cannot be replaced or postponed, and chronic short sleep across years is one of the more consequential things you can do to your future brain. Protect it the way you would protect anything else you cannot buy back.

Frequently Asked Questions

Does one night of poor sleep damage my brain?

The findings that concern researchers most, particularly microglial activation, followed several days of sustained sleep restriction rather than a single night. Occasional short sleep is a normal part of life. The risk lies in chronic patterns.

Is the brain really eating itself during sleep loss?

That phrase overstates it. Astrocytes did increase consumption of synaptic components, but researchers have suggested some of this may be appropriate clearing of worn parts from heavily used connections. The clearer concern is sustained microglial activation after chronic restriction.

Can catching up on sleep at the weekend fix a short week?

Partially at best. Weekend recovery sleep restores some measures of alertness but does not fully reverse metabolic and cognitive effects, and shifting your wake time disrupts circadian timing for the following week. Consistency outperforms catch-up.

How much sleep do adults actually need?

Most adults require seven to nine hours. A small minority genuinely function well on less, but far more people believe they belong to that group than actually do. If you rely on an alarm and feel drowsy mid-afternoon, you are likely under-slept.

Sources

Bellesi, M., de Vivo, L., Chini, M., Gilli, F., Tononi, G., & Cirelli, C. (2017). Sleep Loss Promotes Astrocytic Phagocytosis and Microglial Activation in Mouse Cerebral Cortex. Journal of Neuroscience, 37(21), 5263 to 5273.
Xie, L., et al. Sleep drives metabolite clearance from the adult brain. Science.
Shokri-Kojori, E., et al. Beta-amyloid accumulation in the human brain after one night of sleep deprivation. PNAS.

Disclaimer: These statements have not been evaluated by the Food and Drug Administration. This content is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. The research discussed was conducted in animal models. If you experience persistent insomnia, excessive daytime sleepiness, or suspect sleep apnea, please consult a qualified healthcare provider rather than self-treating.

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Researchers in London have developed engineered nanoparticles that cleared up to 60 percent of toxic brain plaque in mice within a single hour. It is one of the most interesting ideas in Alzheimer’s research in years. It is also entirely preclinical, and understanding why that distinction matters will make you a better steward of your own brain.

A headline has been circulating that reads, roughly, “a new treatment literally removes Alzheimer’s plaque in just one hour.” I have had patients forward it to me with real hope in the message. I understand that hope. I share the excitement about the underlying science. And I owe you a truthful accounting of what this actually is.

The short version: this Alzheimer’s nanoparticle treatment is a genuinely creative approach that worked impressively in mice. No human being has received it. No clinical trial has begun. And there is a great deal you can do for your brain today that does not require waiting a decade.

The Study In Brief

50-60%reduction in brain amyloid-beta within one hour of injection3doses administered across the treatment course0human beings who have received this therapy to dateFixing The Plumbing Instead Of Attacking The Plaque

To appreciate what makes this approach different, you need to understand how most Alzheimer’s drug development has gone.

For roughly thirty years the dominant strategy has been to attack amyloid-beta directly. Amyloid is a protein fragment that accumulates into plaques between neurons in the Alzheimer’s brain. The reasoning was straightforward: the plaque is the problem, so remove the plaque. Enormous sums have been spent on antibodies engineered to bind amyloid and mark it for clearance. Most failed. A few recent ones reached approval with modest slowing of decline and meaningful safety concerns, including brain swelling and microbleeds.

The team at University College London, led by Professor Giuseppe Battaglia with first co-author Dr. Junyang Chen and Professor Lorena Ruiz Perez, asked a different question. Instead of hunting the plaque, what if you repaired the system that is supposed to remove it?

The Key Concept
A healthy brain already clears amyloid continuously. A protein called LRP1, embedded in the blood-brain barrier, acts as a molecular ferry that recognizes amyloid-beta and carries it out of brain tissue and into the bloodstream for disposal. In Alzheimer’s disease, that ferry service degrades. The problem may be less that the brain is producing too much waste and more that it has stopped taking out the trash.

The London team engineered what they call supramolecular drugs. These are nanoparticles assembled with precisely controlled size and specific surface molecules that mimic the natural ligands LRP1 recognizes. Critically, the nanoparticle is not a delivery vehicle carrying a drug inside. The particle itself is the medicine. Its structure and surface are what do the work.

When these particles engage LRP1 at the blood-brain barrier, they reactivate that stalled transport pathway. In effect, they restart the brain’s own waste-clearance plumbing.

What Happened In The Mice

The results in the animal model were, I will say plainly, remarkable.

Within one hour of injection, brain amyloid-beta dropped by 50 to 60 percent. Not over weeks of treatment. Within an hour. Only three doses were administered in total.

The longer-term findings are arguably more interesting than the speed. Researchers treated mice at twelve months of age, roughly equivalent to a human in their sixties, which is to say well into the disease process rather than at its beginning. Six months after treatment, those mice had recovered behavioral patterns matching healthy animals, and brain imaging showed a dramatic reduction in plaque compared with untreated mice.

Six months is a substantial fraction of a mouse’s lifespan. The benefit did not simply flicker and fade. The work was published in Signal Transduction and Targeted Therapy.

“The idea that we should restore the brain’s own clearance system rather than fight its waste product strikes me as both scientifically elegant and quietly biblical. The body was designed to heal itself. Our job is often to remove what is obstructing that design.”

Dr. Don Colbert, MD

Now For The Honest Part

I want to be careful here, because I have seen what false hope does to families managing this disease. It is expensive, it is exhausting, and it displaces attention from things that would actually help.

What this research does not yet show

It has not been tested in a single human being. As of this writing, the work remains entirely preclinical. No investigational new drug application, no regulatory clearance, no Phase 1 trial.

Mouse Alzheimer’s is not human Alzheimer’s. These are genetically engineered animals bred to overproduce amyloid. They do not develop the full complexity of human disease, which involves tau tangles, neuroinflammation, vascular damage, and decades of slow progression. The history of this field is littered with therapies that cured mice and did nothing for people.

Clearing amyloid does not automatically restore cognition. This is the hardest lesson of the last decade. Several drugs successfully removed plaque from human brains while producing little meaningful clinical improvement. Plaque may be a marker of the disease as much as its engine.

The timeline is long. Remaining preclinical work, larger animal studies, toxicology, manufacturing scale-up, and regulatory filings typically take one to three years. Phase 1 through Phase 3 trials for a central nervous system therapy commonly take another six to ten. An optimistic path puts potential availability in the early to mid 2030s. A typical path is longer.

None of that makes the science less impressive. It makes the reporting on it less useful. “Removes Alzheimer’s plaque in one hour” is technically accurate about a mouse and deeply misleading about your mother.

Why The Vascular Angle Still Matters To You

Here is where this research becomes practically relevant, and it is the reason I wanted to write about it at all.

The conceptual shift underneath this study, that Alzheimer’s may be substantially a disease of impaired brain clearance and vascular dysfunction rather than purely a disease of neurons, aligns with a growing body of work. And unlike the nanoparticles, that idea has immediate implications.

Your brain has a waste-clearance system called the glymphatic system. It flushes metabolic debris, including amyloid-beta, out of brain tissue. It runs primarily during deep sleep, when the spaces between brain cells expand considerably to allow cerebrospinal fluid to wash through. It depends on healthy blood vessels and on the integrity of the blood-brain barrier.

Sleep is clearance

Deep slow-wave sleep is when glymphatic flushing peaks. Chronic short sleep has been associated with higher amyloid burden on imaging. This is the most direct lever most people have.

Blood pressure is brain pressure

Midlife hypertension damages the small vessels that supply the brain and compromises blood-brain barrier integrity. Controlling it is one of the best-supported dementia risk reductions available.

Metabolic health protects vessels

Insulin resistance and chronically elevated blood sugar injure the vascular endothelium throughout the body, brain included, and drive the inflammation that degrades barrier function.

Movement drives perfusion

Aerobic exercise increases cerebral blood flow, supports vessel health, and has among the most consistent observational associations with reduced dementia risk of any intervention.

A Word Of Encouragement

“I will praise thee; for I am fearfully and wonderfully made: marvellous are thy works; and that my soul knoweth right well.”

PSALM 139:14

Every time researchers uncover another layer of the body’s design, whether it is a molecular ferry at the blood-brain barrier or a cleansing system that runs while you sleep, I find that verse a little more remarkable. We are not assembling a machine from scratch. We are learning to work with something already built with astonishing care.

What To Do While The Science Catches Up

Six Steps That Do Not Require Waiting

1Prioritize seven to nine hours of quality sleep. Not just time in bed. If you snore, wake unrefreshed, or your spouse reports pauses in breathing, get evaluated for sleep apnea.2Know and manage your blood pressure. Midlife hypertension is one of the most modifiable dementia risk factors identified. Check it at home, not once a year at a rushed appointment.3Address insulin resistance early. Ask for fasting insulin and A1C. Metabolic dysfunction damages brain vasculature quietly for years before symptoms appear.4Move aerobically most days. Brisk walking counts. Cerebral perfusion responds to consistency more than intensity.5Eat for your blood vessels. An anti-inflammatory pattern emphasizing fatty fish, olive oil, leafy greens, berries, and nuts, with refined carbohydrates and processed oils minimized, supports vascular and barrier health.6Be skeptical of anything sold to you on the strength of this study. If a supplement company references brain nanoparticle research or blood-brain barrier repair in its marketing, that is a reason to walk away, not to buy.The Bottom Line

A team at University College London built nanoparticles that reawaken the brain’s natural amyloid export system, cleared most of the plaque from mouse brains within an hour, and restored normal behavior six months later. That is genuinely important work and a legitimately new roadmap for a disease that has resisted nearly everything we have thrown at it.

It is also mouse work, years from any human trial, and by no means guaranteed to translate. Watch for it. Pray for the researchers doing it. And in the meantime, treat your sleep, your blood pressure, your blood sugar, and your daily walk as the brain therapy they already are.

Frequently Asked Questions

When will this nanoparticle treatment be available for people?

No human trial has started. Accounting for remaining preclinical work and the typical duration of Phase 1 through Phase 3 trials for brain therapies, an optimistic estimate places potential availability in the early to mid 2030s, and many therapies at this stage never reach approval at all.

What is LRP1 and why does it matter?

LRP1 is a receptor protein at the blood-brain barrier that binds amyloid-beta and transports it out of the brain into the bloodstream. Its function appears to decline in Alzheimer’s disease, which may allow amyloid to accumulate faster than it is removed.

Can I do anything to support my brain’s clearance system now?

Yes. The glymphatic system that clears brain waste is most active during deep sleep and depends on healthy blood vessels. Consistent quality sleep, treated sleep apnea, controlled blood pressure, stable blood sugar, and regular aerobic exercise all support it.

Why have so many Alzheimer’s drugs failed?

Most targeted amyloid directly. Several succeeded at removing plaque while producing little meaningful cognitive benefit, which suggests plaque may be one feature of a more complex disease involving tau protein, inflammation, and vascular damage rather than its sole cause.

Sources

Chen, J., Ruiz Perez, L., Battaglia, G., et al. (2025). Rapid amyloid-beta clearance and cognitive recovery through multivalent modulation of blood-brain barrier transport. Signal Transduction and Targeted Therapy.
University College London. (2025). Nanoparticles reverse Alzheimer’s pathology in mice. UCL News.
Nedergaard, M., et al. Research on the glymphatic system and sleep-dependent brain clearance.

Disclaimer: These statements have not been evaluated by the Food and Drug Administration. This content is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. The research described is preclinical and has not been tested in humans. No product or protocol described here is a treatment for Alzheimer’s disease or any form of dementia. Always consult your physician regarding cognitive concerns or any change to your health regimen.

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Researchers at the University of Maryland measured what happens inside your blood vessels when you genuinely laugh, and what they found should change how seriously you take joy. Here is the actual science, including the one claim circulating online that goes further than the evidence does.

Solomon wrote that a merry heart does good like a medicine roughly three thousand years before anyone owned an ultrasound machine. When cardiologists finally pointed that ultrasound at the arm of a person watching a comedy, they found he was more literally correct than anyone expected.

I want to talk about laughter and heart health, because it is one of the few areas where ancient wisdom, clinical measurement, and everyday practicality all point in the same direction. It is also an area where the popular retelling has drifted from the research, and I would rather give you the real thing.

What The Ultrasound Showed

+22%average increase in blood flow after watching a comedy-35%average decrease in blood flow after a stressful film30-45minutes the vascular effect persisted after viewingThe Study That Started It

Dr. Michael Miller, a preventive cardiologist at the University of Maryland School of Medicine, ran a deceptively simple experiment. He recruited twenty healthy non-smoking volunteers, averaging about 33 years old and evenly split between men and women. Each person came in twice, with at least forty-eight hours between visits.

On one visit they watched the opening sequence of Saving Private Ryan, which is about as reliable a stress induction as film can produce. On the other visit they watched a segment from the comedy Kingpin. Before and after each viewing, researchers measured something called flow-mediated dilation in the brachial artery of the arm.

Here is how that test works. A blood pressure cuff temporarily restricts blood flow. When the cuff releases, blood rushes back through and the vessel should respond by widening. Ultrasound measures how much it widens. That widening is a direct readout of endothelial function, and endothelial function is one of the best early windows we have into cardiovascular health.

The results were striking. After the comedy, blood flow increased by an average of 22 percent, with nineteen of the twenty volunteers showing beneficial dilation. After the stressful film, blood flow decreased by an average of 35 percent, with fourteen of twenty showing constriction. The effects lingered for thirty to forty-five minutes.

Why The Endothelium Matters
The endothelium is the single-cell lining of every blood vessel in your body. Laid flat it would cover several tennis courts. It regulates vessel tone, controls clotting, and manages inflammation. Endothelial dysfunction is one of the earliest measurable steps on the road to atherosclerosis, appearing long before any blockage shows up on a scan.

Miller repeated and extended the work in 2011, gathering more than three hundred measurements. That follow-up found a 30 to 50 percent difference in vessel diameter between the laughter phase and the mental stress phase. He described the magnitude of change after laughing as consistent with what you might see from aerobic exercise or from a statin.

Let Me Correct One Popular Claim

You may have seen the line making rounds that “two minutes of laughter benefits your heart as much as a twenty-minute walk.” I understand why it spreads. It is tidy, encouraging, and it feels true.

But it is not what the research says, and I will not repeat it as though it were.

What the researchers actually said

Miller compared the magnitude of endothelial change after laughter to what is seen with aerobic activity. That is a comparison of one specific vascular measurement over a short window, not a claim that laughter substitutes for exercise.

His actual recommendation was both: roughly thirty minutes of exercise three times a week, and about fifteen minutes of laughter daily. Not two minutes, and not instead of walking.

These were small studies of short-term vessel behavior in healthy volunteers. No randomized trial has demonstrated that laughter reduces heart attacks or strokes. Miller himself said that such trials are still needed.

Why does this distinction matter to me? Because I have watched patients quietly trade something proven for something pleasant. Laughter is a genuine gift and a legitimate tool. It is not a replacement for walking, for managing blood pressure, or for the unglamorous work of cardiovascular care. Present it honestly and it still stands beautifully on its own.

“I have never had to convince a patient that stress hurts their heart. I frequently have to convince them that joy is not optional.”

Dr. Don Colbert, MD

What Is Happening In Your Body When You Laugh

A real belly laugh sets off a cascade that touches several systems at once.

Nitric oxide release

Laughter appears to prompt the endothelium to release nitric oxide, the body’s own vasodilator. Nitric oxide relaxes vessel walls, reduces inflammatory signaling, and discourages platelets from clumping.

Lower stress hormones

Cortisol and adrenaline drop. Chronically elevated cortisol raises blood pressure, drives visceral fat storage, disrupts blood sugar, and damages the vascular lining over time.

Vagal tone and heart rate variability

Deep laughter engages the diaphragm and stimulates the vagus nerve, shifting you toward parasympathetic dominance. Higher heart rate variability tracks with better cardiovascular outcomes.

Endorphins and pain threshold

Social laughter triggers endogenous opioid release, which is part of why laughing with others raises pain tolerance and why shared laughter bonds people so effectively.

Notice a theme. Almost every one of these is the mirror image of what chronic stress does. Miller put it well when he said that at the very least, laughter offsets the impact of mental stress, which is harmful to the endothelium. If you cannot always add joy, you can at least subtract some damage.

The Kind Of Laughter That Counts

One nuance from this literature deserves emphasis. The studies used mirthful laughter, meaning genuine, spontaneous, felt laughter. Not a polite chuckle. Not a courtesy laugh in a meeting.

There is reason to think the physiological benefit tracks with authenticity. A forced social laugh does not engage the diaphragm the same way, does not produce the same respiratory pattern, and does not carry the same emotional shift. Research on laughter yoga suggests simulated laughter often becomes real laughter within a minute or two, which may be why that practice shows benefit anyway. But the target is the real thing.

Laughter is also profoundly social. People are far more likely to laugh in the presence of others than alone. That fact connects this research to something I have argued for decades: isolation is a cardiovascular risk factor, and community is a cardiovascular intervention.

Ancient Wisdom, Modern Confirmation

“A merry heart doeth good like a medicine: but a broken spirit drieth the bones.”

PROVERBS 17:22

I find it remarkable that Scripture named both directions of this relationship. A merry heart heals. A broken spirit depletes. Three thousand years later a cardiologist put a cuff on twenty arms and watched the vessels open and close in exactly that pattern.

How To Actually Build Laughter Into Your Week

Telling someone to laugh more is about as useful as telling them to relax. Here is what I suggest instead.

Six Practical Steps

1Schedule it like you schedule exercise. Fifteen minutes of something that reliably makes you laugh. A comedy special, a podcast, old clips, whatever works for you. Put it on the calendar rather than hoping it happens.2Laugh with people, not at screens alone. Shared laughter is more frequent, lasts longer, and carries the social bonding benefit on top of the vascular one. Dinner with friends beats a solo scroll.3Audit what you consume before bed. The stress film constricted vessels for up to forty-five minutes. Distressing news and conflict-heavy content late at night are working against both your vessels and your sleep.4Keep the walking. Laughter complements exercise. It does not replace it. Thirty minutes of movement most days remains the foundation, and a walk with someone who makes you laugh gives you both at once.5Practice gratitude alongside it. Gratitude and joy reinforce each other. A short daily practice of naming what you are thankful for makes genuine laughter easier to reach.6Take joylessness seriously. If nothing has made you laugh in weeks, that is clinical information, not a character flaw. Persistent loss of pleasure is a symptom worth discussing with your physician.The Bottom Line

Genuine laughter measurably opens your blood vessels, and mental stress measurably closes them. That much is documented, reproducible, and consistent with everything we understand about the endothelium. The effect is short-lived, the studies were small, and no one has yet proven that laughing more prevents heart attacks.

But here is what I would say to any patient. You are being asked to add something free, pleasant, and available today, with a plausible mechanism, real measured effects, and zero downside. That is an unusually good deal in medicine.

Laugh with people you love. Do it often. And keep walking.

Frequently Asked Questions

Is laughing really as good as exercise for your heart?

No. Researchers compared the size of one short-term vascular change, not overall cardiovascular benefit. Exercise improves fitness, body composition, blood sugar, blood pressure, and mortality risk across decades of study. Laughter is a valuable complement to exercise, not a substitute for it.

How long do the effects of laughter on blood vessels last?

In the University of Maryland research, the improvement in blood flow persisted roughly thirty to forty-five minutes after viewing. This is why frequency matters more than duration.

Does fake laughter work?

The studies measured genuine, spontaneous laughter. Simulated laughter has been studied separately in laughter yoga research and shows some benefit, possibly because forced laughter frequently becomes real laughter within a minute or two.

Can stress really damage my blood vessels that quickly?

A single stressful film reduced blood flow by an average of 35 percent for up to forty-five minutes. That is temporary. The concern is chronic, repeated stress producing that constriction day after day over years.

Sources

Miller, M., et al. University of Maryland School of Medicine. Laughter and endothelial function research presented to the American College of Cardiology, 2005.
Miller, M., et al. Follow-up vascular research presented at the European Society of Cardiology Congress, 2011.
Miller, M., & Fry, W. F. The effect of mirthful laughter on the human cardiovascular system. Medical Hypotheses.

Disclaimer: These statements have not been evaluated by the Food and Drug Administration. This content is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. It is not a substitute for medical care. If you have cardiovascular disease, risk factors for heart disease, or symptoms of depression, please consult your physician. Do not discontinue any prescribed treatment without medical guidance.

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A twenty-year follow-up of one of the most important diabetes trials ever conducted has produced the strongest signal yet that a common, inexpensive medication may help protect the aging brain. I want to walk you through what the researchers actually found, what they did not find, and what it means for the way you guard your memory starting this week.

Every week in my practice I meet someone who is far more afraid of losing their mind than losing their life. That fear is understandable. Alzheimer’s disease and related dementias remain among the few conditions in modern medicine where we still have very little to offer once the process is well underway. So when a study suggests that a drug already sitting in millions of medicine cabinets might cut dementia risk, it deserves a careful look.

The headline making its way across social media says that metformin, a first-line drug for type 2 diabetes that costs pennies a day, may cut later dementia risk by about half. The underlying research is real, it comes from a respected team, and it is genuinely interesting. It is also more complicated than a headline can hold.

The Numbers At A Glance

60%lower odds of dementia in the metformin group compared with placebo1,483participants with long-term cognitive data, median age 7415.5average years of metformin exposure in the treatment armWhere These Numbers Come From

To understand this study, you have to understand the trial behind it. In the late 1990s, researchers launched the Diabetes Prevention Program, a landmark clinical trial that enrolled thousands of adults with prediabetes and randomly assigned them to one of three groups: an intensive lifestyle program built around weight loss and physical activity, metformin, or a placebo.

That original trial ran a little over three years and delivered a clear answer on its primary question. Lifestyle change beat metformin at preventing the progression from prediabetes to full type 2 diabetes, and both beat placebo. Those findings reshaped how we counsel patients with rising blood sugar, and they still hold up.

But the researchers did something unusual and valuable. They kept following the participants. The Diabetes Prevention Program Outcomes Study has now tracked this same group for more than two decades, adding cognitive testing along the way. Between 2009 and 2024, participants completed memory and thinking assessments, and between 2022 and 2024 a panel adjudicated who had developed mild cognitive impairment or dementia.

That is what makes this analysis worth attention. Most of what we know about metformin and the brain comes from observational data, meaning researchers look at people who happened to take the drug and compare them to people who did not. That approach is riddled with confounding, because the people who take a medication differ from the people who do not in a hundred ways you cannot fully measure. Here, the original assignment was randomized. That is a meaningfully stronger foundation.

The Finding That Made Headlines

Among the 1,483 participants with cognitive outcome data, those originally randomized to metformin had roughly 60 percent lower odds of dementia compared with placebo (odds ratio 0.40, 95 percent confidence interval 0.17 to 0.97) and about 62 percent lower odds compared with the intensive lifestyle group (odds ratio 0.38, 95 percent confidence interval 0.16 to 0.89). The metformin group also performed better on memory testing.

Dr. José Luchsinger at Columbia University, who led the work, has described this as the strongest evidence available short of a trial designed specifically around dementia. I think that is a fair characterization.

“When a randomized trial and decades of patience line up behind a finding, I pay attention. But paying attention and changing my prescribing are two very different things.”

Dr. Don Colbert, MD

Now, The Part Most Headlines Left Out

I have been practicing medicine long enough to have watched a great many promising findings evaporate under scrutiny. So let me lay out the honest limitations, because you deserve them.

Four things to hold in mind

1. This is a preprint. The analysis was posted to a preprint server, which means it has not yet completed peer review. Preprints are how modern science moves quickly, and they are useful. They are not final.

2. The estimates are imprecise. The authors say so plainly. There were relatively few dementia cases, and when case counts are small, the confidence intervals stretch wide. Notice that the upper bound of the comparison against placebo reaches 0.97, which sits right at the edge of statistical significance.

3. The overall picture was more muted. When researchers looked at the full distribution of cognitive syndromes across all three groups, the differences were not statistically significant. The dementia signal is a piece of the picture, not the whole of it.

4. This trial was never designed to study the brain. Cognition was added later. That is a legitimate way to generate a hypothesis. It is not the same as testing one.

There is also an oddity worth sitting with. The intensive lifestyle group, the arm that did the best job preventing diabetes itself, showed the highest dementia rate of the three. If the entire benefit were simply about better blood sugar control, you would expect the lifestyle group to do at least as well as metformin. It did not. Either something specific to the drug is at work, or the numbers are noisier than they appear. Both explanations are live.

Why Blood Sugar And The Brain Are So Tightly Linked

Whatever the final verdict on metformin, the broader connection here is not in dispute, and it is the part I want you to carry with you.

Researchers have started calling Alzheimer’s disease “type 3 diabetes,” and while that label is an oversimplification, it points at something real. The brain is a spectacularly energy-hungry organ. It makes up about two percent of your body weight and consumes roughly twenty percent of your energy. When insulin signaling breaks down in brain tissue, neurons struggle to access the fuel they need. Chronic high blood sugar also damages the small vessels that feed the brain, drives inflammation, and accelerates the formation of advanced glycation end products, which are exactly as unpleasant as they sound.

Worth Knowing
People with type 2 diabetes carry roughly a 50 to 70 percent higher risk of developing dementia than people without it. That relationship has been documented across many populations and many years, and it is far more established than any single drug finding.

The possible mechanisms proposed for metformin follow that same logic: reduced vascular inflammation, better glucose handling, and shifts in immune signaling. None has been proven to be the main pathway. The researchers are candid about that.

Should You Ask Your Doctor For Metformin?

Let me be direct, because I think vagueness does patients a disservice here.

No, not on the basis of this study. This finding does not license anyone to prescribe metformin as an anti-dementia pill, and any physician who tells you otherwise is getting ahead of the evidence. Metformin is a well-tolerated drug with a long safety record, but it is not free of consequence. It can cause significant gastrointestinal upset. It is associated with vitamin B12 depletion over the long term, which carries its own neurological implications, and I check B12 levels in every patient of mine who takes it for an extended period. It is not appropriate for people with certain kidney or liver conditions.

What this research does justify is the set of trials now underway testing metformin directly against Alzheimer’s disease and related decline, some in combination with lifestyle programs. If those confirm a benefit, we will have something remarkable: an inexpensive, widely available tool against a disease that is otherwise devastating to treat. That is a result worth waiting for properly.

If you already take metformin for diabetes or prediabetes, this is quiet encouragement to keep taking it as prescribed. If you do not, the conversation to have with your physician is about your metabolic health as a whole, not about one drug.

A Word Of Encouragement

“For God hath not given us the spirit of fear; but of power, and of love, and of a sound mind.”

2 TIMOTHY 1:7

I quote that verse often, and not casually. Fear of cognitive decline can itself become corrosive, driving people toward expensive supplements they do not need and away from the ordinary, unglamorous habits that carry the real evidence. A sound mind is worth stewarding well, and stewardship looks less like chasing headlines and more like faithfulness in small daily things.

What Actually Moves The Needle Right Now

Here is what frustrates me about the way these stories travel. The metformin finding is uncertain and years from being actionable. Meanwhile, the interventions with the strongest evidence for protecting cognition are available to you this afternoon and cost nothing.

The Lancet Commission on dementia prevention has estimated that a substantial share of dementia cases worldwide are linked to modifiable risk factors. Not all of them, and not with certainty for any individual person. But a meaningful share. That is where your energy belongs.

Seven Steps I Give My Own Patients

1Get your fasting insulin and A1C tested, not just fasting glucose. Insulin resistance shows up in your bloodwork years before glucose does. You cannot manage what you have not measured.2Cut the refined carbohydrates and added sugars first. Before you add a single supplement, remove the sugary drinks, the white flour, and the ultra-processed snacks. This is the highest-yield change most people can make.3Walk after meals. Ten to fifteen minutes of easy walking after eating blunts the post-meal glucose spike measurably. It is the single most underused metabolic tool I know of.4Build and keep muscle. Skeletal muscle is your largest glucose sink. Resistance training twice a week does more for your blood sugar in your sixties and seventies than almost anything else.5Protect your sleep and get apnea evaluated. Untreated sleep apnea worsens insulin resistance and independently raises dementia risk. If you snore heavily or wake unrefreshed, get tested.6Treat blood pressure and hearing loss seriously. Both are on the modifiable risk list and both are routinely neglected. Hearing aids are not vanity items. They are cognitive protection.7Stay in community. Social isolation is a documented dementia risk factor. Church, family, friendships, and service are not soft recommendations. They are part of the protocol.The Bottom Line

A twenty-year randomized follow-up found that people originally assigned to metformin had substantially lower odds of developing dementia. The finding is real, it is the strongest of its kind so far, and it is also preliminary, imprecise, not yet peer reviewed, and drawn from a trial that was never built to answer this question.

Hold it loosely. Watch for the dedicated trials. And in the meantime, put your effort where the evidence is already settled: stabilize your blood sugar, move your body, sleep well, protect your hearing, and stay connected to the people God has placed around you. Those are not consolation prizes while we wait for a drug. They are the main event.

Frequently Asked Questions

Does metformin prevent Alzheimer’s disease?

No study has shown that. This research found lower odds of dementia among people randomized to metformin decades earlier, but the estimates were imprecise, the analysis has not been peer reviewed, and dedicated trials testing metformin against Alzheimer’s are still in progress.

Can I take metformin if I do not have diabetes?

Metformin is a prescription medication and its off-label use for longevity or brain health remains unproven and is an individual decision to make with your physician. It carries real side effects, including gastrointestinal symptoms and long-term vitamin B12 depletion.

Why did the lifestyle group have more dementia than the metformin group?

That is one of the puzzling aspects of the results and the researchers do not have a confirmed explanation. It may reflect a drug-specific mechanism, or it may reflect statistical noise from a small number of dementia cases. This is precisely why the findings need confirmation.

Is high blood sugar really connected to dementia risk?

Yes, and this part is well established independent of any metformin finding. Type 2 diabetes is associated with a substantially elevated risk of dementia, likely through vascular damage, chronic inflammation, and impaired insulin signaling in brain tissue.

Sources

Luchsinger, J. A., et al. (2026). Randomized metformin and cognitive outcomes in the Diabetes Prevention Program Outcomes Study. medRxiv preprint. DOI: 10.64898/2026.08.05.26359234.
Diabetes Prevention Program Research Group. Long-term follow-up analyses, Diabetes Care, 2025.
Livingston, G., et al. Dementia prevention, intervention, and care: Lancet Commission reports.

Disclaimer: These statements have not been evaluated by the Food and Drug Administration. This content is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. Metformin is a prescription medication and should only be taken under the supervision of a licensed healthcare provider. Always consult your physician before starting, stopping, or changing any medication or supplement, particularly if you are pregnant, nursing, managing a medical condition, or taking other medications.

The post Metformin and Dementia Risk: What a 20-Year Follow-Up Actually Found appeared first on .

Dr. Colbert’s Broadcast • Pickleball, Longevity & Healthy Aging • Episode 4

Pickleball vs. The Gym: Which Is Better for Aging? | Dr. Don Colbert, MD Ep. 4

A 25-year Danish study ranked ordinary leisure activities by the life expectancy associated with each one, and the order surprised almost everybody, including the people putting in serious hours at the gym. In this episode of Dr. Colbert’s Broadcast, Dr. Don Colbert, MD, Kyle Colbert, and Mary Colbert work through what that research actually found, why the social side of a racket sport may be doing much of the work, what pickleball does for the aging brain and for balance, and how to start playing without ending up in a wrist cast.

Featuring Dr. Don Colbert, MD, Kyle Colbert, and Mary ColbertRead this before your first game

Pickleball looks gentle, and that is exactly how people get hurt. Warm up for 15 to 20 minutes, wear court shoes rather than running shoes, and never backpedal for a lob: turn and run. The single most common serious injury in the sport is a wrist fracture from falling backward onto an outstretched hand.

If you have heart disease, uncontrolled blood pressure, a recent injury or surgery, or you have been sedentary for a long stretch, talk with your clinician before you start. Stop and seek prompt medical attention for chest pain or pressure, unusual shortness of breath, dizziness or fainting, or an irregular heartbeat.

9.7 yearsthe additional life expectancy associated with tennis in the Copenhagen City Heart Study, the largest of any activity measured1.5 yearsthe figure for health club activity in that same study, the smallest of the eight activities tracked8 weeksthe length of the pickleball program tested in pre-frail older adults, where measures of gait and coordination improvedJump to a sectionThe Danish Study Why Social Matters Pickleball vs. The Gym Start for Free Brain & Balance Frailty & Falls Injury Prevention Hydration & Recovery Products DiscussedThe study behind the claim

Kyle opens the episode with a setup: there is an activity associated with roughly ten extra years of life, and it is not running, not swimming, not weightlifting. It is a racket sport.

The source is the Copenhagen City Heart Study, which followed about 8,500 Danish adults for roughly 25 years and compared life expectancy across eight leisure-time activities. Tennis sat at the top by a wide margin. Badminton, the other racket sport in the data, came second.

ActivityYears of life expectancy associated with itTennis9.7Badminton6.2Soccer4.7Cycling3.7Swimming3.4Jogging3.2Calisthenics3.1Health club activity1.5

Pickleball is not in that table, and Dr. Colbert says so plainly. The sport was invented in 1965 and only became a mass phenomenon around 2020, when social distancing made an outdoor, spread-out, four-person game unusually appealing. It is now among the fastest growing sports in the country, but it has nothing like tennis’s 25-year dataset behind it. The reasonable position is the one taken in the episode: pickleball is the same category of activity, similar demands, similar social structure, considerably less strain on the joints.

Read the number honestly. This is observational research, not a trial. Nobody was assigned to play tennis for 25 years. People who take up a racket sport and stick with it for decades tend to differ from people who do not, in income, in mobility, in social support, and in baseline health, and the study cannot fully separate those threads. The finding is a strong signal that this kind of activity travels with a long life. It is not a promise that picking up a paddle adds 9.7 years to yours.

“It’s one exercise you do where you don’t feel like you’re exercising. You’re playing.”

Dr. Don Colbert, MD, in this episode

The part most people skip: other human beings

The most interesting pattern in the Danish data is not that racket sports won. It is which activities clustered at the top. Tennis, badminton and soccer are all played with other people. Cycling, swimming and jogging, done alone with headphones in, sit well below them despite being excellent cardiovascular exercise.

Dr. Colbert’s read is that the social component is not a pleasant side effect of the exercise. It may be a substantial part of the mechanism. Doubles pickleball forces interaction with three other people for the length of a game, and the format shuffles partners constantly, so a regular player accumulates a genuine community rather than a workout routine.

Kyle describes the arithmetic of that in his own life. He had lived in Dallas for ten years and could count the people he considered friends there on one hand. Three years after taking up pickleball, the number is past a hundred. His explanation is that the game compresses friendship: you lose games together and walk off the court disappointed together, you win games together, and you spend a lot of time picking your partner back up. That is a lot of shared experience in a short span.

The Harvard finding Dr. Colbert points to: The Harvard Study of Adult Development has followed participants for more than 80 years, making it one of the longest running studies of adult happiness and health ever conducted. Its most quoted conclusion is that the quality of a person’s close relationships predicts late-life health and happiness better than cholesterol, income, or social class.

Set that alongside the Danish ranking and a picture forms. The activities that keep you connected to other people appear to do something that solo cardio, for all its merits, does not fully replicate.

Mary makes the point that this matters most for the people least likely to act on it. If you live alone, the barrier to walking into a room of strangers is real, and it is also exactly the barrier worth crossing. Her own route through it was lessons, which is covered further down.

Pickleball vs. the gym, fairly stated

The line in the episode that gets the biggest reaction is the comparison between the top of the table and the bottom: nearly ten years for tennis, a year and a half for health club activity. Said quickly, it sounds like an argument against lifting weights.

It is worth being careful here, because it is not that argument, and treating it as one would be a mistake for anyone over 50.

What the comparison does show

An activity you enjoy, do with other people, and keep doing for decades outperforms one you grind through alone and quietly abandon. Adherence and connection are not soft factors. In this data they look like the main event.

What it does not show

That resistance training is not worth doing. Muscle mass and strength are among the strongest predictors of independence in later life, and the trial evidence for resistance training in older adults is robust. The Danish category was self-reported health club activity, which is a broad and inconsistent bucket.

The sensible conclusion is not either-or. Play the racket sport for the cardiovascular work, the coordination, the balance and the community. Keep lifting, two or three sessions a week, to hold onto the muscle that keeps you playing. Dr. Colbert’s own framing is that the trauma-to-benefit ratio favours pickleball over high-impact options, which is a different claim from saying the gym is wasted time.

On calorie burn: Dr. Colbert cites research showing pickleball burns meaningfully more calories than a walk of the same length, and the published work on the sport does place a typical recreational game in the moderate-intensity range, above walking pace, with average heart rates in a training zone for middle-aged and older players. If your current activity is a daily walk, a game is a genuine step up in intensity, which is a reason to build in gradually rather than to start with three hours.

How to start, for almost nothing

This is the most practical stretch of the episode, and it dismantles the two objections people actually have: cost, and not knowing anyone.

Find open play

Nearly every major city has public courts, and nearly all of them run open play sessions split into beginner, intermediate and advanced. The schedule is usually posted online. You show up. That is the whole process.

Buy one paddle

A $20 to $30 paddle is enough to start. Balls are supplied at open play. Do not buy a heavy paddle: it is one of the routes to elbow tendinitis.

Go alone

You do not need a partner. Paddles go in a rack and players are taken in order, so you are matched into games by the system. Many sessions list a coach’s number, and beginner clinics are often free.

Mary’s advice is to take lessons early rather than muddling through. She had a bad shoulder and was hitting most serves out, which was discouraging enough to nearly end the experiment. A few lessons with a good coach fixed the mechanics, and the shoulder stopped being the deciding factor. Her point generalises: technique learned at the start is also injury prevention, and it is far easier than unlearning a habit later.

If pickleball is not for you, the category still is. Badminton is in the Danish data directly. Table tennis carries much of the same eye-hand coordination and brain demand at a fraction of the impact, and Dr. Colbert’s example is an opponent in his mid-80s who regularly beat him. Padel is another option. The common ingredients are a racket, a partner, and someone across the net.

What it does for the brain and for balance

Dr. Colbert’s argument is that a racket sport is a brain game that happens to be played with the body, and that this is where it separates from a treadmill.

BDNF

Exercise raises brain-derived neurotrophic factor, which Dr. Colbert calls Miracle-Gro for the brain. It supports the survival of existing neurons and the growth of new connections.

Neurogenesis and NGF

Aerobic activity is associated with the formation of new brain cells and with nerve growth factor, which supports repair and maintenance of nerve tissue.

Proprioception

Your sense of where your body is in space without looking. It declines with age, and it is why some people have to watch their feet on stairs. Lunging, shuffling, turning and tracking a ball trains it directly.

Reaction time

Mary’s example is unexpected and concrete: six months in, the change she noticed most was in her driving. Merging traffic stopped feeling like an ambush, because she was anticipating instead of reacting.

Balance is the one worth dwelling on. It tends to slip after 70, quietly, and the consequence is a fall. Training balance while chasing a ball is far more likely to actually happen than training it as a set of exercises on a mat, which is the practical case for the whole sport in one sentence.

Frailty, and why eight weeks matters

Frailty is a clinical category, not a figure of speech. It is scored on things like how easily you rise from a chair, arm curl performance, how far you walk in six minutes, sedentary time, and physical and mental quality of life. Adults in the pre-frail range are the ones for whom a single fall can change everything.

Dr. Colbert points to a randomized trial of an eight-week pickleball program in pre-frail older adults with a median age in the late 60s, and reports that a large share of the pickleball group moved out of the pre-frail category while very few controls did. Published work on an eight-week pickleball intervention in pre-frail older adults has examined exactly this population, with improvements reported in dual-task gait performance and inter-joint coordination, both of which sit close to fall risk.

Why the timeframe is the striking part: Eight weeks is short. It is short enough to be a reasonable thing to try, and short enough that if it is going to help you, you will know before the season changes.

The research base on pickleball specifically is still young and the trials are small, so treat the size of any individual result with appropriate caution. The direction of the evidence, though, is consistent with everything else known about how quickly older adults respond to the right kind of activity.

The episode’s illustration is a 90-year-old regular named Margaret, who barely moves on the court, never misses a serve, places the ball wherever she wants it, and routinely beats players a quarter of her age. She is also the argument against the idea that you are past your prime at 70.

How not to get hurt

This is the section Dr. Colbert insists on, because the injuries are predictable and most of them are preventable. His summary rule: play to have fun, not to win, and never sacrifice your health for a single shot.

Wrist fractures, the number one

Almost always from backpedaling for a lob, falling, and landing on an outstretched hand. The fix is a technique: turn your body and run back, never shuffle backwards. Or let the lob go.

Achilles tendinitis and tears

The classic consequence of no warm-up. Fifteen to twenty minutes before you play, every time. This is not optional after 50.

Ankle and knee sprains, meniscus

Court shoes matter here more than any other piece of equipment. Running shoes are built for forward motion and offer little lateral support, which is most of what pickleball asks for.

Pickleball elbow

Lateral tendinitis, the same thing as tennis elbow. Usually traced to a grip that is too tight, a paddle that is too heavy, or too much swing. An elbow sleeve helps.

Shoulder and rotator cuff

Overhead serving with poor mechanics is the usual culprit, which is another argument for early coaching rather than self-teaching.

Heat

Dr. Colbert has had a heatstroke and now plays indoors or in the early morning and late afternoon. Do not play in 100 degree weather. Texas summers are not a test of character.

Two behavioural risks worth naming. The first is starting fast and furious, which is how beginners get hurt in week one. The second is your choice of company: the players most likely to injure themselves and others are the ones playing recreational games like a trophy is waiting. Mary’s rule, learned the hard way in a mixed doubles game, is to avoid partners and opponents who want to win at all costs.

Hydration, joints, and what comes after the game

The origin story for Pickle Powder is told here, and it starts as a problem rather than a product. Kyle would go out intending to play for an hour, get absorbed, and come off the court four or five hours later. The next day his joints hurt badly enough that he started buying turmeric and ginger shots to get through it.

He took the idea to his father: formulate a natural anti-inflammatory powder for people who move, with electrolytes built in, because Texas heat dehydrates players faster than they replace it. The result combines turmeric, ginger and Boswellia with an electrolyte blend to support hydration and joint comfort during an active lifestyle.

One genuinely useful warning: this is concentrated turmeric, and it stains. Open the container over a sink, use the scoop rather than your fingers, and keep it away from light-coloured shoes, socks and shirts. There is a sticker on the tub saying exactly this, and it is there because people have learned the hard way.

Dr. Colbert’s own routine is to combine it with NAD+ Powder in a thermos and sip through a session, alongside plain water rather than instead of it. Afterwards the family uses a hot tub for around five minutes followed by a short cold plunge to the waist, which he finds takes the ache out of the knees and lower back.

Cold plunging is not risk-free. Dr. Colbert flags this himself in the episode. Cold water immersion causes an immediate spike in heart rate and blood pressure, and it is not appropriate for everyone, particularly anyone with known or suspected heart disease, uncontrolled hypertension, or an arrhythmia. Talk with your clinician first, start with shorter and warmer exposures than you think you need, and never plunge alone.

Your first 30 days on the court1Look up open play in your city today. Search your city name plus pickleball open play. Note the beginner session times and the coach’s number if one is listed.2Buy court shoes before you buy a better paddle. A cheap paddle and proper shoes beats an expensive paddle and running shoes, by a wide margin, on the only metric that matters: whether you are still playing in six months.3Book two lessons in your first two weeks. Serve mechanics and footwork. Both are far easier to learn correctly than to correct later, and both are where the injuries come from.4Cap your first sessions at one hour. The pull to keep going when a group needs a fourth is the single most reliable route to a week off with sore joints. Set the limit before you arrive.5Warm up for 15 minutes, every single time. Ankles, calves, hips, shoulders, then a few minutes of easy dinking. This is the cheapest injury insurance available.6Aim for three sessions a week, and keep lifting. Three days a week is the frequency associated with the longevity findings. Two short resistance sessions alongside it protect the muscle that keeps you on the court.Divine Health products and resources related to this episode

These are supportive wellness tools that fit the nutritional themes of the broadcast. They are not treatments for injuries, arthritis, or any medical condition, and they are not a substitute for warming up, proper technique, or medical care.

Pickle Powder

The product built for exactly this problem, and the one discussed at length in the episode. Turmeric, ginger and Boswellia with an electrolyte blend, formulated to support hydration and joint comfort during an active lifestyle.

Shop Pickle Powder →

NAD+ Powder

The powder Kyle combines with Pickle Powder in his thermos for long sessions. Nicotinamide riboside chloride at 600 mg per serving, for cellular energy and cognitive support.

Shop NAD+ Powder →

Joint Formula

For players carrying the everyday aches that come with lateral movement after 50. Nutritional support for joint comfort and mobility, alongside, not instead of, technique and rest.

Shop Joint Formula →

Hydrolyzed Collagen Powder

Collagen is the structural protein of tendons, ligaments and cartilage, the tissues a racket sport asks the most of. An easy addition to a post-game shake.

Shop Hydrolyzed Collagen →

Carb Assist

Named in the segment on blood sugar, where Dr. Colbert describes pairing regular activity with the Beyond Keto approach in his practice. Berberine-based support for healthy blood sugar already in the normal range.

Shop Carb Assist →

Live Long and Strong

Dr. Colbert’s book on the health markers that add years to your life and strength to your days, which is the framework the whole broadcast series is built around.

Get Live Long and Strong →

Supplement safety: turmeric, ginger and Boswellia can affect platelet function and may interact with blood thinners, and berberine can interact with blood sugar and blood pressure medications. Talk with your healthcare professional before starting anything new, particularly if you take prescription medication or have surgery scheduled, and bring your full supplement list to every appointment.

Questions to take to your next appointment✓Given my heart history and blood pressure, is a moderate-intensity racket sport a safe place for me to start?✓Do my knees, hips or shoulders need assessing before I start playing regularly?✓Is my balance where it should be for my age, and would physical therapy help before I add lateral movement?✓Do any of my medications affect hydration, heat tolerance, or heart rate during exercise?✓Is cold water immersion safe for me specifically, or does something in my history rule it out?✓Do turmeric, ginger, Boswellia or berberine interact with anything you have prescribed me?Watch, share, and find a court

The message of Episode 4 is not that a paddle is a miracle. It is that the exercise which extends life is the exercise you will still be doing in ten years, and that the activities people stay with tend to be the ones played with other people. Find open play, buy the shoes, take two lessons, and start slowly enough that you are still playing next spring.

▶ Watch Episode 4 More Dr. Colbert Episodes Visit Divine HealthSources and further readingSchnohr et al., Mayo Clinic Proceedings (2018): Various leisure-time physical activities associated with widely divergent life expectancies, the Copenhagen City Heart StudyEffects of an 8-week pickleball intervention on dual-task gait performance and inter-joint coordination in pre-frail older adultsJournal of Physical Activity and Health (2024): Pickleball participation and the health and well-being of adults, a scoping reviewThe acute and chronic physiological responses to pickleball in middle-aged and older adultsThe Harvard Study of Adult DevelopmentAmerican Heart Association: recommendations for physical activity in adults and kids

Featuring: Dr. Don Colbert, MD, Kyle Colbert, and Mary Colbert

Topics: pickleball, tennis, badminton, racket sports, longevity, healthy aging, the Copenhagen City Heart Study, social connection, exercise adherence, cardiovascular fitness, brain health, BDNF, neurogenesis, proprioception, balance, fall prevention, frailty, wrist fractures, Achilles tendinitis, pickleball elbow, hydration, electrolytes, turmeric, ginger, Boswellia, joint comfort, and cold water immersion.

This content is for education only and does not replace evaluation, diagnosis, treatment, or emergency care from a qualified healthcare professional. Dietary supplements are not intended to diagnose, treat, cure, or prevent disease. Do not start, stop, or change any prescription medication without consulting your prescribing clinician.

The post Pickleball vs. The Gym: Which Is Better for Aging? | Dr. Don Colbert, MD Ep. 4 appeared first on .

Dr. Colbert’s Broadcast • Cellular Energy, Mitochondria & Deep Sleep

Dr. Colbert’s Top 10 Supplements for Energy

If you are tired all the time, the best supplements for energy are not the ones that push you harder. They are the ones that replace what is genuinely running low and rebuild the cells that make energy in the first place. Dr. Don Colbert, MD has spent more than forty years watching patients trade real energy for borrowed energy, and the trade always comes due. This is the list he actually uses, in the order that matters: deep sleep first, then the nutrients most adults are genuinely short on, then the newer compounds that help rebuild the mitochondria you have been losing since your thirties.

Read this before you buy a single bottle

Persistent fatigue is a symptom, not a diagnosis. Low iron, low B12, an underactive thyroid, sleep apnea, depression, diabetes, kidney disease, heart failure and certain cancers all present as exhaustion, and not one of them is fixed by a supplement. Mary Colbert stops the broadcast to make exactly this point: “You need to see someone who knows what they are doing. If you are really tired it could be something else. Low B12, low thyroid, low iron. Have your blood checked.”

Get evaluated first. Fatigue that does not lift once your sleep is fixed is information, so treat it as information. Seek prompt medical attention for fatigue that comes with chest pain, shortness of breath at rest, fainting, unexplained weight loss or new confusion.

5,000mitochondria in a single heart cell, more than any other tissue, because it never stops working3,000 mgof glycine at night, the single cheapest change Dr. Colbert made to his own deep sleep20%of your body’s energy is consumed by the brain, which is only 2% of your weightJump to a sectionWhy Energy FadesThe Top 10On the WatchlistEnergy RobbersGet TestedAction PlanProducts DiscussedWhy your energy fades, and what a supplement can honestly do about it

Nearly every cell in your body carries mitochondria, the structures that produce ATP. ATP is the currency your body spends on everything: a heartbeat, a thought, standing up from a chair. They are not spread evenly. A single heart cell holds roughly 5,000 of them because it never rests. Skeletal muscle and brain cells hold a few thousand. White fat holds almost none, because it is not metabolically busy. Red blood cells have none at all.

Here is the part that explains the slow fade: you lose mitochondria as you age. Fewer factories means less ATP, and less ATP is what people describe when they say they hit a wall at two in the afternoon, or that something changed the year they turned seventy.

So there are only three honest jobs for a supplement here. It can replace something you are short on, such as B12 or magnesium. It can supply raw material your mitochondria run on, such as NAD+ precursors or CoQ10. Or it can support the recycling process that clears out worn mitochondria and builds fresh ones. Everything else is either food, sleep, or a stimulant borrowing against tomorrow.

That is why this list is ordered the way it is. The first item is not a pill at all.

“Most of our energy deficit is coming from lack of good quality sleep. If you are only getting 10 or 15 minutes of deep sleep, you are going to be exhausted. You are never going to recharge.”

Dr. Don Colbert, MD

The top 10, in the order Dr. Colbert would build them1. Glycine, 3,000 mg at night

This is the one Dr. Colbert calls dirt cheap and talks about first, because it changed his own sleep. His account on the broadcast is direct: he was getting about ten minutes of deep sleep a night, started taking three grams of glycine before bed, and moved to over an hour. Mary’s version is that he stopped falling asleep in his chair three minutes after sitting down.

Glycine is a simple amino acid. It appears to lower core body temperature slightly before sleep, which is one of the physiological signals that lets deep sleep begin. In a small polysomnography study, three grams before bed improved subjective sleep quality and shortened the time to reach slow wave sleep. A separate trial in partially sleep restricted volunteers found less daytime fatigue and sleepiness the following day.

How he uses it: 3,000 mg, taken at night. It is mildly sweet and dissolves in water.

Honest placing: the trials here are small and short. This is promising rather than settled. It is also inexpensive and well tolerated, which is why it is worth trying before anything exotic.

2. Magnesium

About half of Americans do not get enough magnesium, and it participates in more than 300 reactions in the body, including the ones that produce and stabilize ATP. Low magnesium shows up as muscle cramps, poor sleep, irritability and a general sense of running on empty.

Form matters more than dose. Magnesium oxide is cheap and poorly absorbed. Chelated forms are gentler and better taken up. Divine Health’s High Potency Magnesium uses chelated dimagnesium malate and chelated magnesium taurate, 150 mg of elemental magnesium per two capsule serving.

Cautions: talk with your clinician before supplementing magnesium if you have reduced kidney function. Magnesium can also affect the absorption of certain antibiotics and thyroid medication, so separate them by a few hours.

3. An NAD+ precursor

NAD+ is the molecule that carries electrons into the electron transport chain, which is the final step where your mitochondria actually make ATP. NAD+ levels fall with age. Precursors such as nicotinamide riboside are the practical way to raise them by mouth.

Dr. Colbert is candid that this one is noticeable in a way most supplements are not. In his practice he has used NAD+ for patients with chronic fatigue, fibromyalgia and heavy brain fog, and for people over seventy who have stopped moving. Kyle describes feeling clearer within about fifteen minutes of a scoop.

One important boundary: Dr. Colbert also discusses injectable NAD+ used under medical supervision in an age management practice. That is supervised clinical care, not a home protocol, and no dosing for it appears here. The oral powder is the at home form.

4. CoQ10

CoQ10 sits directly in the energy production line inside the mitochondria, and it is concentrated in the tissues that work hardest: heart, liver, kidneys and muscle. Your body makes it and you also absorb it from organ meats, fatty fish and poultry, which is why vegetarians and vegans often run low.

Dr. Colbert makes two points here. The first is about form. After roughly age 40 to 50 many adults convert CoQ10 to its active form less efficiently, so he prefers the ubiquinol form from that age onward. The second is about absorption: CoQ10 is fat soluble, so take it with a meal that contains fat.

If you take a statin, read this carefully

Statins lower CoQ10 levels in muscle, and Dr. Colbert notes that this can show up as muscle aches, brain fog and fatigue. A 2025 systematic review and meta analysis found CoQ10 supplementation reduced statin associated muscle symptoms.

This is a reason to add CoQ10 and to talk to your prescriber. It is never a reason to stop or reduce your statin on your own. Dr. Colbert says plainly that he is not against statins and prescribes them for patients with high cholesterol. If your medication is causing symptoms, that is a conversation with the doctor who prescribed it.

5. Vitamin B12, and the activated B vitamins with it

B12 is on Dr. Colbert’s essential list, and his description of deficiency is short and useful: “you start to get real tired.” You can also become anemic, and over time low B12 damages the myelin sheath around nerves, which is the tingling, numbness and burning that people feel in their feet.

Certain groups are much more likely to be low: vegans and vegetarians, anyone on a proton pump inhibitor for reflux, people with celiac disease, Crohn’s or colitis, and anyone who has had gastric bypass surgery. If you are in one of those groups and you are tired, this belongs on your blood panel.

The B vitamins work as a team in energy metabolism. Thiamine and riboflavin help convert food into cellular energy, and B6, folate and B12 together keep homocysteine in a healthy range. Activated forms such as methylcobalamin and methylfolate are the ones Dr. Colbert formulates with.

6. Vitamin D3, with K2

Dr. Colbert calls vitamin D the single most important vitamin, and deficiency is common enough to be worth assuming until proven otherwise. He cites roughly 82% of Black Americans, 69% of Hispanic Americans and 30% of white Americans as deficient. Low vitamin D is strongly associated with fatigue and low mood, particularly through the winter.

His general starting point is at least 2,000 IU daily, ideally checked with a blood level rather than guessed. He pairs it with vitamin K2, because D increases calcium absorption and K2 helps direct that calcium into bone rather than arterial walls.

Cautions: vitamin K2 interacts with warfarin and similar anticoagulants. If you take one, do not add K2 without speaking to your prescriber first.

7. Omega-3 fats

Over 90% of Americans fall short on omega-3 fats. The connection to energy is indirect but real: your brain is roughly 60% fat and consumes 20% of your body’s oxygen despite being 2% of its weight. That much oxygen use generates oxidative stress, and inflammation in the brain is a large part of what brain fog feels like from the inside.

DHA concentrates in the brain and the retina. EPA is the more anti inflammatory of the two. Dr. Colbert suggests at least 1,000 mg a day as a starting point and personally takes considerably more for cardiovascular reasons. If fish oil repeats on you, take it after a meal and start low.

Cautions: higher dose omega-3 can increase bleeding risk. If you take warfarin, clopidogrel, apixaban or another anticoagulant or antiplatelet, clear the dose with your clinician, and tell your surgeon before any procedure.

8. MCT oil, and ketones as clean fuel

Medium chain triglycerides take a shorter metabolic route than most fats. They travel to the liver and convert readily into ketones, which the brain can burn directly. For people who feel wiped out an hour after a carbohydrate heavy lunch, this is often the most immediately noticeable item on the list.

Dr. Colbert is emphatic on the other side of this: refined carbohydrates and bread are energy robbers. “If I eat bread at lunch, it turns my brain off. I am exhausted. I have to go take a nap.” Steady blood sugar is steady energy, and MCTs help by giving the brain a fuel that does not spike and crash.

Start slow. Too much MCT too fast causes cramping and loose stools. Begin with half a serving. If you take insulin or a sulfonylurea, talk with your clinician before shifting toward a ketogenic pattern, because your medication dose may need adjusting.

9. Beet root and citrulline for nitric oxide

Mitochondria cannot make energy without oxygen, and oxygen arrives by blood. Dietary nitrate from beet root converts to nitric oxide, which relaxes blood vessels and improves blood flow. Citrulline supports the same pathway by a different route.

The most consistent finding in the research is that dietary nitrate lowers the oxygen cost of exercise, meaning the same effort demands less oxygen. Meta analyses support a modest benefit for endurance performance. Whether it does this by improving mitochondrial efficiency itself is genuinely disputed, and at least one careful study found the oxygen saving without any change in mitochondrial efficiency. The practical effect holds up better than the proposed mechanism.

Cautions: this one meaningfully lowers blood pressure. If you take blood pressure medication, and especially if you take nitrates such as nitroglycerin or a PDE5 inhibitor such as sildenafil, speak to your clinician before adding beet root. Do not be alarmed by pink urine.

10. Feed your gut so it makes urolithin A for you

This is the newest science on the list and the one Dr. Colbert is most excited about. Mitophagy is the process by which your body recycles worn out mitochondria and builds fresh ones. Urolithin A is a postbiotic compound that supports it. In a randomized trial in middle aged adults, urolithin A improved muscle strength and markers of mitochondrial health.

Here is the catch. You do not eat urolithin A. Your gut bacteria make it from ellagitannins in pomegranate, walnuts, strawberries, blueberries, raspberries and cherries. Only about 30 to 40% of people carry enough of the right anaerobic bacteria, including Akkermansia muciniphila and certain Bifidobacterium species, to do the conversion well. Antibiotics and a high sugar diet are the usual reasons the capacity is missing.

Purified urolithin A works, and Dr. Colbert is blunt that it runs roughly 100 to 200 dollars a month. His alternative is to rebuild the machinery instead of buying the end product: support the gut bacteria, then feed them daily. “Every night I have a handful of walnuts, a little shot of pomegranate juice, my blueberries, strawberries and raspberries.” He puts the cost of that approach around thirty dollars a month.

Honest placing: the trials on purified urolithin A are the strongest evidence here. The idea that you can reliably reproduce that effect through diet plus probiotics is reasonable and mechanistically sound, but it has not been tested head to head. Treat it as a sensible, inexpensive first move rather than a proven equivalent.

On the watchlist

Two more compounds come up repeatedly in the broadcast and deserve a place here, even though they did not make the core ten.

Paraxanthine. When you drink coffee, roughly 80% of the caffeine is metabolized into paraxanthine, and Dr. Colbert’s view is that paraxanthine is the better half of the deal. It supports alertness, focus and short term memory, clears the body faster than caffeine, does not require the same liver metabolism that makes some people slow caffeine metabolizers, and does not raise homocysteine the way caffeine can. He describes his own homocysteine falling below 10 after cutting back to one cup of coffee a day. As with caffeine, nothing after 3 p.m.

Functional mushrooms. Used in China and Japan for over two thousand years and now accumulating modern evidence. Cordyceps is the one most directly tied to energy and cellular ATP production. Lion’s mane stimulates nerve growth factor and is studied for memory. Reishi is an adaptogen that helps calm the nervous system. Chaga, shiitake, maitake and turkey tail are used mainly for immune support.

Divine Health does not currently sell a standalone paraxanthine, urolithin A or Akkermansia product. Dr. Colbert has said on the broadcast that a paraxanthine and NAD+ combination is in development. Lion’s mane is included in Brain Zone Advanced.

The energy robbers, which cost nothing to remove

Dr. Colbert lists these before he lists any supplement, and he is right to. No product on this page outruns them.

Too little deep sleep. The root cause for most people, and the reason glycine is first on the list.Caffeine, especially late. It is a central nervous system stimulant that borrows energy by raising adrenaline, then charges interest. Taken after mid afternoon it degrades the deep sleep you need, so tomorrow is worse than today. Dr. Colbert takes none after 3 p.m.Sugar and refined carbohydrates. The post lunch crash is not a personality trait.Chronic stress and an inability to say no. His phrasing is worth keeping: “when you cannot say no, other people’s problems become your problems.” Saying no kindly is a health practice.Screens in the bedroom. Put the phone and the laptop in another room.Too little movement and too little water. Both unglamorous, both real.

There is a spiritual dimension here too, and it is not decoration. Carrying resentment is physiologically expensive. Chronic bitterness raises blood pressure and keeps the body in a stress state that costs energy every day it goes unresolved. Forgiveness lifts a metabolic load, not only an emotional one.

Get tested before you build a stack

This is the most protective advice in the whole broadcast, and it is also simply the fastest route to feeling better. A supplement cannot correct an underactive thyroid or iron deficiency anemia, and months spent guessing are months lost.

Worth asking your clinician about: a complete blood count, ferritin and iron studies, a full thyroid panel including TSH and free T4, vitamin B12 and folate, vitamin D, a comprehensive metabolic panel, hemoglobin A1c, and testosterone for men. If you snore, wake unrefreshed, or your partner notices you stop breathing, ask about a sleep study.

Two practical routes: Quest Diagnostics offers direct lab testing, or you can schedule an appointment with Dr. Colbert at his offices in Orlando, Florida or Southlake, Texas in the Dallas area.

A wearable helps too. An Apple Watch, an Oura ring or a formal sleep study will tell you how much deep sleep you are actually getting. Without a number you are guessing, and you will not know whether anything you tried worked.

Your next 30 days1Get blood work. Rule out the causes no supplement can touch before you spend money on top of them.2Measure your deep sleep for two weeks. A wearable gives you the baseline that makes everything after this measurable.3Cut caffeine off at 3 p.m. and take the screens out of the bedroom. Free, and often the largest single change on this page.4Add glycine at 3,000 mg before bed. Give it two weeks and watch what your deep sleep number does.5Eat the mitophagy foods every day. A handful of walnuts, a small pour of pomegranate juice, and a bowl of berries. This is the cheapest item on the list and one of the most interesting.6Fix the gaps your labs found. Magnesium, B12, vitamin D and omega-3 in that order, based on what came back low.7Take your prescription list to your pharmacist. Especially before adding beet root, omega-3 or K2. It is a five minute conversation that prevents a real problem.8Change one thing at a time. Start five supplements at once and feel better, and you have learned nothing about which one to keep buying.Questions to take to your doctorCould my fatigue be thyroid, anemia, low B12, blood sugar or sleep apnea? Which of those have we actually tested?What is my vitamin D level, and what number are we aiming for?I take a statin and I feel tired and achy. Is CoQ10 reasonable for me, and are there other options worth discussing?Is any medication I take contributing to this fatigue?I am on a blood pressure medication. Is beet root safe for me to add?Do any of these supplements interact with what I am already taking?Divine Health products related to this list

These are supportive wellness tools that fit the nutritional themes above. They are not treatments for any medical cause of fatigue, and they are not substitutes for testing, evaluation or prescribed care.

NAD+ Powder

The lemon lime powder Dr. Colbert mixes on camera during the energy broadcast. Nicotinamide riboside chloride, for cellular energy and cognitive support.

Shop NAD+ Powder →

High Potency Magnesium

Chelated dimagnesium malate and chelated magnesium taurate rather than magnesium oxide, at 150 mg elemental magnesium per serving. Supports muscle recovery, relaxation and nerve function.

Shop High Potency Magnesium →

Q10 Vital CoQ10

100 mg of water soluble Q10Vital CoQ10 per capsule with thiamine and riboflavin, formulated for absorption. Supports cellular energy production and cardiovascular wellness.

Shop Q10 Vital →

CircuZone

The nitric oxide formula from section 9. Fermented beet root powder as a natural nitrate source plus citrulline, magnesium, vitamin C and B vitamins, in berry limeade.

Shop CircuZone →

Organic Red Supremefood

The most directly relevant product to the urolithin A discussion. A blend of organic fruits with probiotics, prebiotics and enzymes, supporting daily energy, gut balance and antioxidant protection.

Shop Red Supremefood →

Wild Alaskan Salmon Omega-3

A source of EPA and DHA from wild caught salmon, supporting heart, brain, joint and immune health. Living Krill Oil is the alternative if you prefer phospholipid bound omega-3 with astaxanthin.

Shop Omega-3 →

MCT Oil Powder

Clean fuel from medium chain fats to support a healthy metabolic rate, mental focus and appetite control. Instant Ketones Powder is the faster acting option using exogenous BHB.

Shop MCT Oil Powder →

Brain Zone Basic

Built on activated B vitamins including methylcobalamin B12 at 1,000 mcg, P5P, riboflavin-5-phosphate and methylfolate, with trimethylglycine and curcumin. Relevant to sections 5 and 6.

Shop Brain Zone Basic →

Hormone Zone

Contains vitamin D3 with 100 mcg of K2, the pairing described in section 6, alongside support for healthy hormone function, energy and metabolism.

Shop Hormone Zone →

Fermented Green Supremefood

Fully fermented grasses and vegetables for easier digestion and nutrient absorption, supporting the gut environment described in section 10. Pair with Fiber Zone for prebiotic fiber.

Shop Fermented Greens →

Supplement safety. Talk with your healthcare provider before starting any supplement, especially if you are pregnant or nursing, take prescription medication, have a medical condition, or have surgery scheduled. Introduce one product at a time.

Start where the leverage is

You are not simply getting older. There is a mechanism, and mechanisms can be worked on. Fix your sleep first, because nothing else on this list works without it. Get your blood checked, because that is where the fastest answers usually are. Then feed the system that rebuilds your mitochondria. “Beloved, I wish above all things that you may prosper and be in health.” That is the point of all of this.

Read: Why Am I Always Tired?More Dr. Colbert EpisodesVisit Divine HealthSources and further readingYamadera et al., Sleep and Biological Rhythms: Glycine ingestion improves subjective sleep quality in human volunteers, correlating with polysomnographic changesBannai et al.: The effects of glycine on subjective daytime performance in partially sleep restricted healthy volunteersSingh et al., Cell Reports Medicine: Urolithin A improves muscle strength, exercise performance, and biomarkers of mitochondrial health in a randomized trial in middle aged adultsAndreux et al., Nature Metabolism: The mitophagy activator urolithin A is safe and induces a molecular signature of improved mitochondrial and cellular health in humansDepommier et al., Nature Medicine: Supplementation with Akkermansia muciniphila in overweight and obese human volunteers, a proof of concept exploratory studySystematic review and meta analysis, Journal of Nutritional Science: Effects of coenzyme Q10 supplementation on myopathy in statin treated patientsErgogenic effect of nitrate supplementation: a systematic review and meta analysisWhitfield et al.: Beetroot juice supplementation reduces the oxygen cost of exercise without improving mitochondrial efficiencyNIH Office of Dietary Supplements: Magnesium fact sheet for health professionals

Featuring: Dr. Don Colbert, MD, Kyle Colbert, and Mary Colbert

Topics: supplements for energy, chronic fatigue, low energy, brain fog, mitochondria, ATP, deep sleep, glycine, magnesium, NAD+, nicotinamide riboside, CoQ10, ubiquinol, vitamin B12, vitamin D3, vitamin K2, omega-3, MCT oil, ketones, beet root, nitric oxide, citrulline, urolithin A, mitophagy, Akkermansia muciniphila, paraxanthine, cordyceps, lion’s mane, reishi, and healthy aging.

These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease. This content is for education only and does not replace evaluation, diagnosis, treatment or emergency care from a qualified healthcare professional. Do not start, stop or change any prescription medication without consulting your prescribing clinician.

The post Dr. Colbert’s Top 10 Supplements for Energy appeared first on .

Dr. Colbert’s Broadcast • Mitochondria, Deep Sleep & Cellular Energy • Episode 3

Why You’re Always Tired (It’s Not Just Age) | Dr. Don Colbert, MD Ep. 3

Most people accept exhaustion as the price of getting older. Dr. Colbert doesn’t, and he has a reason rooted in cell biology rather than resignation. In this episode of Dr. Colbert’s Broadcast, Dr. Don Colbert, MD, Kyle Colbert, and Mary Colbert walk through what actually drains your energy: not enough deep sleep, and a shrinking population of mitochondria. Then they cover what the newer science says about restoring both, including glycine, urolithin A, paraxanthine, NAD+, and functional mushrooms.

Featuring Dr. Don Colbert, MD, Kyle Colbert, and Mary ColbertRead this before you change anything

Persistent fatigue is a symptom, not a diagnosis. Low iron, low B12, thyroid dysfunction, sleep apnea, depression, diabetes, kidney disease, and certain cancers all present as exhaustion, and none of them is fixed by a supplement. Mary Colbert stops the episode to make exactly this point, and it belongs at the top rather than the bottom.

Before you build a supplement stack, get blood work and be evaluated. Fatigue that does not improve when you fix your sleep is information. Treat it that way. Seek prompt medical attention for fatigue accompanied by chest pain, shortness of breath at rest, fainting, unexplained weight loss, or new confusion.

5,000mitochondria in a single heart cell, more than any other tissue, because it never stops working30 to 40%of people carry the gut bacteria needed to convert berries and pomegranate into urolithin A3 gof glycine before bed, the dose used in the sleep studies, and the one Dr. Colbert takesJump to a sectionYour Energy Factories
Deep Sleep First
Urolithin A
Fasting & Mitophagy
Caffeine Problem
NAD+
Functional Mushrooms
Energy Robbers
Products DiscussedYour energy factories are disappearing

Dr. Colbert opens with a story that stayed with him. His grandson Timmy, then three years old, got stuck behind an elderly man crossing a parking lot at Target and announced, “You’re slow as a turtle.” The man apologized: this is what happens when you get old.

Dr. Colbert’s objection is that this is not simply what happens. There is a mechanism, and it has a name.

Nearly every cell in your body contains mitochondria, the structures that produce ATP, the currency your body spends on everything it does. They are not distributed evenly, and the distribution tells you a lot about what your body prioritizes.

TissueMitochondria per cellWhyHeart muscleAbout 5,000It never stops. Not for a second, for your entire life.Brain & skeletal muscleA few thousandHigh, variable demand. Your brain is 2% of body weight but burns about 20% of your energy.White fat, tendons, connective tissueVery fewNot metabolically active. Dr. Colbert links this to why tendons heal so slowly and injure so easily.Red blood cellsZeroThey carry oxygen rather than burning it, since mitochondria would consume the cargo.

Here is the problem: as we age, we produce fewer and fewer mitochondria. Fewer energy factories, less energy. That is the biological version of “slower than a turtle,” and it explains why so many people describe hitting 70 and feeling like something switched off.

Why studying makes you genuinely tired: Your brain’s enormous energy draw has a byproduct. Burning oxygen produces free radicals (hydrogen peroxide, hydroxyl radicals, singlet oxygen), and that oxidative exhaust damages the very mitochondria producing the energy.

It is a loop: high demand creates damage, damage reduces capacity, reduced capacity feels like exhaustion. Which is precisely why the repair mechanisms in the next sections matter more than any stimulant.

“If you’re only getting 10 or 15 minutes of deep sleep, you’re going to be exhausted. You’re never going to recharge.”

Dr. Don Colbert, MD, in this episode

Before any supplement: are you actually sleeping?

Dr. Colbert is blunt that most energy deficits trace back to one thing: not enough deep sleep. Not hours in bed. Deep sleep specifically.

This distinction catches people out. You can spend eight hours in bed, wake without remembering a single awakening, and still be running on 10 minutes of slow-wave sleep. A wearable such as an Apple Watch or Oura Ring, or a formal sleep study, will tell you where you actually stand. Mary spent a long time pushing him to get one.

The picture she describes is one a lot of families will recognize. He would sit down after work and be asleep within three minutes. She stopped going to movies with him, because the moment the lights went down he was gone, then wanted to rewatch the half he had missed.

Glycine, at 3 grams

His fix was unglamorous and inexpensive. Glycine, an ordinary amino acid, at 3,000 mg (3 grams) before bed. He describes going from roughly 10 minutes of deep sleep to over an hour, and Mary noticed the change before he mentioned it. He is back to leaping out of bed in the morning, which she reports as a mixed blessing.

The research behind that number: The 3-gram dose is not arbitrary. It comes from a body of Japanese research, most notably a polysomnography study in which volunteers given 3 g of glycine before bed showed measurable changes in sleep architecture, including shortened time to fall asleep and to reach slow-wave sleep, alongside improved subjective sleep quality and reduced next-day fatigue.

Glycine also lowers core body temperature slightly, which is one of the physiological signals that initiates sleep. It is inexpensive, widely available, tastes faintly sweet, and has a good tolerability record. As sleep interventions go, it is unusually low-risk for the potential return.

The unglamorous fixes that mattered just as much

Worth noting, because these cost almost nothing and get overlooked in favour of supplements:

Breathing

An ergonomic pillow, plus treating chronic nasal congestion from a deviated septum. Obstructed breathing fragments sleep whether or not you wake up aware of it.

Dry mouth

Xylitol tablets that adhere to the cheek overnight. He had been waking three or four times a night from his mouth drying out. Xylitol also helps prevent cavities.

Screens

Phone and laptop go in another room. Not face-down on the nightstand, another room. This is the rule with no exceptions.

Waking repeatedly, or unrefreshed despite adequate hours? Get evaluated for sleep apnea before assuming supplements will fix it. Loud snoring, witnessed pauses in breathing, morning headaches, and daytime sleepiness are the classic signs. Untreated apnea raises cardiovascular risk independently, and no amount of glycine addresses it. A sleep study is the right next step, not a bigger stack.

Urolithin A: recycling worn-out mitochondria

This is the segment Dr. Colbert is most animated about, because it challenges an assumption: that mitochondrial decline runs one direction only.

Mitophagy is your body’s process for dismantling worn-out mitochondria and building fresh ones from the parts. One compound that appears to promote it is urolithin A, and the interesting thing is that you cannot eat it. It is a postbiotic: your gut bacteria manufacture it from raw materials you supply.

Those raw materials are ordinary foods. Strawberries, blueberries, raspberries, cherries, pomegranate, and walnuts all contain the precursor compounds (ellagitannins). Your microbes do the conversion.

The catch, and it is a big one: only about 30 to 40% of people host the microbial diversity required to make that conversion. For the remaining 60 to 70%, courses of antibiotics and years of dietary sugar have thinned out the anaerobic bacteria that do the work. Two people can eat identical bowls of berries and get entirely different results.

The bacteria that matter here include Bifidobacterium longum, Bifidobacterium adolescentis, and Akkermansia muciniphila, the last of which Dr. Colbert prescribes frequently and takes himself. Akkermansia is a mucin-degrading species that helps maintain the gut lining and has become one of the more closely studied organisms in metabolic health.

His objection to buying it in a bottle

Studies typically use 500 to 1,000 mg of urolithin A, with most using the higher end. At those doses you are looking at roughly $100 to $200 a month, which prompts a characteristic aside from Kyle about his father’s talent for finding the most expensive patented ingredient in any category.

Dr. Colbert’s alternative is to rebuild the bacteria that make it, then feed them properly. His own nightly routine: a handful of walnuts, a small serving of pomegranate juice (about half a small paper cup, not a glass), and mixed berries. He puts the cost at around $30 a month.

Where the evidence currently stands: Urolithin A is one of the better-supported compounds in the longevity category, which is not a high bar but matters here. A randomized controlled trial in middle-aged adults found improvements in muscle strength and in biomarkers of mitochondrial health, and subsequent trials and a 2025 systematic review have continued to examine effects on muscle strength and physical performance.

Two honest caveats. Effect sizes in these trials are meaningful but modest. This is not a transformation in a capsule. And the food-and-microbiome route Dr. Colbert prefers, while sensible and far cheaper, has not been tested head-to-head against supplementation. If you go that way, you are reasoning from mechanism rather than from trial data. That is a legitimate approach, but it is worth knowing which one you are doing.

Intermittent fasting does the same work for free

Fasting for roughly 16 hours triggers autophagy, the clearing out of worn cellular components, and mitophagy alongside it. The same recycling process, no supplement required, no cost.

Dr. Colbert’s honest caveat is that most people simply will not do it, which is why the nutritional route matters. Mary, who has lived an intermittent fasting pattern for years without particularly framing it that way, suspects it explains a good deal of her own energy, an observation that lands during the episode as she works it out mid-conversation.

Intermittent fasting is not for everyone. Do not begin without medical guidance if you take insulin or sulfonylureas for diabetes, where fasting can cause dangerous hypoglycemia; if you are pregnant or breastfeeding; if you have a history of disordered eating; if you are underweight or frail; or if you take medications that must be given with food.

Older adults should also be careful that a compressed eating window does not quietly reduce protein intake, since preserving muscle mass matters more with age, not less.

The caffeine problem, and what comes after it

Dr. Colbert draws a line between two things people conflate: energy, and stimulation. Caffeine is a central nervous system stimulant that raises adrenaline. You get several hours, then you crash. Take it late and it erodes the deep sleep that would have restored you, so tomorrow starts lower than today did.

That is the loop worth seeing clearly. The tireder you are, the more caffeine you use; the more caffeine you use, the worse you sleep; the worse you sleep, the tireder you are.

Two problems he considers seriousMetabolism is unpredictable

Caffeine is processed by the liver, and people are genetically either fast or slow metabolizers, and most of us have never been told which. In slow metabolizers it lingers for many hours, quietly dismantling deep sleep long after the alertness has faded.

It raises homocysteine

Dr. Colbert was drinking two to three cups each morning with a homocysteine around 14. Above 10 is considered high. Elevated homocysteine is a recognized risk factor for memory loss, fatigue, and arterial plaque. Cutting to one cup daily brought him below 10, where it has stayed.

Paraxanthine: what caffeine becomes anyway

Roughly 80% of the caffeine you drink is metabolized into paraxanthine. Dr. Colbert’s argument is simple: why not skip to the metabolite? Kyle reframes it neatly in the episode as cleaner fuel.

Paraxanthine appears to support short-term memory, focus, attention, and alertness. It clears the body faster than caffeine, does not require liver metabolism the same way, tends to carry fewer side effects, and does not appear to raise homocysteine. Provided you avoid it after 3 p.m., it is less disruptive to sleep.

Keeping this in proportion: Paraxanthine is a genuinely interesting ingredient with published safety assessments and early human and animal work on cognition and neuroplasticity. It is also new, and that cuts both ways.

Caffeine has a century of research and billions of person-years of use behind it. Paraxanthine has neither yet. The comparative claims are promising rather than settled, and much of the head-to-head data is preliminary. It is still a stimulant: the same cautions apply regarding pregnancy, anxiety disorders, arrhythmias, and uncontrolled blood pressure, and it should not simply be stacked on top of your existing coffee.

NAD+ and the last step of energy production

NAD+, or nicotinamide adenine dinucleotide, is a coenzyme that shuttles electrons into the electron transport chain, the final stage where ATP is actually made. Levels decline substantially with age, which makes it a natural target.

Dr. Colbert calls it one of the most striking supplements he has used, and makes a point worth repeating: with a multivitamin you are taking it on faith, whereas with NAD+ he describes noticing clarity and energy within about 15 minutes.

A clarification on the biochemistry: The terminology moves quickly in this segment. NAD+ itself is not what is in most oral products. What you take is a precursor your body converts. The most studied are nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN). Divine Health’s NAD+ Powder uses nicotinamide riboside chloride at 600 mg per serving.

This matters when you are comparing products: “NAD+” on a label almost always means a precursor, and which one, at what dose, is the useful question.

On the evidence: oral NR reliably raises blood NAD+ levels, and that part is well established. Whether raising the number produces the benefits people want is the live question, and the answer is still developing. A 2025 randomized controlled trial in long-COVID patients reported improvements in fatigue and cognitive symptoms, which is among the more encouraging clinical results to date. Trials in healthy aging have been more mixed.

On the injectable protocol: Dr. Colbert describes using injectable NAD+ in his clinical practice with patients who have chronic fatigue, fibromyalgia, or persistent brain fog, and with patients over 70 who have lost their energy, often getting them back to walking, exercising, and playing pickleball. That is supervised medical care delivered after examination, and it is not something to source or attempt on your own. The oral products discussed here are a different thing entirely.

Functional mushrooms

Medicinal mushrooms have been used in China and Japan for more than 2,000 years, and the modern evidence base has grown considerably. Dr. Colbert reports patients describing a noticeable lift within 10 or 15 minutes, and clarifies, with the timing of a man who has been asked before, that he means culinary and medicinal mushrooms, not the other kind.

Cordyceps

A natural energy booster that supports cellular ATP production, the most directly relevant of the group to this episode’s theme.

Reishi

Known in Chinese tradition as the mushroom of immortality. An adaptogen that helps calm the nervous system and support the stress response, which, given the sleep discussion above, may be the most useful one for a tired person.

Lion’s Mane

Stimulates nerve growth factor and is associated with brain repair and memory support. This is the one in Brain Zone Advanced.

Chaga

Supports immune function. Shiitake, maitake, and turkey tail belong to the same family of options.

Two practical notes. Mushroom products vary enormously in what they actually contain. Look for extracts specifying fruiting body rather than mycelium grown on grain, where much of the weight is residual starch. And check interactions: reishi may affect platelet function and matters if you take anticoagulants or have surgery scheduled, and people with mushroom allergies or on immunosuppressants should speak with their clinician first.

What’s actually robbing your energy

Dr. Colbert’s list, in the order he gives it. Most people scanning this will find two or three that apply, and fixing those beats adding anything.

Inadequate deep sleep

The single largest factor, and the one most likely to make everything else irrelevant if unaddressed.

Chronic stress & being too busy

Not a character flaw, but a physiological drain with measurable effects.

Not being able to say no

His phrasing: when you cannot say no, other people’s problems become your problems. He directs this particularly at people whose faith makes them feel obligated to say yes, and argues that saying no kindly is a skill worth developing.

Too much caffeine

His own rule: one cup, in the morning, nothing after 3 p.m.

Sugar and refined carbohydrates

He is specific: bread at lunch ends his afternoon. If a meal reliably makes you want to lie down, that is data.

Screens, inactivity, dehydration, aging

The quiet accumulators. Individually small, collectively decisive.

Your next-30-days action plan1Measure your deep sleep before changing anything. A wearable for two weeks gives you a baseline. Without one you are guessing, and you will not know whether anything worked.2Get blood work first. Iron and ferritin, B12, thyroid panel, blood sugar. Rule out the causes a supplement cannot touch before you build a stack on top of them.3Move your caffeine cutoff to 2 p.m. for two weeks. Free, reversible, and for slow metabolizers it can be the single biggest change on this page.4Phone and laptop out of the bedroom tonight. Not face-down. Another room. Buy an alarm clock if that is the obstacle.5Add the mitochondria foods nightly. A handful of walnuts, a small serving of pomegranate, mixed berries. Cheap, pleasant, and it feeds the bacteria doing the work.6Change one thing at a time. If you start five supplements at once and feel better, you have learned nothing about which one to keep buying.Divine Health products and resources related to this episode

These are supportive wellness tools that fit the nutritional themes of the broadcast. They are not treatments for any medical cause of fatigue, and they are not substitutes for testing, evaluation, or prescribed care.

NAD+ Powder

Named directly by Dr. Colbert during the energy discussion, the lemon-lime powder he mixes during the episode. Nicotinamide riboside chloride at 600 mg per serving, for cellular energy and cognitive support.

Shop NAD+ Powder →

Brain Zone Advanced

Referenced in the functional mushroom segment. Combines Lion’s Mane at 1,000 mg with citicoline, tyrosine, and 7,8-dihydroxyflavone for focus, memory, and brain cell support.

Shop Brain Zone Advanced →

Organic Red Supremefood

The most directly relevant product to the urolithin A discussion: a berry blend of 10 organic fruits with probiotics, enzymes, and fiber. These are precisely the ellagitannin-rich foods your gut bacteria convert.

Shop the Supremefood Pack →

Fermented Green Supremefood

Supports the microbiome side of the equation. 14 organic fermented vegetables and grasses with a prebiotic inulin and Bacillus coagulans blend plus digestive enzymes.

Shop Fermented Green Supremefood →

Fiber Zone

Prebiotic fiber feeds the anaerobic bacteria discussed in the urolithin A segment. A blend of soluble and insoluble fiber including psyllium and prebiotic inulin.

Shop Fiber Zone →

Live Long and Strong

Dr. Colbert points to this book during the episode as where he lays out the key health markers and tests in full detail, including the ones Mary urges viewers to have checked before self-treating.

Get Live Long and Strong →

Dr. Colbert also offers his full energy supplement list by request. Email info@divinehealth.com and the team will send it over.

Supplement safety: Dietary supplements are not a substitute for evaluation and treatment of an underlying medical cause of fatigue. Several ingredients discussed in this episode, including reishi and other functional mushrooms, can interact with blood thinners and other medications. Talk with your healthcare professional before starting anything new, and bring your full list to every appointment.

Questions to take to your next appointment✓Could my fatigue have a medical cause such as iron, B12, thyroid, blood sugar, or sleep apnea?✓Should I have a sleep study, given how much of this comes back to deep sleep?✓Could any medication I take be contributing to my fatigue or disrupting my sleep?✓Is glycine at 3 g before bed reasonable for me, given my other medications?✓Is intermittent fasting safe for me specifically, or does something in my history rule it out?✓Do any of my supplements interact with what you have prescribed?Watch, share, and start with sleep

The message of Episode 3 is not that exhaustion is inevitable after 70. It is that fatigue has mechanisms, and mechanisms can be worked on. Start with deep sleep, because nothing else in this article works without it. Then feed the bacteria that rebuild your mitochondria. The rest is refinement.

▶ Watch Episode 3
More Dr. Colbert Episodes
Visit Divine HealthSources and further readingYamadera et al., Sleep and Biological Rhythms: Glycine ingestion improves subjective sleep quality, correlating with polysomnographic changesSingh et al.: Urolithin A improves muscle strength, exercise performance, and biomarkers of mitochondrial health, a randomized trial in middle-aged adultsSystematic review (2025): Effects of urolithin A supplementation on muscle strength, muscle mass and physical performance in humansFrontiers in Toxicology: Paraxanthine safety and comparison to caffeineParaxanthine enhances memory and neuroplasticity more than caffeine (preclinical)eClinicalMedicine (2025): Effects of nicotinamide riboside on NAD+ levels, cognition, and symptom recovery in long-COVID, a randomized controlled trialAmerican Heart Association: Sleep and cardiovascular health

Featuring: Dr. Don Colbert, MD, Kyle Colbert, and Mary Colbert

Topics: chronic fatigue, low energy, brain fog, mitochondria, ATP, deep sleep, glycine, sleep architecture, urolithin A, mitophagy, autophagy, intermittent fasting, gut microbiome, Akkermansia muciniphila, prebiotics, probiotics, postbiotics, paraxanthine, caffeine metabolism, homocysteine, NAD+, nicotinamide riboside, cordyceps, reishi, lion’s mane, chaga, healthy aging, and longevity.

This content is for education only and does not replace evaluation, diagnosis, treatment, or emergency care from a qualified healthcare professional. Dietary supplements are not intended to diagnose, treat, cure, or prevent disease. Do not start, stop, or change any prescription medication without consulting your prescribing clinician.

The post Why You’re Always Tired (It’s Not Just Age) | Dr. Don Colbert, MD Ep. 3 appeared first on .

Dr. Colbert’s Broadcast • Advanced Lipid Testing & Plaque Stability • Episode 2

Your Cholesterol Test Isn’t Enough: What You Need to Know | Dr. Don Colbert, MD Ep. 2

A standard lipid panel gives you four numbers. It does not tell you whether the plaque in your arteries is stable or ready to rupture. In this episode of Dr. Colbert’s Broadcast, Dr. Don Colbert, MD, Kyle Colbert, and Mary Colbert walk through the advanced blood markers most people have never been offered — lipoprotein(a), oxidized LDL, myeloperoxidase, Lp-PLA2, and particle testing — plus the diet, blood pressure, nitric oxide, and emotional factors that influence whether plaque stays quiet.

Featuring Dr. Don Colbert, MD, Kyle Colbert, and Mary Colbert

Read this before you change anything

This episode discusses prescription medications, including statins, by name. Nothing here is a recommendation to stop, reduce, or skip a medication your clinician prescribed. Stopping a statin, blood-pressure medication, antiplatelet therapy, or diabetes medication on your own can raise your risk of a heart attack or stroke. If you are having side effects, that is a reason to call your prescriber and discuss alternatives — not a reason to quit on your own.

For new chest pressure or pain, shortness of breath, pain in the arms, back, neck, jaw or stomach, cold sweat, nausea, unusual weakness, or lightheadedness, call 911 or your local emergency number.

1 in 5adults worldwide carry elevated lipoprotein(a), an inherited risk factor a standard panel does not measureOnceis how often Lp(a) needs testing — 2026 guidance now recommends it for every adult, at least one time125nmol/L (or 50 mg/dL) is the threshold above which Lp(a) is treated as a risk-enhancing factorJump to a sectionThe Testing Gap
Three Goals
The Advanced Panel
Lp(a) Explained
Cholesterol Options
Diet & Lifestyle
Heart & Emotions
Products DiscussedFour numbers are not the whole picture

Most people leave a physical with the same four results: total cholesterol, LDL, HDL, and triglycerides. Dr. Colbert’s argument in this episode is that those four numbers describe how much cholesterol is floating in your blood — not how much plaque is in your artery walls, what kind it is, or whether it is inflamed and unstable.

That distinction matters because of how heart attacks actually happen. Most are not caused by an artery slowly closing to zero. They are caused by a plaque that ruptures, triggering a clot that shuts off blood flow in minutes. A plaque can be modest in size and still be dangerous if it is soft, inflamed, and thinly capped. A larger, calcified, stable plaque may sit quietly for decades.

Dr. Colbert notes that many of these markers are not routinely ordered, and that insurance coverage is inconsistent. It is worth being fair about why: some of these tests have strong guideline backing and some are used mainly by preventive and integrative clinicians while the outcome evidence continues to develop. Knowing which is which helps you have a more productive conversation with your own doctor.

Timely context: In March 2026, the American College of Cardiology and the American Heart Association released a new dyslipidemia guideline that replaced the 2018 cholesterol guideline. Two of its headline changes point in exactly the direction this episode argues for.

First, it recommends that every adult have lipoprotein(a) measured at least once in a lifetime — the first time universal Lp(a) screening has carried the strongest class of recommendation in a U.S. guideline. Second, it expands the use of apolipoprotein B (apoB) to assess risk that LDL-C alone can miss. Dr. Colbert has been ordering advanced markers for years; the mainstream position has now moved closer to his.

“When you have a heart attack, it’s from a ruptured plaque, from soft plaque rupturing.”

— Dr. Don Colbert, MD, in this episode

The three goals Dr. Colbert works toward

Rather than chasing a single cholesterol number, the episode frames prevention around three objectives. They are useful because they give you something to measure progress against.

1. Reduce the plaque

Lower the burden where possible. Dr. Colbert is candid that calcified plaque generally cannot be removed — the realistic aim is to slow or halt progression rather than erase it.

2. Stabilize the plaque

Reduce the inflammation and oxidation that make a soft plaque fragile. This is where the inflammatory markers in the panel below earn their place.

3. Prevent rupture

The event itself is the thing to avoid. Blood pressure control, blood sugar control, and not smoking all matter here alongside lipid management.

The advanced panel: what each marker actually tells you

Dr. Colbert orders many of these through Quest Diagnostics, which offers the Cleveland HeartLab panel. Here is what each one measures and where it currently stands in mainstream practice, so you know which to push for and which to discuss as optional.

MarkerWhat it measuresWhere it standsLipoprotein(a)
“Lp little a”An inherited, particularly atherogenic lipoprotein particle. Largely genetic and stable across your life.Strongest backing of the group. 2026 guidance recommends it for every adult, once.Apolipoprotein B
apoBThe number of atherogenic particles, rather than the cholesterol they carry. Catches risk LDL-C underestimates.Guideline-endorsed for selective use, especially with diabetes, high triglycerides, or metabolic syndrome.Oxidized LDLLDL particles that have been chemically damaged. Oxidation is a step in plaque formation, and Dr. Colbert ties it to fried and refined seed oils.Available commercially; used more in preventive practice than in routine cardiology.Myeloperoxidase
MPOAn enzyme released by white blood cells that signals active inflammation in the artery wall. Dr. Colbert calls it a check-engine light.Specialty marker. Interpret alongside the full picture, not in isolation.Lp-PLA2An enzyme associated with inflammation specifically inside the vessel wall, linked to plaque buildup and instability.Specialty marker, same caveat as MPO.NMR LipoProfileUses nuclear magnetic resonance to count LDL particles and size them. Small, dense LDL is considered more atherogenic than large, buoyant LDL.Established test. Many clinicians now use apoB for a similar purpose at lower cost.hs-CRPGeneral, whole-body inflammation. Non-specific, but widely available and inexpensive.Long-recognized risk-enhancing factor. Easy first ask if your doctor is hesitant about the rest.

On the specific target numbers in the episode: Dr. Colbert cites cutoffs from his own practice and lab. Reference ranges and units differ between laboratories — Lp(a) alone is reported in both nmol/L and mg/dL, which are not interchangeable. Always read your result against the range printed on your own report, and ask your clinician what it means for you specifically.

Lipoprotein(a): the inherited risk most people have never been tested for

If you take one action item from this episode, make it this one. Lp(a) is an LDL-like particle with an extra protein attached that makes it both more plaque-forming and more clot-promoting than ordinary LDL. Roughly one in five people worldwide carries an elevated level, and because it is inherited, it does not show up as a lifestyle problem you can spot from the outside.

Dr. Colbert says he checks it whenever he sees a family history of heart attacks in the forties and fifties. That instinct is sound — premature family history is exactly the pattern elevated Lp(a) produces. As of 2026, the recommendation goes further: every adult should have it measured at least once, regardless of family history. Because levels are genetically set and stable, one test is generally enough for life.

If your Lp(a) is normal

You can set the marker aside and focus on the factors you control — LDL, blood pressure, blood sugar, weight, activity, and tobacco. No need to retest.

If your Lp(a) is elevated

Current guidance is to treat every other modifiable risk factor more aggressively — particularly LDL-C. Elevated Lp(a) is also worth mentioning to first-degree relatives, since it runs in families.

One update worth knowing: Dr. Colbert says in the episode that no medication lowers Lp(a). That was the accepted position for a long time, and it remains true that statins and ezetimibe do not lower it. The picture has since shifted in two ways.

PCSK9 inhibitors — including Repatha, which Dr. Colbert discusses elsewhere in this same episode — lower Lp(a) modestly, on the order of 15–25%. And several targeted therapies designed specifically to lower Lp(a) by 80–95% are in late-stage trials. None is FDA-approved yet, and approval depends on trials showing that lowering the number actually prevents heart attacks. If your Lp(a) is high, this is a good question for your clinician about whether a trial or a specialist referral makes sense.

About the nutritional approach discussed: Dr. Colbert describes using alpha-lipoic acid and aged garlic in his practice for patients with elevated Lp(a). This reflects his clinical experience over many years. In fairness to readers, controlled trials have not established that either supplement meaningfully lowers Lp(a) — a meta-analysis of randomized trials found no significant Lp(a)-lowering effect for garlic. Both have been studied for other cardiovascular measures, including modest blood-pressure and LDL effects for aged garlic. If you try either, treat it as a supportive addition to a plan built on proven risk reduction, keep your clinician informed, and recheck your labs.

Where imaging fits alongside the bloodwork

Blood markers describe the chemistry. Imaging shows the anatomy. Dr. Colbert uses both, and the episode revisits the tools covered in Episode 1: the coronary artery calcium (CAC) score, coronary CT angiography (CCTA) with AI-assisted plaque analysis, nuclear stress testing, and cardiac catheterization.

The 2026 guideline gives CAC scoring a defined role: it is recommended for adults at borderline or intermediate risk who are undecided about starting cholesterol medication, and if any calcium is present, statin therapy is recommended. That is a useful frame — the test is most valuable when the result would actually change a decision.

On catheterization, Dr. Colbert makes a point worth repeating: some people avoid it out of fear, and a cath can identify and treat a blockage in real time. He also notes that treatment approaches vary between practitioners, and that a second opinion is reasonable before committing to a major procedure. Both of those are fair. What a reader should not take from this is that any one procedure is universally preferable — that decision depends on which arteries are involved, how many, your other conditions, and your surgeon’s and cardiologist’s assessment.

Catch up on Episode 1: Is Your Heart at Risk? →

Cholesterol-lowering: what to do when statins are hard to tolerate

Dr. Colbert is direct in this episode that some patients struggle with statins, particularly with muscle aches, and that a meaningful number stop taking them. That problem is real and well documented. His response is not to abandon LDL lowering — it is to find a route the patient can actually stay on.

The options he discusses fall into a few categories. All of them are decisions for you and your prescriber.

Lower or intermittent statin dosing

Dr. Colbert notes that patients who cannot tolerate a high dose often do fine on 5–10 mg. A tolerated low dose beats an abandoned high dose.

Non-statin prescriptions

Ezetimibe (Zetia), colesevelam (Welchol), bempedoic acid, and PCSK9 inhibitors such as evolocumab (Repatha) all lower LDL through different mechanisms and can be layered.

Plant sterols and soluble fiber

Both work in the gut to reduce cholesterol absorption. Modest effects individually, but well tolerated and additive to other measures.

Red yeast rice

Described in the episode as a natural statin — which is close to literally true, and the reason it needs care. See the safety note below.

Red yeast rice safety: Red yeast rice contains monacolin K, which is chemically identical to the prescription drug lovastatin. That means it can cause the same muscle and liver side effects as a statin, and it should not be combined with a prescription statin without medical supervision. Potency also varies widely between products because it is regulated as a supplement, not a drug. Tell your clinician and your pharmacist if you take it.

A note on the side-effect account in the episode: Dr. Colbert relays a report of someone developing an autoimmune condition after a statin dose increase. Individual reports like this cannot establish that a medication caused a condition. Statins do have real, documented side effects that deserve a serious conversation with your prescriber — and that conversation is the right response, rather than stopping treatment.

Diet, blood pressure, and the lining of your arteriesOlive oil, and why the type matters

Dr. Colbert’s dietary centerpiece is a healthy Mediterranean pattern built around extra virgin olive oil — specifically high-polyphenol and high-oleocanthal oil, which comes from olives harvested early, before they ripen. It takes far more olives to produce, which is why it costs more and is harder to find. He takes roughly two tablespoons a day.

The mechanisms he describes are reasonable ones: reducing oxidative stress, limiting LDL oxidation, supporting blood vessel dilation, and reducing platelet aggregation. Mary asks a good practical question in the episode about whether more is better, and the answer is no — olive oil is calorie-dense and large amounts will cause digestive upset well before they cause benefit.

Seed oils and oxidized LDL

The episode connects repeatedly fried and refined seed oils to oxidized LDL. This is an area of genuine ongoing scientific debate — the evidence on seed oils is more mixed than the episode’s framing suggests, and much of the concern centers on oils heated repeatedly at high temperatures rather than on the oils themselves. What is not controversial: reducing deep-fried and ultra-processed food is good for your arteries by several independent mechanisms.

Blood pressure and nitric oxide

Dr. Colbert explains endothelial dysfunction clearly: the lining of your blood vessels is a single cell thick, and it produces nitric oxide, the gas that lets arteries dilate on demand. Production declines with age, which means arteries do not open the way they should when demand rises. He uses beetroot extract and grape seed extract, along with sodium reduction, and mentions an Ayurvedic herbal preparation for blood pressure.

Two practical cautions. Herbal blood-pressure preparations vary considerably in composition, and some traditional formulas contain botanicals with real pharmacological activity and real drug interactions — identify exactly what is in any product before taking it, and tell your prescriber. And if you already take blood-pressure medication, adding a supplement that also lowers blood pressure can stack effects; monitor at home and report what you find.

Kyle asks a sharp question in this segment: can someone with soft, unstable plaque safely take nitric oxide boosters? It is a good instinct, and the honest answer is that this has not been specifically studied. If you have known unstable plaque or established coronary disease, clear any vasodilating supplement with your cardiologist first — especially if you take nitrates.

Bleeding-risk note: Garlic, high-dose fish oil, and several other supplements discussed in this episode can affect platelet function. If you take aspirin, clopidogrel, warfarin, or a direct oral anticoagulant, or you have surgery or a dental procedure scheduled, review your full supplement list with your clinician or pharmacist.

Cellular energy, forgiveness, and the heart

The heart contains more mitochondria than any other tissue in the body, for an obvious reason: it never stops working. Dr. Colbert discusses supporting cellular energy production with CoQ10 in its ubiquinol form, NAD+, and D-ribose, alongside the nutritional foundation above. These are best understood as general cellular and cardiovascular wellness support — not as treatments for heart failure or any diagnosed cardiac condition, and never as a replacement for prescribed cardiac therapy.

The segment that may stay with viewers longest, though, is the one about emotions. Mary and Dr. Colbert make the case that anger, bitterness, and unforgiveness are not merely spiritual problems but physiological ones — they constrict blood vessels and raise blood pressure. Chronic psychological stress is a recognized contributor to cardiovascular risk, so the underlying point is well founded.

Kyle shares a personal example about praying blessing over people he was in conflict with during a lawsuit, and describes it as freeing. Whatever your framework, the practical instruction holds: carrying resentment has a physical cost, and putting it down is worth doing deliberately.

“God did not design us to carry all this deadly emotion.” — Mary Colbert

Your next-appointment action plan1Ask for a lipoprotein(a) test. If you have never had one, you are due — current guidance says once for every adult. It is a single blood draw and you never need to repeat it.2Ask whether apoB would add anything. Particularly relevant if you have diabetes, metabolic syndrome, or high triglycerides, where LDL-C can understate your true particle burden.3Write down your family history first. Who had a cardiac event, at what age, and on which side. Premature events in the forties and fifties change the conversation more than any single number.4If statins are the sticking point, say so plainly. There are several non-statin routes to a lower LDL. Your prescriber cannot offer them if they do not know you are struggling.5Bring your complete supplement list. Every bottle, with doses. Several items in this episode interact with common cardiac medications.6Build the foundation regardless. Whole foods, olive oil, fiber, consistent movement, sleep, blood pressure and blood sugar control. No panel result changes the value of these.Divine Health products and resources related to this episode

These are supportive wellness tools that fit the nutritional themes of the broadcast. They are not treatments for coronary artery disease, and they are not substitutes for testing, prescribed medication, or medical care.

CircuZone

Relevant to the nitric oxide and endothelial function discussion. A berry limeade powder formulated to support the body’s natural nitric oxide production, healthy circulation, and blood pressure already within a normal range.

Shop CircuZone →

Q10 Vital — CoQ10

Connects to the segment on mitochondria and cellular energy in heart tissue. Formulated for bioavailability, supporting cellular energy production and antioxidant defense.

Shop Q10 Vital →

NAD+ Powder

Named directly by Dr. Colbert during the discussion of mitochondrial support and energy production. A lemon-lime powder for daily cellular energy support.

Shop NAD+ Powder →

Fiber Zone

Soluble fiber binds cholesterol in the gut — the same mechanism behind one of the prescription options discussed. Provides a blend of soluble and insoluble fiber including psyllium and prebiotic inulin.

Shop Fiber Zone →

Wild Alaskan Salmon Omega-3

Omega-3 fatty acids from wild Alaskan salmon oil, supporting cardiovascular wellness. Relevant to the triglyceride and inflammation themes across this series.

Shop Wild Alaskan Salmon Omega-3 →

High Potency Turmeric with BioPerine

Ties to the inflammation markers discussed in the advanced panel. Combines 95% curcuminoids with sunflower phosphatidylcholine and BioPerine for absorption.

Shop High Potency Turmeric →

Live Long and Strong

Dr. Colbert refers to this book repeatedly during the episode as the place where he lays out the health markers in full detail. If this article made you want to go deeper on the numbers, this is the companion resource.

Get Live Long and Strong →

Browse the full Heart Zone collection →

Supplement safety: Dietary supplements are not a substitute for statin therapy, blood-pressure medication, antiplatelet therapy, or any other prescribed cardiovascular treatment. Several ingredients discussed in this episode can interact with blood thinners and blood-pressure medications. Talk with your healthcare professional before starting anything new, and bring your full list to every appointment.

Questions to take to your next appointment✓Have I ever had my lipoprotein(a) measured? If not, can we add it to my next draw?✓What is my LDL-C target given my personal risk category, and am I currently at it?✓Would apoB or hs-CRP tell us something my current panel is missing?✓Given my family history, would a coronary artery calcium score change what we do next?✓If I am having side effects from my current medication, what alternatives could we try before I stop?✓Do any of the supplements I take interact with what you have prescribed?Watch, share, and get tested

The message of Episode 2 is not that your doctor is failing you. It is that the standard panel was designed to answer a narrower question than the one you actually care about — and that better questions are now available to you. Start with Lp(a). It is one blood draw, once in your life, and it may be the most informative number you have never been given.

▶ Watch Episode 2
More Dr. Colbert Episodes
Visit Divine HealthSources and further reading2026 ACC/AHA/Multisociety Guideline on the Management of Dyslipidemia (Circulation)American College of Cardiology: Updated Guideline for Managing Lipids and CholesterolAmerican Heart Association: Lp(a) Discovery ProjectJACC: 2026 Dyslipidemia Guideline HubCirculation: Lipoprotein(a) as a Pharmacological TargetAmerican Heart Association: Coronary Artery Calcium TestPhytotherapy Research: Aged Garlic Supplementation, Blood Pressure and Lipid Profile — Systematic Review and Meta-Analysis

Featuring: Dr. Don Colbert, MD, Kyle Colbert, and Mary Colbert

Topics: advanced lipid testing, lipoprotein(a), Lp(a), apolipoprotein B, oxidized LDL, myeloperoxidase, MPO, Lp-PLA2, NMR LipoProfile, hs-CRP, Cleveland HeartLab, statins, PCSK9 inhibitors, red yeast rice, plaque stability, plaque rupture, endothelial dysfunction, nitric oxide, olive oil, polyphenols, blood pressure, CoQ10, mitochondria, and heart health.

This content is for education only and does not replace evaluation, diagnosis, treatment, or emergency care from a qualified healthcare professional. Dietary supplements are not intended to diagnose, treat, cure, or prevent disease. Do not start, stop, or change any prescription medication without consulting your prescribing clinician.

The post Your Cholesterol Test Isn’t Enough: What You Need to Know | Dr. Don Colbert, MD Ep 2 appeared first on .

Dr. Colbert’s Broadcast • Heart Health & Prevention • Episode 1

Is Your Heart at Risk? Take This Test Now | Dr. Don Colbert, MD Ep. 1

Heart disease can develop quietly for years before obvious symptoms appear. In this episode of Dr. Colbert’s Broadcast, Dr. Don Colbert, MD, Kyle Colbert, and Mary Colbert explain how coronary plaque develops, why some heart attacks seem to come without warning, what a coronary artery calcium (CAC) score can and cannot tell you, and which blood pressure, blood sugar, cholesterol, inflammation, diet, and lifestyle markers deserve a serious conversation with your healthcare professional.

Featuring Dr. Don Colbert, MD, Kyle Colbert, and Mary Colbert

Heart attack symptoms are an emergency

Call 911 or your local emergency number for new chest pressure, squeezing or pain; shortness of breath; pain or discomfort in the arms, back, neck, jaw or stomach; cold sweat; nausea; unusual weakness or fatigue; lightheadedness; or other symptoms that could represent a heart attack. Do not wait for symptoms to become severe and do not drive yourself if emergency medical services are available.

0CAC score means no detectable coronary calcium on that scan, although other risk factors still matter100+CAC at or above this level can materially change preventive treatment discussions150 minof moderate-intensity activity per week is a widely used heart-health target for adultsJump to a sectionSilent Risk
How Plaque Causes Trouble
Warning Signs
Calcium Score
Tests & Markers
Action Plan
Products DiscussedThe dangerous part: heart disease can be silent

The episode opens with a question that gets straight to the point: if your coronary arteries were significantly narrowed, would you necessarily know it? Dr. Colbert’s answer is often no. Kyle and Mary reinforce the reason this subject feels so urgent: a person may feel normal until exertion, plaque rupture, or another event suddenly exposes an underlying problem.

That does not mean every tired afternoon or episode of indigestion is heart disease. It means feeling well is not a complete cardiovascular screening strategy. Atherosclerosis can develop for years without obvious symptoms, which is why family history, blood pressure, cholesterol, blood sugar, tobacco exposure, weight, activity, sleep, and other risk factors matter even when you feel healthy.

Important distinction: The broadcast uses examples of arteries being 60% to 75% blocked without symptoms. The broader medical takeaway is that coronary artery disease can be asymptomatic. The exact relationship between a percentage of narrowing and symptoms varies by the artery involved, plaque characteristics, blood-flow demand, collateral circulation, and the individual patient.

“Most people say, ‘I feel great, so I know I don’t have any heart disease.’ That’s a poor monitor of heart disease.”

— Dr. Don Colbert, MD, in this episode

What actually causes many heart attacks?

Dr. Colbert compares an artery to an aging pipe and then to a highway losing lanes. Both illustrations make the same point: plaque can accumulate gradually, but the event that triggers a heart attack is often more sudden. A plaque can become disrupted or rupture, prompting platelets and clotting activity that can abruptly reduce or block blood flow to heart muscle.

Calcified plaque

A CAC scan detects calcium associated with coronary atherosclerosis. Higher scores generally mean a greater burden of calcified plaque and higher future cardiovascular risk.

Non-calcified plaque

A calcium score does not directly measure every kind of plaque. Coronary CT angiography (CCTA) can provide additional information about the coronary arteries, including non-calcified plaque and narrowing, when clinically appropriate.

Heart attack warning signs people may dismiss

The broadcast emphasizes that the classic “elephant sitting on my chest” presentation is not the only way a heart attack can appear. Symptoms can be intense, mild, unusual, or intermittent.

Possible warning signWhat it may feel likeWhat to doChest discomfortPressure, squeezing, fullness, pain or discomfort in the center of the chestTreat new or concerning symptoms as urgentShortness of breathMay occur with or without chest discomfortSeek emergency evaluation when sudden, unexplained or accompanied by other warning signsUpper-body discomfortPain or discomfort in one or both arms, the back, neck, jaw or stomachDo not assume it is only a muscle, reflux or dental problem if the pattern is concerningUnusual fatigue or weaknessA marked or unexplained drop in energy, especially with exertional symptomsDiscuss persistent changes with a clinician; seek urgent help when paired with acute warning signsNausea, cold sweat or lightheadednessSymptoms that can be mistaken for a stomach bug, stress or dehydrationCall emergency services when a heart attack is possibleThe test at the center of this episode: coronary artery calcium scoring

A coronary artery calcium test is a non-contrast CT scan that measures calcium in the coronary arteries. It can help refine cardiovascular risk and guide prevention decisions in selected people, especially when the decision about treatment is not already clear.

Dr. Colbert walks through practical score ranges during the broadcast. Current professional guidance also emphasizes that the score should be interpreted alongside age, sex, family history, cholesterol, blood pressure, diabetes status, smoking, symptoms, and the rest of the clinical picture.

CAC resultGeneral interpretationConversation to have with your clinician0No detectable coronary calcium; generally reassuring but not a guarantee of zero cardiovascular riskHow do my other risk factors affect what I should do next?1–99Coronary calcium is present; preventive treatment may be favored depending on age and overall riskShould this change my LDL-lowering plan or other risk-reduction priorities?100+Associated with meaningfully higher cardiovascular risk and often supports more active preventionWhat treatment intensity is appropriate for me?300+Represents a high plaque burden and higher event riskHow aggressively should we address LDL, blood pressure, blood sugar, smoking, weight, exercise and other modifiable risks?

Do not self-order a test based only on age. CAC scanning is most useful in selected patients. People with chest pain or other concerning symptoms need a symptom-focused medical evaluation, not simply a screening calcium score.

What about CCTA and AI plaque analysis?

Later in the episode, Dr. Colbert discusses coronary CT angiography (CCTA) and AI-assisted plaque analysis such as Cleerly. Unlike a standard calcium scan, CCTA uses contrast and can show coronary anatomy, narrowing and plaque characteristics in greater detail. AI-enabled analysis can help quantify and characterize plaque from CCTA images.

This is not automatically the “next test” for every person with a positive calcium score. Whether CCTA, a stress test, additional blood testing or another evaluation is appropriate depends on symptoms, kidney function, known coronary disease, baseline risk and the clinical question being asked.

The heart-health numbers worth knowing

Dr. Colbert repeatedly returns to a simple prevention principle: know your numbers before a crisis forces you to learn them. The episode focuses on the following areas.

Blood pressure

Track your trend, not just one office reading. Optimal blood pressure is generally below 120/80 mm Hg, while diagnosis and treatment decisions require the full clinical context.

Hemoglobin A1C & glucose

Elevated blood sugar and diabetes materially increase cardiovascular risk. Know whether you are in a normal, prediabetes or diabetes range and what your personal target should be.

Lipid panel

Total cholesterol, LDL-C, HDL-C and triglycerides are the starting point. People with established atherosclerotic disease or very high risk may need substantially lower LDL-C targets than lower-risk patients.

Risk-enhancing markers

Depending on your history, a clinician may consider markers such as high-sensitivity CRP, lipoprotein(a) and apolipoprotein B to refine risk.

A useful appointment question: “Based on my age, family history, blood pressure, A1C, LDL-C, triglycerides, smoking history and symptoms, would a CAC score or another test actually change my treatment?” That is a much better question than simply asking for every available scan.

Fiber, blood sugar and the Keto Zone approach

One of the strongest nutrition themes in the show is Dr. Colbert’s defense of fiber. He specifically discusses soluble fiber, legumes and Fiber Zone while pushing back on the idea that a heart-conscious low-carbohydrate diet should be built around meat alone.

That fits the broader Keto Zone philosophy: a low-carbohydrate plan can still prioritize non-starchy vegetables, avocados, nuts, seeds, olive oil, fish and adequate fiber. The goal is not “zero plants.” It is a nutrient-dense eating pattern that also helps control excess added sugar and highly refined carbohydrates.

Current American Heart Association dietary guidance likewise emphasizes an overall heart-healthy pattern rich in vegetables and fruits, healthy protein sources, unsaturated fats, minimally processed foods and fiber while minimizing added sugars and excess sodium.

A practical heart-risk action plan1Know your baseline. Blood pressure, lipid panel, A1C/glucose, weight or waist trend, tobacco exposure and family history are the starting point.2Ask whether a CAC score would change management. Screening is most useful when the result could change a real prevention decision.3Build meals around whole foods. Prioritize vegetables, fiber, healthy fats, fish and other quality proteins while cutting back on added sugar, refined carbohydrates and ultra-processed foods.4Move consistently. For most adults, work toward at least 150 minutes of moderate-intensity aerobic activity weekly, plus strength work as appropriate for your health and ability.5Take prescribed treatment seriously. Lifestyle and supplements can support a wellness plan, but they are not reasons to stop statins, blood-pressure medication, diabetes medication, aspirin or other prescribed therapies without your clinician.6Know the emergency signs. Prevention matters, but speed matters too. If a heart attack is possible, call emergency services immediately.Divine Health products and resources discussed in this episode

The broadcast names several Divine Health products or nutrient categories. These are best presented as supportive wellness tools, not as treatments for coronary artery disease or replacements for medical care.

Fiber Zone

Discussed directly by Dr. Colbert while explaining the importance of soluble fiber. Each serving provides a blend of soluble and insoluble fiber, including psyllium and prebiotic inulin.

Shop Fiber Zone →

Wild Alaskan Salmon Omega-3

The episode discusses fish oil in the context of triglycerides and cardiovascular wellness. Divine Health’s formula provides omega-3 fatty acids from wild Alaskan salmon oil.

Shop Wild Alaskan Salmon Omega-3 →

Super K2

Vitamin K2 is discussed repeatedly in the broadcast. Research into vitamin K supplementation and vascular calcification continues to evolve, so use it as part of an individualized plan rather than as a substitute for proven cardiovascular risk reduction.

Shop Super K2 →

Nano Glutathione Spray

Dr. Colbert mentions Nano Glutathione while discussing CT contrast and his own kidney history. Divine Health markets the spray for antioxidant and cellular support. It should not be described as proven to prevent contrast-associated kidney injury.

Shop Nano Glutathione Spray →

Live Long and Strong

Mary highlights Dr. Colbert’s book during the show as a practical reference for health markers and longevity. It is a natural companion resource for viewers who want to go deeper on the numbers discussed in the episode.

Get Live Long and Strong →

Omega-3 safety note: Do not use an over-the-counter fish-oil supplement as a substitute for aspirin, antiplatelet medication, statin therapy or other prescribed cardiovascular treatment. If you take blood thinners or have a bleeding disorder, discuss supplements with your healthcare professional.

Keto Zone takeaway: low carb does not have to mean low fiber

A common mistake is turning a low-carbohydrate diet into an all-meat diet. Dr. Colbert argues against that approach in this episode. Keto Zone can include abundant non-starchy vegetables, avocado, chia, flax, nuts, seeds, olive oil and other whole-food sources of fiber and unsaturated fats.

Read: How to Get Enough Fiber on Keto Zone →

Questions to take to your next appointment✓What is my overall 10-year cardiovascular risk, and what are the biggest modifiable drivers?✓Would a coronary artery calcium score meaningfully change my treatment plan?✓What LDL-C, blood-pressure and A1C targets make sense for my personal risk level?✓Should I be tested for lipoprotein(a), apoB or hs-CRP based on my family history or current results?✓If I have symptoms, is a CAC score the right test, or do I need a different evaluation such as ECG, blood tests, CCTA, stress testing or cardiology referral?Watch, share, and know your numbers

The central message of Episode 1 is not to live in fear of a heart attack. It is to stop assuming that “I feel fine” is the same thing as “my cardiovascular risk is low.” Know your numbers, understand your family history, build a sustainable lifestyle, and use the right testing when it can change what you do next.

▶ Watch Episode 1
More Dr. Colbert Episodes
Visit Divine HealthSources and further readingAmerican Heart Association: Coronary Artery Calcium TestAmerican Heart Association: Warning Signs of a Heart AttackAmerican College of Cardiology: CAC Scoring for ASCVD PreventionAmerican Heart Association: 2026 Dietary Guidance to Improve Cardiovascular HealthAmerican Heart Association: Omega-3 Fatty Acids and HypertriglyceridemiaCleerly: AI-Enabled CCTA Plaque Analysis Overview

Featuring: Dr. Don Colbert, MD, Kyle Colbert, and Mary Colbert

Topics: heart disease, coronary artery disease, atherosclerosis, coronary artery calcium score, CAC scan, CCTA, Cleerly, cholesterol, LDL, triglycerides, blood pressure, A1C, inflammation, soluble fiber, Fiber Zone, omega-3, Vitamin K2, Keto Zone, and heart attack warning signs.

This content is for education only and does not replace evaluation, diagnosis, treatment, or emergency care from a qualified healthcare professional. Dietary supplements are not intended to diagnose, treat, cure, or prevent disease.

The post The Silent Heart Attack Risk: The Test That Could Save Your Life | Dr. Don Colbert, MD appeared first on .

Dr. Colbert’s Broadcast • Lyme Disease & Tick Safety • Episode 3

Lyme Disease Is Spreading Fast | How to Spot an Infected Tick | Dr. Don Colbert, MD Ep. 3

A tick can be smaller than a poppy seed, its bite may go unnoticed, and the classic bull’s-eye rash does not appear in every case. In this episode, Dr. Don Colbert, MD and Mary Colbert explain which ticks are associated with Lyme disease, the warning signs that deserve attention, how to remove a tick correctly, and the prevention steps families, hikers, hunters, pet owners, and outdoor workers should know.

Featuring Dr. Don Colbert, MD and Mary ColbertImportant medical note

This article is educational and is not a diagnosis or treatment plan. Tickborne illnesses can progress quickly and may resemble other conditions. Contact a qualified healthcare professional if you develop a spreading rash, fever, facial weakness, severe headache, neck stiffness, heart palpitations, breathing difficulty, new neurological symptoms, or illness after a known or possible tick exposure. Do not take antibiotics or other prescription medications without medical supervision.

476,000estimated U.S. diagnoses and treatments each year70–80%of infected people develop an erythema migrans rash36–48 hrstypical attachment window before transmission in most casesJump to a sectionWhy It Is Growing
Know the Ticks
Warning Signs
Remove a Tick
Prevention
Tick-Bite ChecklistWhy Lyme disease deserves more attention

Lyme disease is the most frequently diagnosed vector-borne illness in the United States. The CDC estimates that approximately 476,000 people may be diagnosed and treated each year. That estimate is not the same as the number of confirmed surveillance cases, but it shows how large the clinical burden has become.

Risk is not evenly distributed. Lyme disease remains most concentrated in the Northeast, Mid-Atlantic, and Upper Midwest, with additional risk along parts of the Pacific Coast. However, tick ranges and human exposure patterns continue to change. Outdoor recreation, expanding development near wooded habitats, wildlife movement, warmer seasonal conditions, and increased recognition all contribute to the growing conversation.

Clinical clarification: The broadcast briefly mentions speculation about Lyme disease originating from laboratory activity. Reliable public-health and scientific sources identify Lyme disease as a naturally occurring tickborne infection that was recognized clinically in Connecticut and whose bacterial cause was later discovered. There is no credible evidence establishing a laboratory release as its origin.

“An ounce of prevention is worth a pound of cure.”

— Dr. Don Colbert, MD

Know the tick before you assume the disease

Not every tick transmits Lyme disease. The episode distinguishes three ticks that people commonly confuse:

TickWhat to noticeAssociated concernsBlacklegged or deer tickDark legs; nymphs can be about the size of a poppy seedPrimary U.S. vector for Lyme disease; can also transmit other pathogensAmerican dog tickLarger body with pale or patterned markingsCan transmit Rocky Mountain spotted fever and tularemia; not the main Lyme vectorLone star tickAdult female often has a single pale spot on the backAssociated with ehrlichiosis and alpha-gal syndrome; not considered a competent Lyme vector

Why nymphs matter: They are extremely small, active during warmer months, and easily missed during a quick inspection. Many people never feel the bite.

The delayed red-meat reaction many people miss

Dr. Colbert also discusses alpha-gal syndrome, a potentially serious allergy that can develop after certain tick bites, most often associated in the United States with the lone star tick. Unlike many food allergies, symptoms often begin several hours after eating mammalian meat or exposure to another alpha-gal-containing product.

Possible symptoms

Hives, swelling, abdominal pain, nausea, vomiting, diarrhea, breathing difficulty, dizziness, or anaphylaxis.

Timing matters

Symptoms commonly occur about 2–6 hours after exposure, which can make the trigger difficult to identify.

Lyme disease symptoms: early clues and later complications

The most useful takeaway from the episode is that Lyme disease does not always look dramatic at first. Early symptoms may resemble the flu, and the rash can vary considerably.

1Early localized illness

Early symptoms commonly begin 3–30 days after a bite and may include fever, chills, headache, fatigue, swollen lymph nodes, muscle aches, and joint aches.

Erythema migrans rash: This expanding rash occurs in roughly 70–80% of infected people. It may form a target-like pattern, but it can also appear as a uniformly red or warm expanding patch. It is often not painful or itchy.

2Early disseminated illness

Untreated infection can spread and may cause facial palsy, severe headache or neck stiffness, nerve pain, numbness, additional rashes, heart palpitations, irregular heartbeat, dizziness, or shortness of breath. Facial drooping or cardiac symptoms warrant prompt medical evaluation because stroke, heart disease, and other emergencies must also be ruled out.

3Later manifestations

Months after untreated infection, some people develop arthritis, especially swelling and pain in larger joints such as the knees. Neurological complications can also occur. Persistent symptoms require careful medical evaluation rather than assuming every case is active ongoing infection.

How to remove a tick correctly

Fast, careful removal reduces risk. Do not wait for the tick to detach on its own.

1Use clean, fine-tipped tweezers. Grasp the tick as close to the skin’s surface as possible.2Pull straight upward with steady pressure. Do not twist, crush, jerk, or squeeze the tick’s body.3Clean the area and your hands. Use soap and water or rubbing alcohol.4Record the date and location. A clear photo of the tick and bite area may help a clinician evaluate species, engorgement, exposure risk, and symptom timing.

Do not use: petroleum jelly, nail polish, essential oils, heat, a lit match, gasoline, or other methods intended to smother or irritate the tick. These methods delay removal and may increase the chance of the tick releasing fluids.

Testing and treatment: what readers should understand

Lyme disease is diagnosed by combining symptoms, exposure history, physical findings, and laboratory testing when appropriate. Early blood tests can be falsely negative because antibodies may take several weeks to develop. A characteristic expanding erythema migrans rash in a person with relevant exposure may allow a clinician to diagnose and treat without waiting for a positive blood test.

The episode discusses commercial tick-testing laboratories. Saving a tick for species identification and evaluation of engorgement may be useful, but a tick’s laboratory result should not replace clinical evaluation. A positive tick does not prove transmission occurred, and a negative result does not exclude another exposure or pathogen.

Post-exposure antibiotics: A single dose of doxycycline may be considered after certain high-risk blacklegged-tick bites when specific criteria are met, including likely attachment for at least 36 hours and treatment within 72 hours of removal. This is a medical decision. It is not automatically appropriate after every tick bite.

The prevention plan that matters most

Dr. Colbert repeatedly emphasizes prevention. The most effective approach uses several layers rather than relying on one spray or one quick check.

✓Treat clothing and gear appropriately. Use products containing permethrin only as directed on clothing, footwear, tents, or gear. Do not apply fabric-only permethrin products directly to skin.✓Use an EPA-registered skin repellent. Effective active ingredients include DEET, picaridin, IR3535, oil of lemon eucalyptus/PMD, and 2-undecanone. Follow age restrictions and label directions.✓Dress strategically. Wear long pants, closed shoes or boots, and light-colored clothing that makes crawling ticks easier to see.✓Stay in the center of trails. Avoid brushing against tall grass, leaf litter, and dense vegetation when possible.✓Shower soon after outdoor exposure. Inspect the body before and after showering.✓Dry clothing on high heat when appropriate. Check garment instructions and follow CDC guidance for killing ticks on dry or damp clothing.The seven places people forget to checkScalp and hairlineBehind and inside the earsUnder the armsAround the waist and waistbandGroin and between the legsBehind the kneesBetween the toes, around ankles, and anywhere clothing fits tightlyQuick reference: what to do after a tick biteStepActionWhy it mattersRemoveUse fine-tipped tweezers and pull straight upPrompt removal lowers exposure timeCleanWash the bite and handsReduces local contaminationDocumentPhotograph the tick, bite, and dateHelps evaluate species, size, and timingAssessConsider region, species, engorgement, and attachment timeDetermines whether medical prophylaxis may be consideredWatchMonitor for rash, fever, fatigue, swollen nodes, pain, facial weakness, or cardiac symptomsSymptoms may appear days to weeks laterFaith, knowledge, and responsible action

“My people are destroyed for lack of knowledge.” — Hosea 4:6

Mary Colbert closes the episode by connecting faith with practical wisdom. The message is not to live in fear of the outdoors. It is to use knowledge, preparation, prompt action, and appropriate medical care so that preventable exposure does not become a long-term health problem.

Products discussed in this episode

No Divine Health dietary supplement was specifically recommended or named in Episode 3. The prevention products discussed were over-the-counter tick repellents and fabric treatments. Use only EPA-registered products and follow the product label. For Divine Health educational resources and wellness products, visit DivineHealth.com.

Watch, share, and protect someone you love

Send this episode to parents, grandparents, hunters, hikers, campers, gardeners, pet owners, and anyone who spends time near wooded or grassy areas. One careful tick check can prevent weeks or months of uncertainty.

▶ Watch Episode 3
More Dr. Colbert Episodes
Visit Divine HealthSources and further readingCDC: Preventing Lyme DiseaseCDC: Signs and Symptoms of Untreated Lyme DiseaseCDC: Testing and Diagnosis for Lyme DiseaseCDC: What to Do After a Tick BiteCDC: About Alpha-gal SyndromeEPA: Skin-Applied Repellent Ingredients

Featuring: Dr. Don Colbert, MD and Mary Colbert

Topics: Lyme disease, blacklegged ticks, erythema migrans, tick removal, tick checks, doxycycline prophylaxis, alpha-gal syndrome, repellents, and outdoor prevention.

This content is for education only and does not replace evaluation, diagnosis, or treatment by a qualified healthcare professional.

The post Lyme Disease Is Spreading Fast | How to Spot an Infected Tick | Dr. Don Colbert, MD Ep. 3 appeared first on .