Making Longevity Achievable @vitavedahealth (Formerly Astamcloud)
US
Joined October 2021
- Tweets8.3K
- Following899
- Followers5K
- Likes15.2K
Priyank Sharma MD retweeted
A prescription the patient can't afford, or the payer won't approve, doesn't treat anything.
Today we launched Access Intelligence: copay savings, patient assistance, program enrollment, and prior authorization, inside OpenEvidence. Free for all clinicians.
The help exists. There are thousands of support programs, and prior auths can be won. But the work is scattered across payers and programs, each with its own forms and criteria, and you have a few minutes per patient.
What's live now:
* Ask about availability and eligibility across 2,500+ patient support programs, updated daily.
* Send copay savings and discount offers to the patient with Patient TakeHome.
* Download pre-populated enrollment forms, or enroll on OpenEvidence.
* Write prior auth requests, appeals, and letters of medical necessity grounded in clinical guidelines, with PA checklists and relevant ICD-10 codes.
Choosing the right treatment should be the hardest part of getting a patient treated.
None of these are established, they are all studies that show a correlation, not causation
These are *potential* benefits of creatine
established benefits of creatine:
-sleep deprivation - improved cognitive function (20-25g/day)
-strength, sprinting, lean muscle gain (1-2kg), muscle recovery (5g+/day)
-alzheimer's dz - improved cognitive function (20g/day)
-male fertility - improved sperm count (5g+/day)
-traumatic brain injury - cognitive improvements (25g+/day)
emerging benefits:
-cancer (animal models)
-skin aging (topical)
-heart failure
-depression
-fibromyalgia
-COPD
-osteoarthritis
-fatigue
these benefits are often more pronounced in women who tend to have lower endogenous stores.
no, creatine does not cause hair loss or worsen kidney function.
yes, you can (and should!) get it from red meat but few eat 2+lbs per day (approx 5g dose).
monohydrate form is most studied. dissolve in warm water if you get gi side effects.
if you are not taking creatine, you should be. get it from a 3rd party tested source!
1
2
208
The downside with a model trained only on Epic data is it's going to skew towards sicker / older people since that's who shows up in the hospital (where Epic is dominant) and frequently in clinics
Won't be as useful to a guy like Bryan, but still quite useful overall
Medicine is a compute problem.
This model was able to predict your next health event.
Trained on 300M patients and 16B health encounters.
We overestimate the mystery of our bodies and are more predictable than we want to believe.
Cool seeing that illusion chipped away.
1
207
Cognitive dissonance (noun): psychological conflict resulting from incongruous beliefs and attitudes held simultaneously
Because the inner conflict feels uncomfortable, people try to reduce the stress by changing their behavior or by rationalizing/changing their beliefs
Seth Rogen says he and his wife are now more grateful than ever that they decided not to have children he’s not afraid to explain why.
He admits they used to question whether they’d made the right decision, but now their conversations have shifted to, “Honestly, thank God we don’t have children.”
His reasoning? They’re in the prime of their lives, understand themselves better than ever, and have the freedom to pursue their careers, enjoy life, and build the kind of relationship they’ve always wanted.
But Seth took it a step further, saying he sees people with children struggling to find the same time for work and personal enjoyment that he and his wife have.
“I seem to get a lot more active enjoyment out of not having kids than anyone I know seems to get out of having kids.”
That statement will probably divide people. Some see raising children as life’s greatest joy, while others believe a fulfilling life doesn’t have to include parenthood.
Do you think Seth has a point, or is there a kind of happiness you can only understand after having children?
346
Another datapoint - consumer health is the quiet boom that's happening
Half of 500 Americans surveyed would pay for one app that handles their records, labs, wearable data, and booking care.
That's the race to become the "healthcare home," one of six trends identified. The others:
- Non-toxic everything, from water filters to organic mattresses
- Peptides beyond GLP-1s
- Cholesterol treatment that can reverse some of the plaque in your arteries
- Wearables that measure far more than steps
- Brain-computer interfaces and wearables for the brain
Across all six, consumers are ready to act. They're seeking out tests, trying new products, and spending their own money on health. The opening for founders is helping them follow through.
"As AI makes answers and interpretation cheaper, value will migrate to the companies that can figure out the action layer."
Full piece from a16z's Daisy Wolf and Eva Steinman: a16z.news/p/the-state-of-lon…
176
Priyank Sharma MD retweeted
For those who don't get it, the backlash shouldn't be against zone2, it's against the hype of zone 2 and that to "run fast you need to run slow" - a ridiculous statement with no context.
If you want to be a good runner you need to do all zones training weighted for how many hours a week (and frequency) you can train, your goal distance and your strengths and weaknesses.
I ran a 4.21 mile on no more than 10 miles a week, I only did 3 sessions a week, 2 x hard intervals and one very fast 4 or 5 miler. That's it. No easy runs. However, the mistake I made was not running anywhere near enough miles to improve my time - this would have necessitated running easier, which includes zone 2. There's a reason top milers run up to 60miles a week.
Because my aerobic fitness was lacking (for a runner), as I went up in distance my relative performances got worse and worse. So, if you want to maximise your potential you NEED to do mileage, you NEED to do all zones training. This is not controversial, runners have been doing it for decades.
A few years ago HIIT was all the rage, the same thing applies to HIIT (a subset of interval training) as applies to the hype of Zone 2. If you are unfit you are not even able to DO HIIT, your HIIT is practically a jog compared to a fit person you are not fit enough to do a HIIT session - you need to start easy. Telling up unfit person to do intense sessions before they have even a semblance of fitness is dangerous and ludicrous.
Then again, there;s the accounts that say you only need to walk to get very fit, the same dumb hype of what should be NORMAL. Start easy, start with walking, maybe go to rucking, then do some faster work, add in more effort, keep things mix, exercise within your limits, progress slowly. Walking is a BASE, but you will never get very fit just walking.
A few years ago it was deadlifting being hyped, it would solve all your weakness and turn you into a beast; if you can't deadlift X you're not a real man. I've seen the hype of all sorts of exercises, techniques, training systems and tomfoolery over 50yrs of exercise and training.
The problem is we have accounts which overhype ONE thing, as if that is the silver bullet of fitness - it never is. You need to do all sorts of things for true fitness and strength. So, deadlifts good, Z2 good, walking good, HIIT good - but there's no need for the hype, because very few things live up to the hype.
This is why you have to take what Attia says with a grain of salt
The next shoe to drop will be "turns out you don't need massive muscles, just focus on strength"
Peter Attia takes a one year hiatus and the first thing he says when he came back was “Zone 2 is overrated my bad lol.”
My bad? Do you know how many boring ass hours of stationary bike I’ve done in the last two years?
2
315
The reason doctors don't change how they practice, despite evidence, is it's so damn difficult to operationalize
@vitavedahealth is changing this
4
5
249
Great move, this is 100% what is necessary. Excited to see the results of this deeper integration.
NYU Langone Health @nyulangone is bringing OpenEvidence into the chart, with patient context, for the care teams behind 12.4 million outpatient visits a year.
Patient-aware means a clinician asks a question in Epic and the answer draws on both the peer-reviewed literature and that patient's own record, without leaving the chart. The evidence will be the same in the hospitals and at a community health center in Brooklyn.
New York has always been where American medicine goes to prove itself at scale. The world's medical literature is about to be in the room for every one of those visits.
ALT OpenEvidence and NYU Langone logo
1
2
221
Gambling is an under the radar epidemic.
Management of any addiction should be a key part of one's mental health assessment
today is the only sports equinox of 2026, the day on which all four major north american sports leagues play- MLB, NBA, NFL, and NHL all have games today.
over $1 billion in legal wagers will likely be made today with over $100 million lost.
the majority of this will be from young men, many of whom are already financially strained.
bank of america institute data found that gen Z + millenials accounted for 88% of betting activity within their customers.
just like porn, alcohol, and nicotine, online betting is an addiction for young men that is eroding our society.
men, you've been warned.
2
3
232
AI is resulting in the need for more doctors, not fewer
Since the # of new doctors is limited by medical school spots, those spots will only get more competitive, and doctor shortages will increase
215
A longevity protocol that costs $50k is inefficient and lazy
The real engineering in Longevity is starting with the lightest touch way to check something, then going deeper (more time, $$) if justified
2
1
235
Priyank Sharma MD retweeted
Summed up perfectly.
Evidence that AI won’t replace us 👇🏼
Generative, evidence-based AI still requires CLINICIAN SCIENTISTS to produce original research to provide high quality syntheses of information.
Thank you @OpenEvidence @NEJM! @ShadiYaghi2 @RichaSharmaMD
This is why apoB is the one cholesterol marker you need to check
The most useful cholesterol number may be the one nobody points out.
Most people open a lipid report and look straight at LDL.
That makes sense. LDL-C is one of the most important markers we use to assess cardiovascular risk.
But LDL is not the whole story.
Cholesterol is also carried in VLDL, IDL, remnant particles and Lp(a) — all of which can contribute to atherosclerosis.
This is where non-HDL cholesterol becomes useful.
And you usually do not need another blood test to know it.
Non-HDL-C = Total cholesterol − HDL cholesterol
That simple subtraction gives you the cholesterol carried by essentially all the potentially harmful lipoprotein particles, not just LDL.
It becomes especially useful when triglycerides are elevated or the lipid profile is metabolically more complex, where LDL-C alone may give an incomplete picture.
So the next time you look at a lipid profile, don't stop at LDL.
There is another useful number already sitting in the same report.
2
2
262
To all the looksmaxxers out there
Whatever is healthy looks good, it's always been the case
Get enough sleep, exercise, keep a normal weight
It's simple, though not easy to do consistently
2
1
256
Priyank Sharma MD retweeted
Exercise and remission from cancer: A randomized trial found 37% improved survival, 28% disease-free survival. But little is being done to incorporate in practice except @UPMC 1st health system covering "exercise oncology" program.
gift link, by @AgrawalNina
nytimes.com/2026/10/06/well/…
I target 1g/kg/day, not 1g/lb/day
The latter is not supported by evidence for longevity.
Strength is what matters, not muscle mass, so track performance not size. If protein becomes a strength barrier up it
Btw different story if going for bulk (then load up protein)
So for my current weight loss and muscle growth goals I’m supposed to eat 160 grams of protein each day.
This seems pretty hard…
Are you guys eating entire chickens or what?
216
Domain experts are the best at building automated AI systems and that will only get more pronounced over time
1
3
187
Just spoke with an excellent metabolic / hormone doctor who is looking to leave the traditional system
Not for money, but so they can actually solve health problems
They'll be joining consumer health, as will all the best experts
This is how healthcare will change
1
171
This is what happens when the government foots the bill in an opaque convoluted system
Consumer healthcare will fix this
NEW: RFK Jr. says Medicare spending on wound care patches exploded from $200 million in 2019 to $14 billion last year: "It's all stolen."
Bad actors billed Medicare billions by slapping the most expensive skin grafts on elderly and dying patients who didn't need them.
"The doctors who prescribed them would get 6% of the sales cost. And so, they were incentivized to prescribe more expensive products. In Europe, they spend 35 cents a cubic inch. We were spending $135, and that went up to $2,000 a cubic inch."
"So 2019, we were paying $200 million. Last year we spent 14 billion. All stolen. It's all stolen. And we were on track to spend 23 billion this year."
"We put an end to it, and we now have driven that cost down to somewhere around a billion dollars."
In one Arizona case, the owners of two wound care companies pleaded guilty to more than $1.2 billion in fraudulent claims. Medicare paid over $1 million per patient for grafts slapped on elderly patients who didn't need them, many of them dying in hospice.
In June, DOJ charged 11 more defendants over more than $2 billion in allograft claims, including a company accused of issuing sham invoices to inflate what Medicare paid.
It feels like every week I learn a new way people were ripping off taxpayers for billions.
1
3
242