In this video, Dr. Justin and David Korsunsky from Heads Up Health discuss the importance of tracking biometric data, blood glucose, functional medicine tests, and other health-related data. They highlight the challenges of consolidating and monitoring this data and how Heads Up Health offers a solution that makes health data measurable and understandable for individuals. The software allows users to monitor their sleep quality, blood glucose levels, and other health data in real time, empowering them to make informed decisions about their diet and lifestyle to improve their overall health.
The video also explores the future of health tracking, which includes passive sensor data collection and at-home lab tests. Also, they discuss the benefits of continuous glucose monitors, which allow individuals to track their blood sugar levels in real-time and make necessary adjustments to their diet and lifestyle. Furthermore, they discuss the growing interest in peptides for weight loss and other health benefits. The software also offers a transcription service that consolidates health data from multiple portals and sources, making it easier for individuals to monitor their health data and make informed decisions.
Heads Up Health Sign Up: https://justinhealth.com/headsup
In this episode, we cover:
00:32 – Heads Up Software
02:56 – Blood Glucose Monitoring
11:10 – Peptides Monitoring
12:06 – Health History Consolidation
18:20 – Weight Loss Peptides
Dr. Justin Marchegiani: Hey guys! Dr. Justin Marchegiani in the house with Dave Korsunsky from Heads Up Health. Today we're going to be talking about ways to track your biometrics, your blood glucose/your continuous glucose monitor, your biometric data, functional medicine test. I see this as a big problem in the functional medicine field. People got all this data. How do you consolidate? How do you track it? How do you measure? How do you monitor it? We'll be talking to Dave all about that today. Dave, how you doing man? Welcome to the show!
Dave Korsunsky: Hey Doc! Thanks for having me on the show. Awesome to reconnect with you. It's been far too long my friend.
Dr. Justin Marchegiani: Absolutely brother. So, tell us a little bit more about the people that haven't kind of understood about your software, about Heads Up. Just give us like that elevator pitch. Like what does it do? What's the big value why anyone should even get it?
Dave Korsunsky: Yeah, there's really two things to think about that. First is how do you actually measure that your health is improving? Everyone listening to your show is trying to make improvements in their health. There’s Thyroid health, their body composition changes. They want to sleep better, eat better, feel better, reverse their chronic condition. But really, as an individual, how do you actually measure that it's working?
So what we do at Heads Up is we make your health measurable. We give you the tools to give you empowerment and agency so you can actually see the changes in real time. That's when it becomes really, really motivating. And I remember when I was working with you Doc as you, you are my functional doctor, and you might remember, I was putting all my labs in a spreadsheet back at the time. But that was the only way I could see the changes, from test to test to test. And I was going on supplement protocols, and I was trying different recommendations that you were giving me. And we were monitoring those thyroid markers in a spreadsheet.
And just being able to see all that information as a medical layperson, I wasn't the doctor, but it helped me better understand the changes I was making and whether or not they were working. So that's what we want to provide to everybody in a really simple accessible way. Its just to give you the tools to measure and understand your own health, and make sure it's moving in the right direction.
Dr. Justin Marchegiani: I absolutely love that. So you've been doing this for many years. You guys have grown your company up. I remember just a few years back, much smaller. Now you've grown a much bigger company, way more services, way more lab Integrations. Out of all the people that are kind of using your services, what are the the top two or three things people are really using you the most for?
Dave Korsunsky: I would say, if you're an individual consumer, okay? Like you're self-managing your own health at this stage in the game, I would say, some of the most popular things we see people using us for are measuring their sleep quality. So typically they're using something like an Oura Ring or a CardioMood, or something that's measuring really, really precise sleep measurement. And when I say sleep I mean, things like the quality of your sleep, your resting heart rate, your heart rate variability. So I'd say the first one is sleep monitoring. Oura being the most common.
The second one that I know you and I want to talk about a little bit more here today are what's called “Continuous Glucose Monitors”. And these are just little patches you wear on the back of your arm or on the stomach.
Dr. Justin Marchegiani: Like this? This is Libre right here.
Dave Korsunsky: Yeah, exactly. Yeah, I use the Dexcom. But these are game changers because what these devices do is they put the power back to the people. And and they let you see your blood sugar values in real time. And the thing with blood glucose is that it's a little bit different for everybody. Two people eat a banana, okay? One person sees their glucose go up, one person actually might see it go down. Same banana. So, if you go look at the American Diabetes Association recommendations, or you look at it just based on the amount of carbohydrates listed on the label, you're not getting the full story.
So this lets you actually see what happens to your blood sugar after you eat different things, after you fast, after you exercise, and that lets you make real-time adjustments. So here's a really good example Doc. You go have some lunch, and you have, let's say you go for some Thai food. And they bring you a side of rice with the Thai food. And you have the Thai food and you have maybe, half a cup of rice for instance. And you're watching your glucose monitor, it's taking readings every five minutes, right to your phone. Wow! After that meal, my blood sugar went to 180 milligrams per decimeter, right? That's way too high, postprandial. (Totally!)
So what was it? Well okay, I had some veggies and some chicken. That probably wasn't it. I probably had too much rice. So the next time you have a quarter cup of rice. I'm not saying you got to completely eliminate it. Maybe then you get it down to 140 postprandial. Just by that simple change in portion size, okay? And now, “Okay, maybe I'll just keep it at a quarter cup. I want to stay below 140, 2-hour.” Whatever your goal is. (Yep!) But now you've made that one change and you extrapolate that over the next 10 to 15 years of what that does to preserving the health of your pancreas and your metabolic health. And that one change has now had a massive impact on your future health and longevity. So I would say the second one are these continuous glucose monitors.
Dr. Justin Marchegiani: And just to highlight there a little bit too. I've seen some patients go a little bit higher and just go to, go for a 10 minute walk afterwards. Go for a 10-minute walk, go do some jumping jacks, go do some air squats. Sometimes that can be enough to lower it just 10 or 20 points in a 10 minute period by just getting those glute-4 receptors up on the muscle. They can pull some of that glucose in and then start to lower the blood sugar pretty simply. So that's an easy change you can make.
And then just looking at the inflammation. I had someone the other day just sub out the gluten and put potatoes in instead. Similar carb levels but their blood glucose was 50 points lower than when they had gluten in. (Exactly) Because you have the carbohydrate load, the glycemic load, but then you don't have the inflammatory load that can then, create a cortisol-adrenaline spike. Which then will also mobilize glucose on top of that.
Dave Korsunsky: And this is putting, this is giving individuals a tremendous amount of insight into their own health/ You know, the conventional doctors, unless you have type 1 or type 2 diabetes, they might never look at your CGM data. There's no reason for them or billable code or anything. So how are you going to make those changes now that are going to help you? First of all, blood glucose actually and monitoring your glucose, is my number one weight loss tip. You know, a lot of people don't associate blood sugar control with weight loss. Exactly.
So you know for just regular average Joe who wants to keep the pounds off over the long run, keeping the glucose levels in check with the continuous glucose margin. It's an awesome lever that we have and then to your point, you just find these really simple easy ways to make better decisions. And that is for me, that that's really, you know longevity is this big buzzword. Everybody's talking about longevity these days. But for me longevity is just like keep your blood sugar under control and make sure you know what it is, okay? Don't BS yourself like you should know. (Yeah) And get lots of sleep and move, and so that you know, these simple changes to me are really at the core of longevity. It doesn't have to be super complicated.
Dr. Justin Marchegiani: Absolutely. When we look at glucose, we're really just trying to get an indirect measurement of insulin, right? Because the higher glucose is, the more insulin we need to kind of bring it down. Obviously, that could be off with your type 1 diabetic. That's not going to be quite the same there. But that's a good kind of, indirect kind of measurement, and glucose if it's too high, creates oxidative stress. Can create a lot of inflammation and advanced glycation and products in the small tissues, the capillaries, the brain.
Obviously like Alzheimer's and a lot of that. That's all like type 3 diabetes. And then of course insulin, making lots of insulin of itself can create all kinds of problems like ovarian cyst, increase cancer growth, increase inflammation, increase blood pressure, metabolic syndrome. So that gives us some really good Insight. What's next? What's the next big thing you're seeing a lot of your users use? And also we'll put some links below to kind of access and you guys can sign up with Heads Up. We'll put those in the description. What's the next big modality or test?
Dave Korsunsky: Good question Doc. I think we're if I just look out to the future a little bit, what I'm seeing is, and and we integrate every kind of device on the market, every kind of lab test. So we see a lot. Like we we integrate 10 or 20 different medical devices into the system. You know, thousands of different laboratory tests. So if I extrapolate out to the future a little bit Doc, what I'm seeing is more ways for individuals to test at home. So let me give a few examples of what I mean by that. First of all, there's going to be more of these sensors like the continuous glucose monitor, but sensors that can now start to measure more than glucose.
So now imagine you put that CGM patch on and it's measuring continuous ketones, it's measuring continuous glucose, maybe it's measuring a continuous lactate, maybe they start to monitor or other things on there like other metabolites. So I'm seeing a trend towards more of this passive sensor collection data. The reason these continuous measurements are so valuable is because; A. You as the individual, you don't have to change your behavior. You don't have to test with like a glucometer, or a blood test it's just happening automatically in the back.
Dr. Justin Marchegiani: It's just there. But then when you get that data, then that can allow you the awareness to potentially change your behavior. Like, “Oh, I didn't get enough sleep last night or this workout was too hard my HRV dropped.” And then it gives you the ability to then, have data and now, make a better decision with what's coming next in your life.
Dave Korsunsky: Exactly! So you've got more types of continuous passive data. I think that's just a win because then these apps built on top of the sensors. like you said. They give you these awesome insights. “Hey you're too high go for a 20 minute walk.” Game-changing insight right there so simple. Second one is more at home lab testing. Okay, so you, there's going to be less reasons why you have to go to Quests or LabCorp to get the blood draw. There's more tests that can be done through blood lot .
There's even companies coming out where you can take a self-administered vial from the blood at home. And then there's also coming back to consumer electronics so there's more sensors being implemented into the home. I know this may sound a lot a little silly for a lot of listeners, but there were several companies at the Consumer Electronics Show in Las Vegas, that were making sensors actually implanted into the toilet bowl. And it's actually doing real-time urinalysis. Protein, creatinine, electrolyte levels, hydration levels. So there's going to be more of these things that are just in the home and you just get more of this instant biofeedback. And you make more of these instant real changes.
Dr. Justin Marchegiani: Love that. that's really good. Yeah I want to see a fasting insulin, see like a monitor. I want to see like a growth hormone or a testosterone, that'd be great. Like, “Okay, my workout – 20-30 minutes, my testosterone peaked.” Or (Yeah) “Nine hours sleep – I went to bed at 10 o'clock versus midnight.” You know, what does that look like? That's awesome, very cool. (Yeah.) One thing I’d like to talk with you-
(…)
Dave Korsunsky: Yeah, we're seeing a ton of interest. Yeah we're seeing a ton of interest in peptides. There's a lot of chatter out there about, what are called these, GLP-1 weight loss peptides,Wegovy, Ozempic, these kinds of things. We're seeing a ton of interest in those and then also we're seeing a lot of interest in other peptides. Like the growth hormone secretor peptides, BPC. These are really, really powerful compounds that are starting to get increasingly well understood, and we're seeing more and more practitioners on our system who have really really good protocols to take these peptides, and wrap around them all the other lifestyle changes. So now you've got to, you've got the glucose in check, you've got your sleep dialed in, and you're starting to wrap a peptide protocol around that. That's another really huge growth area we're tracking very closely.
Dr. Justin Marchegiani: Love that. That's awesome. I have patients that come and see me all the time. And Kaiser is notorious for this, but a lot of the insurance companies, you'll go into your portal, and instead of like one page of lab data, you'll literally click, let's say blood glucose, or you'll click just one lab value, and you get one page. And so you'll have literally 30 pages of lab data that could just be on one page. And I've heard that you guys have kind of expanded and have a transcription service or people can plug in that data and consolidate that. Can you talk more about that?
Dave Korsunsky: Yeah, well this actually started when I was working with you Doc. And I was your patient and and we were trying to monitor all these labs. And you were in Austin and I was in San Francisco, and I had some of my lab data in the UCSF portal which is University of California in San Francisco. Because they were right next to my house, so I'd go there to get some blood. I had some data in the quest portal. I had some of my labs in the Lab Corps portal. I had some of my labs in the St. Mary's portal. I had some of my labs in the Stanford portal and then the rest of them were sitting in in PDF files and paper.
And this is the state of health care right now. Even inside of the Pfizer portal like you said. It's so bad that like you cannot even get a simple trend line of arguably the most important data for your time above ground. So, one of the things we do in our software is we make it really easy to get data from all these fragmented places and put it on one trend line. And when I did that for myself I could actually see back 10-15 years into my medical history.
Even though the doctor I've been working with only has one or two years of information on me. I had another 12 years of data. So we can now reach a point where actually the individual patient is far more educated and empowered on the trends of their body even in their doctor because we're giving you ways to have the full story, the longitudinal data, it just doesn't exist. It's kind of mind-boggling actually that the industry is still so behind in just basic data presentation.
Dr. Justin Marchegiani: Unbelievable. Well, that's amazing that you have this ability now to consolidate it. So someone goes in, they create an account. Is it just they take all their PDFs that they may have saved on their Google drive or Dropbox and just kind of drag it in and it uploads? How does that all kind of start? How does that process start?
Dave Korsunsky: Yeah let me give you an example. You'd sign in, okay? You'll have a dashboard-
Dr. Justin Marchegiani: Oh, by the way, its real quick. I can share my screen with you if you want to just show it. Do you have the ability to show it live?
Dave Korsunsky: I do, can I share my screen?
Dr. Justin Marchegiani: Yeah, let me get you set up. Yeah, you can do that. Just go and I think, do you see the little up arrow button next to the camera? Should be in the middle. (Yeah I do) Yeah hit share screen.
Dave Korsunsky: Okay, it's going to allow me to give permissions- (Perfect) See if this works. It wanted me to restart Chrome doc, but let me see if I can just- Here we go, can you see it?
Dr. Justin Marchegiani: There it goes, yeah! There it goes. Perfect!
Dave Korsunsky: All right, so let's take a look. So the first thing you'll notice is you want to start tracking on your dashboard. You can see I've got my Dexcom sensor connected here, these are all my glucose measurements coming in. I'm also tracking certain supplements and medications so you can see this is the dose I'm taking of my weight loss peptide. You have ways to track symptoms, whether you've completed your workout, your body composition data. So this is like the stuff you measure at home.
Then you have the labs, that's what you were asking about. Let me show you how that works. The first thing you can do is connect your portal. So you gave the example of Kaiser, okay? So all you'd have to do is come in here and connect your Kaiser portal, not unlike you'd connect your bank account to like QuickBooks, for example or mint.com. You connect your portal here and then what we do is we pull all of that data in, and we put it on one beautiful trend line. So you can see here's my cholesterol, (Love it!) it's going- (Absolutely love it!)
So this is, you can see this was my result stock from last month. I was 150. And I can go all the way back to 2000. Oh sorry, this was the oldest that's 2005. So in 2005, I was at 150, that's how far back I can go and then September. When was this 9-3-2021, I'm at 196 on my most recent reading. So me as the individual, I've now got 16 years of history. These are all coming from different patient portals and labs and everything like that. So, you connect your patient portal and then, if you have PDF files, all you have to do is upload those PDF files, and we'll transcribe them so they show up on your chart. So now we’re giving you-
Dr. Justin Marchegiani: Its that a little file tab. Is that a file tab? And then you can just literally throw them in there?
Dave Korsunsky: File, upload and then, we have a team that will key them into your account. Why does that matter? Because now, you're not looking back through three different doctor portals and 14 PDF files, to see the trend in your triglyceride levels. Like, it should just be right there at your fingertips. That’s the most important data you’ll-
Dr. Justin Marchegiani: By the way, looking at the labs, those HDLs were going up real nice! I like that!
Dave Korsunsky: Hey, you know, I'm lifting heavy doc! I keep it really, really tight. Low carb, (Good fast probably, right?) Paleolithic diet, occasional keto, occasional. I'll do a 72-hour fast maybe like (Nice) three times a year. And lifting, working out, doing cardio, doing all the things. And I use that data to make sure that everything I'm doing is working. And like each year I get older, my labs and everything just keep getting better. (Getting better! I like that!) And that's the way it should be.
Dr. Justin Marchegiani: I love that! So people can plug in their Oura Ring there. Imagine their Fitbit too?
Dave Korsunsky: Oura Ring, Libre, Dexcom, Fitbit, Withings. Everything's in there plus you get all your labs in there as well. That's when you can see the full story of your health.
Dr. Justin Marchegiani: And that was pretty simple. Just that lab tab on the left, click it and then you can drag it in and you're good. Tell me a little bit more you're talking about the the peptides for weight loss, tell me a little bit more about that.
Dave Korsunsky: Well, as you know Doc, traditionally if you're dealing with Diabetes, Type-2 Diabetes for example. The standard of care is to use something like metformin or insulin or something like that. But now, they have the peptides that have come out. They're actually called GLP-1 peptides.
Dr. Justin Marchegiani: GLP-1, is that the same as Ozempic?
Dave Korsunsky: That's exactly what it is. Yeah. And so these work on the insulin pathways, the CERT1 pathways that really control metabolic health. And so, what you're able to do is when you're on on peptides, it is actually, it's actually able to increase your postprandial glucose which sounds a little bit counterintuitive. But after you eat, it's able to quickly make sure that all of the glucose is quickly utilized. And then when you're not after, when it's not a postprandial situation, it's able to actively suppress appetite. It works on the signals that control and regulate hunger and appetite. So you're actually able to get some significant appetite reduction and it's working on the insulin pathways.
All of those things that allow the, you mentioned it, the glut-4 receptors basically, to get supercharged and to get super activated. And that's the pathways that it works on so they work extremely well for weight loss, and then what you do is, as you go on these peptides, as your appetite gets reduced, you start to make healthy lifestyle changes as well. You start getting more ability to exercise. You start getting better quality sleep. The pounds start coming off, the inflammation starts coming down, you're able to work out more, you start having more energy. And at some point you're able to transition off, keep all those healthy lifestyle changes that you've made. And start to maintain a very, very healthy body composition and metabolism for the long haul.
So they're extremely effective when they're combined with the right protocol. I want to emphasize that. Because too many people use them without the right protocol, and they're not going to get the right results.
Dr. Justin Marchegiani: And so with you, what's your experience? How long have you been doing that for? Obviously you're already doing a lot of good things from your health, from an inflammatory, anti-inflammatory nutrient-density standpoint. How long have you been doing it and have you see any benefits?
Dave Korsunsky: I tested these products personally because that's just part of our mantra here at Heads Up. We test everything. So what I did Dr. J, for my personal experiment, is I did 12 weeks of Semaglutide, which is the (Yeah, Ozempic) GLP-1, yeah exactly. Now, one of the things you can also stack with these peptides, because you know quite well doc, as you lose fat, inevitably some muscle is going to come along for the ride. So I wanted to lose fat but not lose muscle. It depends at your starting point, if you're starting where you're very, very overweight, a lot of people who are overweight, they actually do still have a lot of muscle mass.
So, they don't necessarily need to worry about losing lean mass initially, so you can just start with the with the GLP-1 peptide. So I did that for 12 weeks, I also stacked it Justin, with the growth hormone peptides, which are called CJC-1295 and Ipamorelin. That actually allowed me to increase my muscle mass while I was losing body fat. And then I got all of my blood work run before and after I did the experiment. I actually had the best labs I've ever seen in my entire life. Cholesterol, HDL, LDL, triglycerides, insulin, HbA1-c. They were as good or better as the numbers when I was 25 years old.
Dr. Justin Marchegiani: Wow! And so can you repeat the peptides? So you were doing the Ozempic, What are the other ones?
Dave Korsunsky: The Semaglutide, (yeah Ozempic) Yeah, I stacked it with CJC-1295 and Ipamorellin. Those are growth-hormone stimulator peptides. They stimulate your pituitary to secrete your own growth hormone. So you're not taking exogenous growth hormone.Your body is just being signaled to make more. And then I also added in to the stack, another peptide called BPC12, BPC157, (Yep, that’s for the gut right?) which is the general, yes for the gut. And I used that, I was lifting at the gym, so I was lifting about three times a week. Heavy strength training. I did before and after dexa scans and I did before and after labs.
On the dexa scan, I put on eight pounds of lean mass in seven weeks. (Wow!) And the labs that I got back were the best labs I've ever seen. Like all of the cardio-metabolic markers were incredible.
Dr. Justin Marchegiani: Got it, so you're on the BPC157, the Sermorelin one, which is a Secretagogue, that works on growth hormone BPC157. I know it helps with gut repair, gut permeability, I've seen that. And then you have the-
Dave Korsunsky: But growth hormone one, very specifically Justin, were CJC-1295 and Ipamorelin. Those are two different growth hormone peptides. They're typically packaged together.
Dr. Justin Marchegiani: Yeah, okay that's cool. Any side effects you experience at all so far?
Dave Korsunsky: One of the, one of the side effects potentially with Semaglutide is nausea and constipation, and fatigue. So you really have to-
Dr. Justin Marchegiani: That’s just a once a week, right? Just a once a week injection?
Dave Korsunsky: Once a week subcutaneous injection. So you have to work with a medical professional and they're going to help you start at a small dose. And then each week you titrate up to your maximum dose, and the maximum dose is going to be different for everybody. That's why you need to carefully track your symptoms and work with a professional. And they'll get you to that max dose and then you'll sustain. It'll take a while and you'll get to your goal weight, and in that period, you make all the dietary and lifestyle changes you need to make. And then you slowly titrate off, and then you just stay at that new equilibrium point that you've created for yourself.
Dr. Justin Marchegiani: That's great and what's the best way to get a script for, some of these peptides if you're already healthy and you're looking more on the biohacking side?
Dave Korsunsky: There's places you can go online where they'll do a prescription for you online. Once that you can check out is HSRX. There's others out there and that'll be the easiest way to do it. If you just want to go like bypass and just get it online, there's companies that can do the telemedicine consultation for you online and get your script.
(That’s great!) It's expensive, don't get me wrong. Like it's only covered by insurance. The on-label applications are certain classes of obesity type-2 diabetes. So there's a few FDA-approved conditions where insurance will cover it. So, if you can get it covered, its better. If you're a biohacker and you just want to test it, then you've got to go online to one of the telemedicine sites.
Dr. Justin Marchegiani: Interesting! Well, very cool. I love that you're kind of incorporating all of this data into one place which is great, so when you're working with people like me, it's very easy for me to come in there and look at it. By the way, how do you share it? If someone's plugging all this in, they're going to reach out to someone like myself, how do they share with a practitioner?
Dave Korsunsky: Well, there's two ways you can do it. You can have a practitioner account and you can invite other people in, and then they'll be able to monitor at home, and you'll be able to remotely coach them on the data. If you're just an individual, you just go to the website, you sign up and you start accessing it that way.
Dr. Justin Marchegiani: Very good, excellent! I'll put a sign up link here down below. People want to reach out and connect, I'll put that down below so everyone's got it. Dave, anything else you want to leave with the listeners here?
Dave Korsunsky: No, I just want to say that it's great to reconnect with you, Justin. You've been following our journey since the very, very early days, way way back when I was writing my first lines of code. So, (Yes!) fast forward here, many, many years later, you're still doing your thing, I'm still doing my thing, so it's just always a pleasure, my man.
Dr. Justin Marchegiani: Yeah, I remember you took like what, three or six months off of work and do one of those like coding things, like coding boot camps, and you literally were able to bootstrap this even though you don't have a a coding background, which is quite admirable.
Dave Korsunsky: Yeah, I learned how to write software and well, I was always working in engineering roles, but I wrote the prototype for this myself. And then I had to get some smarter people on board to help me do it properly.
Dr. Justin Marchegiani: Love it! Love it, man. Well that's great! You're an inspiration. Very cool, put a link down below justinhealth.com/heads up. Heads Up Health, put the link down below so you guys can see it. Dave, anything else you want to leave the listeners with, any other coordinates you want to give to reach out or connect?
Dave Korsunsky: No, I think that's fine. You can find us at headsuphealth.com. Our support email is there and if you want to reach me, you can you can access the support alias and they'll track me down.
Dr. Justin Marchegiani: Love it, awesome Dave! Well, very cool. Let's be in touch soon, have a good one!
Dave Korsunsky: Thanks Doc!
Dr. Justin Marchegiani: All right, bye.
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