Medicine Redefined

Darsh and Altamash break down why health outcomes are shaped by small, repeated choices (not occasional slip-ups). Using weight gain around the holidays as an example, they discuss how consistency and habit adherence matter more than intensity or “reset” culture. They explore how simplifying habits makes them easier to stick with, and why prioritizing maintenance during high-risk periods can prevent long-term health decline. A practical conversation on building health that actually lasts. On this episode… 04:30 – Holiday Survival and why maintenance matters 08:15 – Managing workouts at Disney World & South Korea. 13:00 – Nutrition Tips with protein treats and fasting 20:15 – James Clear’s Rule: "Reduce the scope, stick to the schedule." 28:00 – The Protein Debate 36:00 – The cost of going all in 39:30 – Why you need to decide in advance what you will fail at. 48:00 – Future guests, the newsletter returns, and what’s next! Resources mentioned… Protein Targets & Muscle Physiology The Helms Paper (Bodybuilders/Lean Mass): A systematic review of dietary protein during caloric restriction in resistance trained lean athletes (Helms et al., 2014) Protein for Adults: Optimizing Protein Intake in Adults (Wolfe, 2017) Supplements & Training: Meta-analysis of protein supplementation on resistance training gains (Morton et al., 2018) Anabolic Resistance: Skeletal muscle protein metabolism in the elderly (Breen & Phillips, 2011) Position Stand: ISSN Position Stand: Protein and Exercise (2017) Sleep & Circadian Protocols Morning Light: Phase advancing human circadian rhythms with morning bright light (Crowley & Eastman, 2015) Exercise Timing: Circadian rhythm phase shifts caused by timed exercise (Thomas et al., 2020) Jet Lag: Physical exercise accelerates reentrainment of human sleep-wake cycles (Yamanaka et al., 2010) Sleep Tools: Eight Sleep System | 15% off Remade Sleep Supplement: https://getremade.com/?ref=doctor.darsh Habits, Identity & Mindset James Clear: Atomic Habits ("Reduce the scope, stick to the schedule") Jonathan Haidt: Conversations with Tyler (Transcript regarding "The Anxious Generation") Oliver Burkeman: Four Thousand Weeks Intermittent Fasting: Intermittent fasting strategies and effects on cardiometabolic risk factors (BMJ, 2024) Connect with Us! Website: medicineredefined.com Follow: @doctor.darsh | @dr.altraja Altamash’s New Practice: Refining Health & Performance (Now accepting patients in NJ, NY, PA, FL)

Join Dr. Altamash Raja and Dr. Darsh Shah on Medicine Redefined as they introduce Dr. Darren Candow, a leading researcher on creatine supplementation. The episode dives into the benefits of creatine, not just for muscle performance, but also for brain health, bone density, and cardiovascular health. Addressing myths and misconceptions, the conversation highlights creatine's potential role in cognitive function, aging, cancer prevention, and post-concussion recovery. Brain Health, TBI & Sleep Deprivation The "Germany Study" on Sleep Deprivation (30g Dose): Reference: Gordji-Nejad, A., et al. (2024). Single dose creatine improves cognitive performance and induces changes in cerebral high energy phosphates during sleep deprivation. Scientific Reports. Brain Creatine in Vegans vs. Omnivores (The "Brazil Study"): Reference: Solis, M. Y., et al. (2013). Brain creatine depletion in vegetarians? A cross-sectional 1H-magnetic resonance spectroscopy (1H-MRS) study. British Journal of Nutrition. Creatine for TBI in Children: Reference: Sakellaris, G., et al. (2006). Prevention of traumatic headache, dizziness and fatigue with creatine administration. A pilot study. Acta Paediatrica. Creatine for Depression (The "Utah Studies"): Reference: Kondo, D. G., et al. (2011). Open-label adjunctive creatine for female adolescents with SSRI-resistant major depressive disorder. Journal of Clinical Psychiatry. Reference: Roitman, S., et al. (2007). Creatine monohydrate in resistant depression: a preliminary study. Bipolar Disorders. Bone Health, Aging & Long COVID Creatine for Long COVID: Reference: Slankamenac, J., Ostojic, S. M., et al. (2023). Creatine supplementation combined with breathing exercises reduces respiratory discomfort and improves creatine status in patients with long-COVID. Journal of Postgraduate Medicine. Creatine & Bone Health (Post-Menopausal Females): Reference: Chilibeck, P. D., Candow, D. G., et al. (2015). Effects of creatine and resistance training on bone health in postmenopausal women. Medicine & Science in Sports & Exercise. Alzheimer’s Disease (The 2024 Study): Reference: Fairman, C. M., et al. (2024). Eight weeks of creatine monohydrate supplementation is associated with increased muscle strength and size in Alzheimer's disease. Frontiers in Aging Neuroscience. (Note: This is likely the "groundbreaker" he mentioned from this year). Bioavailability & Dosing The Original "Big Paper" (1992): Reference: Harris, R. C., et al. (1992). Elevation of creatine in resting and exercised muscle of normal subjects by creatine supplementation. Clinical Science. Meat vs. Solution vs. Candy (Gummies): Reference: Harris, R. C., et al. (2002). Absorption of creatine supplied as a drink, in meat or in solid form. Journal of Sports Sciences. Note: This is the study confirming that creatine in solid forms (like gummies/candy) is bioavailable. Caffeine Interference (The "350mg" Threshold): Reference: Vandenberghe, K., et al. (1996). Caffeine counteracts the ergogenic action of muscle creatine loading. Journal of Applied Physiology. Reference: Trexler, E. T., & Smith-Ryan, A. E. (2015). Creatine and Caffeine: A Brief Review of Concurrent Use. ACSM's Health & Fitness Journal. People Mentioned Dr. Sergej Ostojic: Leading researcher on creatine for Long COVID and clinical applications (University of Novi Sad). Dr. Scott Forbes: Frequent collaborator with Dr. Candow on brain and bone health. Dr. Chad Kerksick & Dr. Andrew Jagim: Cited for their reviews on creatine safety in children.

Join Dr. Altamash Raja and Dr. Darsh Shah in a comprehensive discussion with Dr. Allison Grimaldi on femoral acetabular impingement (FAI) and hip health. This episode of Medicine Redefined dives into part two of the hip-focused conversation. Dr. Grimaldi provides a deep dive into FAI, discussing types of impingement, symptoms, and the importance of accurate diagnosis and individualized treatment. The conversation also touches on advances in hip arthroscopy, metabolic health, and the role of systemic inflammation in joint conditions. Tune in for valuable insights into hip pathology, patient care, and the future of hip health. 00:00 Introduction and Exciting Update 00:40 Recap of Part One and Introduction to FAI 01:04 Understanding Femoral Acetabular Impingement (FAI) 03:49 Imaging and Diagnosis of FAI 07:53 Development and Risk Factors of FAI 12:05 Weightlifting and FAI in Adolescents 16:07 Surgical Interventions and Outcomes 24:53 Non-Surgical Management and Rehabilitation 29:48 Post-Surgery Expectations and Long-Term Management 41:15 Micro Instability and Dysplasia 45:02 Understanding Hip Dysplasia and Instability 46:44 Clinical Tests and Imaging for Hip Dysplasia 49:29 Rehabilitation Approaches for Hip Instability 53:47 Exercises for Deep Muscle Recruitment 01:02:23 Metabolic Health and Tendon Pathology 01:09:41 Considerations for Aging Athletes 01:14:18 Future of Hip and Pelvic Pain Care 01:19:51 Shifts in Understanding Hip Impingement 01:22:28 Final Thoughts and Advice for Practitioners Resources & citations 2016 Warwick Agreement on FAIS (consensus statement).  UK FASHIoN RCT: arthroscopy vs physio for FAIS (BMJ 2019).  Australian FASHIoN trial: cartilage imaging & outcomes (BMC 2021).  Hip microinstability: international consensus diagnostic criteria.  Post-arthroscopy effusion/synovitis and outcomes: overview blog + PubMed.  Modern Hip Arthroscopy for FAIS May Delay the Natural History of Osteoarthritis in 25% of Patients: A 12-Year Follow-up Analysis. - PubMed Connect with Dr. Grimaldi Website: dralisongrimaldi.com.  Hip Academy: Program & membership.  Instagram: @dralisongrimaldi.  X (Twitter): @alisongrimaldi.

Join hosts Darsh and Altamash as they sit down with Dr. Allison Grimaldi to dive deep into the complexities of hip pain and the latest research in the field. In this episode, Dr. Grimaldi sheds light on the challenges of diagnosing and treating hip issues, the anatomy of the hip joint, and the critical role of gluteal tendinopathy.  Learn how significant lifestyle changes and thorough education can alleviate symptoms more effectively than traditional corticosteroid treatments. Don't miss this enlightening discussion aimed at both clinicians and patients who are eager to better understand their bodies. TIME STAMPS 00:00 Introduction to Postpartum Health Challenges 00:27 Welcome to Medicine Redefined 01:05 Exciting Update: New Practice Launch 01:34 Introducing Dr. Allison Grimaldi 01:46 Why Focus on the Hip? 06:18 Understanding Hip Anatomy 08:44 Lateral Hip Pain and Its Complexities 22:55 Diagnosing Gluteal Tendinopathy 27:16 Identifying Hip Pain: Key Questions and Symptoms 27:52 Differentiating Gluteal Tendinopathy from Other Conditions 29:19 Common Presentations and Misdiagnoses 31:14 Effective Sleep Positions for Hip Pain Relief 36:07 Diagnostic Tests for Gluteal Tendinopathy 39:31 Insights from the LEAP Study 44:16 Balancing Short-term Relief and Long-term Solutions 46:11 The Role of PRP in Treatment 50:13 Concluding Thoughts and Next Steps SOURCES LEAP Trial: https://www.bmj.com/content/361/bmj.k1662 Gluteal Masterclass: https://pubmed.ncbi.nlm.nih.gov/39854929/

Ever felt like your insurance company is gaslighting you? Dr. Altamash Raja shares a real story that turned a routine billing error into a masterclass on how to actually navigate health insurance. From copays and deductibles to hidden tiers and the fine print that drains your wallet - this Progress Note breaks it all down. Join hosts Dr. Darsh Shah and Dr. Altamash Raja as they cut through the noise, explain the system in plain English, and arm you with the knowledge to advocate for yourself next time your claim gets “lost”. TIMESTAMPS 00:36 Insurance Negotiations Frustrations 06:33 Understanding Health Insurance Terms 17:26 Navigating Insurance Plans and Benefits 23:56 Navigating Insurance Verification 25:52 The Business Side of Healthcare 26:37 Challenges in Inpatient Rehab 28:41 Understanding Healthcare Metrics 31:59 Emergency Visits and Insurance 34:10 Planning for Medical Emergencies 37:14 Insurance Tiers Explained 40:01 Practical Tips for Managing Insurance 46:20 Final Thoughts and Recap 48:10 Outro and Disclaimer SOURCES [00:06:00] — Premiums, Deductibles, Coinsurance & Copays Explained – Aetna [00:17:00] — HMO vs. PPO: Which Is Right for You? – Humana [00:34:00] — What Is a “Surprise Medical Bill” and What Should I Know About the No Surprises Act? – Consumer Financial Protection Bureau [00:34:00] — No Surprises Act: Balance Billing Rules for Emergency and Air Ambulance Services – Centers for Medicare & Medicaid Services [00:40:00] — Navigating the Insurance Appeals Process –Patient Advocate Foundation