Greg Goetz DO

At first I agreed with Bezos here. Then I thought "No. F that. Both with the low income earner and the high income earner, taxation is the same thing . . . . theft." The revolutionary war was fought over a 3% tax on tea. WTF happened to us tolerating a national income tax?

How is waist circumference a "fitness test"? This might be pedantic but it's technically a sign, an objective measurable aspect of the patient (vs a symptom). So yes, it's health metric, not it's not a fitness test. Waist circ is a surrogate for visceral adiposity, which is important, but by no means a functional test of fitness, like say, VO2 max is. I administer fitness tests and I also conduct body comp tests so Im familiar with the differences.

Walk into your next annual physical. They'll weigh you. They'll measure your height. They'll calculate your BMI. They probably won't measure your waist circumference. The Whitehall II cohort just published 11-year follow-up data suggesting that they should The Whitehall II study has followed UK civil servants for over three decades. In this latest analysis (Ben Hassen et al., GeroScience, 2026), researchers tracked 4,593 adults from a baseline age of 65 for a median of 11 years to identify who would lose the ability to perform basic daily activities: dressing, bathing, transferring, walking, toileting, feeding. They wanted to know which midlife test would best identify who would decline. They tested 10 standard geriatric and fitness measures: walking speed, timed chair rises (how fast you can stand up from a chair five times), balance on one leg, grip strength, lung function (FEV1), BMI, and others. These are the measures geriatricians actually use in practice. When the researchers ranked all 10 measures by predictive accuracy for 10-year disability, waist circumference came out on top. Higher than walking speed. Higher than grip strength. Higher than balance, chair rises, or lung function. The same pattern held for severe disability, defined as needing help with two or more daily activities. The team then ran a machine learning analysis to find the smallest combination of measures that would maximize prediction. The final selected set: age, sex, waist circumference, walking speed, timed chair rises, and balance. For severe disability prediction, walking speed dropped out of the model entirely. Here's the part that matters for practice. Adding walking speed, chair rises, and balance to waist circumference barely improved the prediction over waist alone. Waist circumference did almost all of the work on its own. Why does this one measurement carry so much weight? Because waist circumference captures visceral adipose tissue, the metabolically active fat that wraps around your abdominal organs. Subcutaneous fat (the fat under your skin you can pinch) is mostly storage. Visceral fat is a different organ entirely. It secretes inflammatory cytokines including TNF-alpha and interleukin-6 that drive systemic insulin resistance. It promotes ectopic fat deposition in the liver, pancreas, and skeletal muscle. It correlates with atherosclerosis, type 2 diabetes, dementia, and frailty at higher rates than any other fat depot. BMI cannot distinguish a person carrying weight as muscle from one carrying it as visceral fat. Two adults with identical BMIs can have radically different metabolic profiles. A 70-year-old man with a BMI of 27 and a 102 cm waist is metabolically a different person from a 70-year-old with the same BMI and an 88 cm waist. The first is at substantially higher cardiometabolic risk despite belonging to the same "weight class." This is not an argument to skip exercise. Walking speed, grip strength, and balance remain important markers of physical reserve. The Whitehall II finding is specifically about screening: when you have to pick one measurement to predict who will decline over the next decade, waist circumference outranked the entire fitness battery in this cohort. What this looks like in practice. Add waist circumference to your annual physical or your own self-tracking. Measure at the level of your navel, tape parallel to the floor, after exhaling normally. A rising waist circumference with stable weight is the signal that body composition is shifting toward visceral fat accumulation, a metabolic warning that BMI will miss entirely. The most informative aging marker in this 4,593-person cohort was a strip of plastic. The annual physical that skips it is missing the strongest individual predictor of the next decade of independence. Ben Hassen et al., GeroScience, 2026

Keith Nichols, a colleague of mine with a men's health practice in Tennessee just posted a magnum opus level video on YT on the benefits of estradiol in men on testosterone therapy and the harm of blocking it with aromatase inhibitors. 4 hours long. 360 slides. Incredibly well researched and evidence based. youtube.com/watch?v=jgGcUp…

Preparation tactics here. Tenderize and marinade the public with fear based pieces like this Telegraph article so that when it the next virus is 'accidentally' released the public fear has already been established and it just needs some more stoking. Boy manipulation becomes easy using fear. Gotta love psy-ops. The key word in the Telegraph image is "may", which = we don't know for sure. The mainstream media cold not survive without fear based reporting.

@digijordan When it's just one person, that's not even a study Jordan. It's known as a case report.

“Hantavirus can remain in human semen for up to six years and has the potential for sexual transmission even after a person has recovered, according to a peer-reviewed study.” What they don’t tell you is the ‘study’ consisted of ONE person 🙄 They just don’t want people having kids anymore.

I have a good podcast topic idea for you. Normal and abnormal lab tests. How they are derived. When is an abnormal test clinically relevant? Just read a fantastic 2025 review paper by Journ of Amer Family Practice on the topic (see attached). My big take away was if 20 tests are ordered on completely healthy disease-free humans, there will be false abnormals for 64% of those tested. When it's increased to 30 tests the number is 79%. A prospective patient of mine asked me if he should get the 160 test panel offered by the company Function testing. I did the math and the likelihood of him getting false abnormals is 99.97%. It's a statistical certainty. Perfect if there is supplement sold by the same company or a subsidiary to correct those abnormals or even more testing necessary to sort it all out. A 160 test panel is the sneakiest, fear based lead generation funnel I've ever heard of.

@Doc_Man_G I also see a lot of these guys saying my result for x test is (fill in the blank). Little original documents shown?

All the biggest "Biohackers" are non-clinicians. Gary Brecka, Bryan Johnson and Dave Asprey are great examples. Biohacking is a genius term - it's appeals to the masses that want a short cut - a pill, potion or procedure - to undo 2 or 3 decades of bad lifestyle choices and bad self care. There is no shortcut to anywhere worth going.

@theproof @MikhailaFuller Let’s set up a debate between Mikayla Peterson and Tom Dayspring to clear up the nuances of evidence based reduction of ASCVD risk via lipid modification. Since she’s a subject matter expert.

@MikhailaFuller For completeness. Nicks on multiple lipid lowering drugs now.

The high cholesterol = heart disease theory needs to die

Interesting, but the big problem isn't whether people are supplementing with the right vitamin during exercise, it's getting them to exercise at all. What's the heaviest weight at the gym? The front door.

Savage.

Lets admit it - who hasn't had a dream about snowboarding down a snow covered pyramid being chased by a fire-breathing brontosaurus and returning fire with an AR 15 in one hand?

@Tellit007 @robertlufkinmd It’s not clear to me what Lufkin is all about. Initially I followed him and quickly unfollowed him. Sounds to me like you understand him better. How would you characterize him? Seems to me that he is an attention seeker as opposed to a truth teller.

It is not called that because it is not that. Classic @robertlufkinmd Type 2 diabetes involves two distinct pathologies. Insulin resistance, which the carbohydrate framing captures. And progressive beta-cell failure, which it erases entirely. Many patients require insulin not because they eat carbohydrates but because their pancreatic beta cells can no longer produce adequate insulin regardless of diet. Roy Taylor's DiRECT trial achieved T2D remission through negative energy balance, not carbohydrate restriction specifically. The mechanism is ectopic fat removal from the liver and pancreas. The window is the vehicle. The deficit is the driver. Precious. And when we asked what happens to cardiovascular outcomes in people with T2D and obesity who lose the weight and improve the metabolic picture, SELECT answered: 20% reduction in major cardiac events across 17,604 patients. That is the outcome data. The carbohydrate intolerance reframe has none. Not even a hint. Yet people keep flocking to this ApoB boosting lifestyle like lemmings. Why? You gotta love the short term effects. Long term consequences? Fugetaboutit! We are all LMHRS right? Whatever that means. Fascinating Reframing a disease to make standard treatment sound optional is not a thought experiment. It is a business model. Never give up. Never surrender!

@theproof "Highly invasive intravascular ultrasound" is a new one. CIMT was the best method to my knowledge. I did US assisted nerve blocks when I was an anesthesiologist and never learned about "HIIUS". Simon, look up the evidence for estradiol reversal of CIMT, it might surprise you.

Slide from Dr Dan Soffer

Without envy, communism can’t exist.

The best voice in evidence based nutrition right now is Alan Aragon. @TheAlanAragon

I love how this grizzly forged his own path & sits atop this mountain, gazing upon his kingdom but it doesn't strike me as a particularly food dense location. He must climb down the mountain occasionally in order to get some salmon at a nearby river. What a G.

This is proof that even the most educated and evolved men want their own chance to be the man in the arena.

🎤 drop

No cancer is not parasites - thousands of pathologists look at millions of cancer specimens per year and this nutjob thinks theyve discovered something new.