John Roberts

@agingroy What about only one of the two Shingrix shots. Just before Covid. Is it too late to get a second?

Source: Kim & Crimmins, "Association between shingles vaccination and slower biological aging: Evidence from a US population-based cohort study," pubmed.ncbi.nlm.nih.gov/41556115/ Study of 3,884 adults aged 70+ from the US Health and Retirement Study. Used DunedinPACE (epigenetic), transcriptomic aging measures, inflammation markers, adaptive/innate immunity, cardiovascular hemodynamics, and composite biological aging score. Adjusted for sociodemographic and health covariates. Shingrix (the current vaccine) is recommended by the @CDCgov for adults 50+. Covered at $0 under Medicare Part D (Inflation Reduction Act) and most ACA-compliant private insurance in-network. Free on the @NHSuk for adults 65+ and immunocompromised adults 18+. Without insurance in the US, it costs approximately $400-530 for the 2-dose series.

A single shot that slows your biological clock. Five aging markers improved. Benefits lasting 4+ years. New study (n=3,884, US Health and Retirement Study) Shingles vaccination was associated with: -> Lower inflammation (p=0.003) -> Slower epigenetic aging (p=0.0001) -> Slower transcriptomic aging (p<0.0001) -> Lower composite biological aging score (p=0.0002) The mechanism: chickenpox virus hides in your nerve cells for life. As you age, it reactivates silently, fueling chronic inflammation even without causing shingles. Suppressing that reactivation removes a hidden accelerant of biological aging. The shingles vaccine is recommended for adults 50+ and covered at no cost by most insurance plans. Vaccines aren’t just for preventing infection anymore. They’re longevity tools.

@alt_w_v_g The reality of your presentation came at the end: 47 minute cancellation torture. So many of us went through that and don’t ever want to experience it again. I actually liked SiriusXM. But won’t re-subscribe b/c it’s too torturous to cancel.

Ran some diligence on SiriusXM this weekend Not because anyone asked Because my 14-year-old nephew connected his phone to my car via Bluetooth, played a Spotify playlist, and asked me what the "SXM" button was for I didn't have an answer So I pulled the 10-K SiriusXM is an $8.56B revenue company with nearly $10B in debt and a $7.4B market cap Read that again The debt is larger than the company Their business model, simplified: 1. Pay automakers to install radios nobody asked for 2. Give every new car buyer a free trial they didn't request 3. Hope they forget to cancel 4. Charge them $25.99/month for something their phone does for $10.99 That's it. That's the model. They have 33M subscribers. Sounds impressive until they lost 301,000 self-pay subscribers last year. And hundreds of thousands the year before that. Revenue has declined three consecutive years The average subscriber is 35-64, male, household income over $150K. Over half have been paying for 10+ years. These aren't loyal customers These are people whose spouses haven't noticed the $25.99 charge on the Amex yet The crown jewel of the portfolio is Howard Stern. They pay him roughly $100M a year. He works three days a week. His show averages 125K daily listeners. That's $800 per listener per year My analyst did the math three times because he thought he was wrong He wasn't For that price, you could buy each listener a Spotify family plan, an Audible subscription, and still have enough left for AirPods Speaking of Spotify. Nearly 290M premium subscribers. Growing double digits. $10.99/month. Available on every device ever made. SiriusXM. 33M subscribers. Shrinking. $25.99/month. Requires a satellite. Spotify's full-year revenue grew 19%. SiriusXM's declined 2%. Spotify trades at 74x earnings. SiriusXM trades at 5x. The market is not confused about which direction these businesses are headed Their growth strategy is called the "trial funnel." There are 7.3M people driving cars with free SiriusXM trials. The conversion rate is not publicly disclosed. Probably because it's embarrassing They have 180M "enabled vehicles" in the U.S. They have 33M subscribers. That's an 18% attach rate on hardware they already paid to install. 82% of the cars with their radios in them are generating zero revenue In any other industry an 18% hit rate gets you fired In satellite radio, it gets you a seat on the NYSE Adjusted EBITDA margin is 31%. Looks healthy. Until you realize "adjusted" is doing a LOT of heavy lifting in a company that posted a $2.08B net loss the year prior. Adjusted EBITDA was $2.73B that same year The distance between those two numbers is called addbacks And they're working overtime 2026 guidance: flat revenue, flat EBITDA, slightly fewer subscribers. The CEO called this stability and meaningful progress. On Wall Street, we call this managed decline Warren Buffett owns 35.4% of this company. This is the most confusing part. The man who said "be fearful when others are greedy" bought a satellite radio company in the age of Bluetooth. His entry was a Liberty Media arb play that accidentally became a long-term hold. The stock is down over 50% from its highs. I don't know why he's still in. You don't know why. His shareholders definitely don't know why. The bull thesis: SiriusXM has 33M people who have been paying $15/month for a decade and have no plans to stop. That's $6B in recurring revenue from people who may not even remember they're subscribed. Churn is 1.5%. Lower than most SaaS companies. The bear thesis: Every teenager alive today has never used a car radio Both are probably right SiriusXM's competitive moat is not content. It's not technology. It's not brand. It's the 47 minutes it takes to cancel over the phone SiriusXM isn't a bad company. It's a case study in what happens when your moat is consumer apathy and your growth strategy requires General Motors. Plz fix. Thx. Sent from my iPhone

@tferriss Animal House Caddy Shack Dumb and Dumber

What are your favorite laugh-until-it-hurts movies that more people should see?

@TheAtlantic @drjordanmetzl Paywalled. Seriously, this just frustrates people. Entice them to check out an article they are promoting then you do and then they block you.

As a sports-medicine physician, @drjordanmetzl sees the consequences of the modern longevity movement up close. Many enthusiasts, he argues, are headed for disappointment—if not harm. theatlantic.com/health/2026/02…

@washingtonpost Why post this if you paywall it?

Some have welcomed Southwest’s new seat assignment and boarding system. The airline has said research showed more people would fly the carrier if it offered assigned seats. But many are in mourning for a company that once stood out but now blends in with crowd. wapo.st/4bXdJTU

@BradOnMessage @SouthwestAir @WildTurkey @washingtonpost Paywalled. Why post?

Sanity has to prevail somewhere in the halls of power at ⁦@SouthwestAir⁩ - get some ⁦@WildTurkey⁩ & channel your inner Herb Kelleher & go back to common sense, folks. My take in today’s ⁦@washingtonpost⁩…. washingtonpost.com/travel/2026/02…

My experience working directly with, riding on, and promoting SWA goes back almost 45 years. Many meals (and drinks!) with Herb, Colleen, Rollins and certain Board members were both fun and deeply interesting. My view, based on this (the above post) and a life of sky’ing with the airline leads me to this, and it’s said without equivocation: all those noted above would be deeply mired in a slew of despondency at what is happening to their baby. But, importantly, they would never have been bullied into doing this makeover in the first place.

@ASillyPerson1 Hi, and thanks for reaching out to us. Based on the information provided, it appears that all seats ahead of row 22 were reserved by other Customers prior to you booking your reservation, and we're sorry for your disappointment. (1/2)

Booking work trip, as usual, @SouthwestAir is my first choice… right up until the point I saw what seat I was given. Back of the plane. This is what 35 years of loyal flying gets you. This is what status gets you. Southwest shit canned customers, we are now just consumers. 👎

@Drlipid @SteHaller It hasn’t it been shown in the literature as efficacious in these matters? Looking at it as one more tool to serve the objectives you’ve pursued so passionately.

@johnrroberts3 @SteHaller Or better yet no nattokinase. Can we concentrate on the meds with better evidence

Can you reverse plaque in your arteries? Yes you can! I am the living prove. Here’s my story: A year ago I got my blood lipids tested (I haven’t had a blood lipid test in over 5 years before) and everything was sky high: Total cholesterol: 350mg/dl HDL: 72mg/dl LDL: 259mg/dl Non-HDL: 278mg/dl Triglycerides: 115mg/dl My LDL-C has always been high my whole life (150-175mg/dl) because I always loved eating red meat and dairy but it never has been this high. I always was very active in sports my whole life, had low blood pressure, low body fat, never smoked so I thought my LDL-C was no big deal. Wrong! My family physician ordered a sonogram of my carotid arteries to see if I got plaque. The cardiologist who did the sonogram found soft plaque (CIMT 2 mm). He told me I need to go on 10mg of Rosuvastatin and 10mg of Ezetimibe to get my LDL-C under control and to stabilize my plaque. I ask him if we can reverse the plaque and he told me it is very unlikely. I was devastated but also motivated to prove him wrong. When I was home I turned to @grok and tried to find out every study that showed how you can reverse plaque. I listened to @PeterAttiaMD’s podcast series with @Drlipid and read everything I could find about cholesterol. I watched videos by @MohammedAlo, followed @gregmushen and many others. I stopped eating red mead immediately and retested my blood lipids two weeks later. We also tested Lp(a) and ApoB. New numbers: Total cholesterol: 263mg/dl HDL: 69mg/dl LDL: 179mg/dl Non-HDL: 195mg/dl Triglycerides: 62mg/dl Lp(a): 26nmol/l ApoB: 132mg/dl Much better but still a long way to go. I started taking Nattokinase (12000FU), citrus bergamot (1500mg), aged garlic (1500mg), Berberine (1500mg), Coenzyme Q10 and vitamin K2 (everything based on my research). 12 weeks later new blood test: Total cholesterol: 208mg/dl HDL: 58mg/dl LDL: 146mg/dl Non-HDL: 149mg/dl Triglycerides: 108mg/dl ApoB: 107mg/dl Much better but still not good enough. I found the works of Dr. Esselstyn (and his son @RipEsselstyn), Dr Ornish, Dr. McDougall and read the China study by T. Colin Campbell. So I went on a WFPB oil free diet (with the exception of some clam meat two times a week for vitamin B12. After 12 weeks new blood tests. Total cholesterol: 170mg/dl HDL: 59mg/dl LDL: 109mg/dl (90 if you calculate it) Non-HDL: 111mg/dl Triglycerides: 84mg/dl ApoB: 87mg/dl I lost 10kg on this new diet and my body-fat % went down to basically non existent. After that I added 10grams of psyllium husk before every meal. Yesterday I went to my cardiologist again to do another sonogram of my carotid arteries because it has been 12 months since we did the first one. Unfortunately I couldn’t get in a new blood test before to check how the psyllium husk worked because I had too much going away. The results even stunned the cardiologist: The soft plaque shrank by 30%. CIMT down from 2mm to 1.4mm. Huge win! But I am not done yet. I will work on lowering my ApoB even more (the lower the better I learned) and we will recheck my arteries in 12 months. The goal is zero plaque. After the sonogram the cardiologist sat down with me for an hour and wanted to know exactly everything I have done to get these results. I wish I knew 25 years ago what I know now. But as you can see it is never too late. If you have high LDL-C/ApoB start to get it down. Now!

@patrick_oshag Goodness. One Battle After Another?

Two favorite movies seen in the last year Perfect Days One Battle After Another What are yours?

@Drlipid @SteHaller And maybe high dose nattokinase (see newest paper on this)?

You seem to be taking a lot of totally unneeded and costly supplements. Good luck with the successful lipid-modulating diet which unfortunately the vast majority of people will not stay on long-term. Carotid imaging (results can vary and are very operator related) is not the best way to follow arterial changes. CCTA is the far more accurate way to evaluate what is happening. Wish you had an apoB as it looks like a bit more lowering of your beta-lipoproteins are needed.

When I taught at a major university, I gave all my students three options for midterm and final exams: written multiple choice, written long form answers to three to five big questions, or 30 minute oral exam. No question, the r2 would be 1.0 or nearly so: the smartest students always took the oral exam and the least prepared took the written multiple choice.

Professors are turning to oral exams to stop AI use

@VivaLongevity Willett w/Simon: he’d say yogurt or eggs & Simon wld discuss plant alts and Willett would concede. ? for Willett “why don’t you include plant foods when you note certain animal foods fulfill the nutritional requirements?”

@johnrroberts3 Fair point. It was Walter Willett who got me to think of nuts not a small occasional snack, but a central part of meals. And oils like olive and canola as healthy. It was a struggle for me because it's not intuitive, but damn he has a lot of data. I will do a short about it.

Welp. It's been >100 years and I still haven't been able to find a good study to show that low carb diets, practiced the way 90% of influencers promote them, are healthy long term. Have I missed a memo somewhere? youtu.be/z4TMQ1PFYpU

@drpatrick @realDonaldTrump What action is he referring to?

President @realDonaldTrump can make this happen and change the lives of millions of Americans with cancer. The Cancer Moonshot went nowhere with the past administration but could succeed with President Trump's decisive action today. AMERICAN FIRST.

Mold

Mold toxicity is one of the most under-diagnosed root causes of fatigue, anxiety, brain fog, and unexplained illness. Removing exposure isn’t enough. You need a full cellular detox protocol to recover. In this post, I'll cover everything you need to know about mold detox: 1) Where mold hides in your home 2) Common symptoms 3) Why bloodwork won't catch it 4) My client's mycotoxin results 5) Complete cellular detox protocol BONUS: If you RT this post and comment "MOLD," I'll send you the full protocol. Let's dive in. 1) Where mold hides in your home: - Poorly maintained HVAC systems (recirculating spores) - Water damage or leaks (behind walls, under flooring) - High-humidity environments (basements, humid climates) - Poor ventilation in bathrooms and kitchens Up to 50% of homes in humid regions harbor toxic mold. The worst offenders are Stachybotrys (black mold) and Aspergillus. They thrive behind drywall, carpets, and HVAC units. You might not see it, but you’re breathing in spores laced with poisonous mycotoxins every day. These mycotoxins are lipophilic, meaning fat-loving. They lodge in your brain (60% fat) and tissues, where doctors don't look. They attack mitochondria, drain energy, suppress thyroid function, and overload detox pathways. Bloodwork looks "fine" but you feel like sh*t. 2) Common symptoms include: - Chronic fatigue - Brain fog and poor memory - Anxiety or panic attacks - Insomnia - Bloating and food sensitivities - Sinus congestion or chronic cough If you’ve “tried everything” and nothing works, suspect mold. 3) Why won't bloodwork catch it? Mycotoxins don't show up on standard bloodwork. Symptoms can mimic anxiety, burnout, or hypothyroidism. Only a few labs order mycotoxin panel or ERMI dust tests. Mold illness is called "the great imitator" for a reason. 4) I had a client with crippling insomnia, low recovery capacity, and a suppressed immune system. We transformed his lifestyle and got him on a well developed protocol. His markers improved, but the results just didn't add up. Until we tested him for mold. We performed a comprehensive mycotoxin panel on him. The results revealed multiple mycotoxin exposures: ochratoxin, trichothecenes, and gliotoxin. All of a sudden, his health puzzle made sense. 5) Complete cellular detox protocol Fix your exposure FIRST, or nothing else will stick. Step one: Clear the mold from your environment. This means professional remediation, replacing contaminated items, and upgrading your HVAC filtration. (I'm giving away a complete mold remediation guide at the end of this post) But removing exposure alone isn't enough. The mycotoxins are already IN your tissues, lodged in fat cells, organs, and brain tissue. You need a strategic detox protocol to mobilize and eliminate them. The approach you take is determined by which mycotoxins you're exposed to. This is a foundational protocol that addresses the core pathways: 1. Mitochondrial Support - CoQ10 100-200 mg/day, PQQ 20 mg/day - Liposomal Glutathione, NAC, Shilajit, Lion's Mane - Prioritise Zone 2 cardio (45-60 mins, nasal breathing) 2. Detox & Binder Stack (Essential) - Add daily binders & mycotoxin binding smoothies (my go-to's are in the last post) - Support bile & liver with calcium-D-glucarate, milk thistle, phosphatidylcholine, TUDCA - Sauna 3-4x/week 3. Hormonal Recovery Focus - Strength training for hormone signalling - Ensure adequate copper/zinc, retinol, and vitamin D/K2 - Lots of micronutrients + movement 4. Sleep Restoration - Magnesium glycinate + phosphatidylserine or reishi for evening cortisol smoothing - Deep-clean environment: Without remediation, symptoms will recur despite intervention TLDR: If you suspect mold exposure: - Get tested (urine mycotoxin panel + ERMI dust test) - Remediate your environment - Implement a targeted detox protocol P.S. Don't forget to RT and comment "MOLD" for a free guide covering all of this: - Clearing your environment - Binding ingredients - What not to consume. And thanks for reading! Make sure you follow me @bensmithlive for more health protocols in the future.

@jakescottMD @NEJM Nice job on the effectiveness component. But your analysis says the work reviews safety and effectiveness. Was there discussion of the safety side of the equation that I missed? If so, could you point to the safety component in your work here?

Our systematic review on Covid-19, RSV, and influenza vaccines was just published in @NEJM. With federal vaccine guidance processes in flux, we felt independent evidence synthesis was crucial for the 2025-2026 respiratory virus season. 🧵nejm.org/doi/full/10.10…

@MdBreathe @POTUS And like all of us, if high, what do we do? Precisely?

“I had the vaccine, I was very happy with it. Here I am.” Check your spike protein antibody levels @POTUS.

@RogerSeheult What’s your take on it?

Reduced incident of lung cancer in COPD patients taking NAC! e-century.us/files/ajcr/15/…

@NutritionMadeS3 If a patient had that APoB in the 80s pre LLT, make sense to Rx Ezetimibe alone as a trial? That is, to see if APoB could be reduced even a little bit w/least amt of intervention?

@johnrroberts3 ApoB in the 80s pre LLT (ok if no other risk factors)

Full Bloodwork on 5mg rosuva + 10mg Ezetimibe Cholesterol 97 LDL-C 50 Trigs 79 nonHDL-C 56 ApoB 56 lp(a) 164 (nmol/L) Glucose 86 HbA1c 5.3% Insulin 5.3 hsPCR 0.055 CK 103 Myoglobin 48