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Are your immune cells aging faster than you are? In this episode, Dr. Gabrielle Lyon sits down with Dr. Anurag Singh, a leading physician-researcher and Chief Medical Officer at Timeline, to discuss a groundbreaking discovery: the gut-muscle-immune axis.

While we often focus on muscle mass for longevity, new research published in Nature Aging reveals that our immune system undergoes a similar decline, with youthful sentinel cells (naive CD8 T-cells) dropping by 75% as we reach age 50.

Dr. Singh explains how mitophagy —the targeted recycling of damaged mitochondria—is the key to "rewiring" an aging immune system to fight infection 20% more effectively. In this episode: Alzheimer’s of the Muscle: Why sporadic inclusion body myositis (sIBM) is often misdiagnosed as simple aging.

The Power of Urolithin A: How this postbiotic compound induces mitophagy to increase mitochondrial abundance by 20% in just 28 days. Immune Imprinting: Why children get 6-8 colds a year while adults only average 2-4. Repurposing Longevity Drugs: Dr. Singh’s take on Metformin, Rapamycin, and GLP-1s for life extension. The 1:1 Exercise Rule:Why 150 minutes of moderate activity is the threshold for mitochondrial biogenesis.

Thank you to our sponsors:

BodyHealth - Use the code LYON 20 to get 20% off your first order https://www.bodyhealthaffiliates.com/73L4QL3/7XDN2/

Timeline - Get 35% off a Mitopure subscription at https://www.timeline.com/drlyon

Manukora - Go to https://www.MANUKORA.com/DRLYON to save 31% plus $25 worth of free gifts.

Chapters:

0:00 - Can You Tell If Your Immune System Is Healthy?

1:37 - Alzheimer’s of the Muscle: Muscle-Immune Dysfunction

5:59 - The Thymus Design Flaw: Why Our Immune "Ammo" Disappears

8:44 - Naive CD8 T-Cells: The Elite Forces of Immunity

12:24 - The Axis of Aging: Mitochondria and Immune Cells in Muscle

16:15 - Mitophagy vs. Autophagy: Targeted Cellular Recycling

19:11 - Study Review: Rewiring the Immune System with Urolithin A

24:13 - Mitochondrial Remodeling: Switching from Glucose to Fatty Acids

27:45 - The Trifecta: Gut-Muscle-Immune Axis Connection

31:13 - Parkinson’s and the PINK1/Parkin Mitophagy Pathway

35:04 - Clinical Results: Improving Leg Strength in 4 Months

38:51 - Joint Health: Can We Remodel Cartilage with Mitophagy?

43:34 - Targeted Mitophagy Inducers: Exercise vs. Postbiotics

46:44 - Precision Nutrition: The Ideal Muscle Longevity Supplement

53:33 - Why Alzheimer’s is Now Considered an Inflammatory Disease

1:00:13 - The Placebo Effect: You Cannot Deceive the Immune System

1:03:13 - Lymphocyte Counts: The Clinical Marker for Immune Aging

1:08:14 - Rapamycin and Metformin: The Future of Longevity Drugs

1:11:42 - Optimal Dosing: Why 1,000mg of Urolithin A is the Standard

1:15:13 - Sports Medicine: Reducing Muscle Damage Markers (Creatine Kinase)

1:20:03 - The Final Frontier: Brain Aging and Selenium Repair

Connect with Dr. Anurag Singh

Instagram: @timeline_longevity

Website: https://www.timeline.com

Find Dr. Gabrielle Lyon at:

1. Instagram:@drgabriellelyon
2. TikTok: @drgabriellelyon

Pre-Order The Forever Strong PLAYBOOK and receive exclusive bonuses: https://drgabriellelyon.com/playbook/

Want ad-free episodes, exclusives and access to community Q&As? Subscribe to Forever Strong Insider: https://foreverstrong.supercast.com

If you are only focusing on building muscle, you are missing half the equation for long-term mobility. In this mashup episode, Dr. Gabrielle Lyon brings together top orthopedic experts to discuss the critical importance of joint and tendon health.

While muscle develops relatively quickly, your tendons and ligaments can take 6 to 9 months to fully adapt to a new training stimulus. This gap is where most injuries happen. We dive deep into the biological mechanics of tendons, the"athletic accommodation timeline," and why you must progressively overload your connective tissue—not just your muscle bellies.

You will learn:

1. The Menopause Connection: Why women face a 30% higher risk of arthritis and rapid bone loss after age 50, and the role of estrogen in joint inflammation.
2. Osteoporosis Prevention: Why high-impact "flight" exercises (jumping) are more effective for bone density than traditional lifting alone.
3. The Frozen Shoulder Mystery: How to identify the warning signs and why this condition is often linked to hormonal shifts rather than trauma.
4. Injury Recovery & Prehab: The truth about PRP, needle tenotomy, and the "anti-fragility" mindset needed to build a resilient body.
5. The History of Muscle: How ancient Greek views of "pneuma" and the "gift of strength" shaped our modern misunderstanding of movement.

Stop training until you break. Learn how to track your progress, prioritize stability over raw mobility, and design a life built for anti-fragility.

0:00 - The Gap Between Muscle and Tendon Adaptation

1:32 - What Are Tendons? Visco-Elasticity and Force Dissipation

4:36 - The Rotator Cuff: Stabilizing the "Golf Ball on a Tee" 6:40 - The Athletic Accommodation Timeline: Why 6-9 Months Matters

8:36 - Progressive Overload for Connective Tissue, Not Just Muscle

11:36 - GLP-1s and Bone Health: Does Ozempic Increase Fracture Risk?

14:34 - Preventing Osteoporosis: The Power of Impact Training

18:15 - Bisphosphonates vs. Mechanical Loading for Bone Quality

21:10 - The Hidden History of Muscle: From Galen to Ancient Greece

26:48 - The Myth of "Pneuma" and the Soul in the Muscle

30:55 - Supercompensation: The "Gift from Zeus" in Performance

36:35 - Defining Impact Exercise: Why "Flight" is Better for Bones

39:48 - Building Your Base: Why Bone Health is Won Before Age 30

42:38 - Oral Contraceptives and Peroperative Blood Clot Risks

45:21 - The Hard Truth: How Nicotine Destroys Orthopedic Healing

47:55 - Testosterone and Muscle Mass vs. Bone Density in Women

51:41 - Relative Energy Deficiency in Sport (RED-s) and Stress Fractures

55:53 - Long-Term Menopause Consequences: Mobility and Hip Fractures

1:01:58 - Tendinopathy Treatments: Needle Tenotomy, 10X, and PRP

1:07:26 - Full Thickness vs. Incomplete Tendon Tears

1:12:05 - Prehab is Real: The Push-Up with a Plus and Skater...

Pre-Order The Forever Strong PLAYBOOK and receive exclusive bonuses: https://drgabriellelyon.com/playbook/

Want ad-free episodes, exclusives and access to community Q&As? Subscribe to Forever Strong Insider: https://foreverstrong.supercast.com

Thank you to our sponsors:

1. BodyHealth - Use the code LYON20 to get 20% off your first order https://bodyhealth.com/
2. Manukora - Visit MANUKORA.com/DRLYON to save 31% plus $25 worth of free gifts.
3. BON CHARGE - Holiday Sale https://boncharge.com for 25% off
4. Our Place - Visit fromourplace.com/DRLYON and use code DRLYON for 10% off

Find Dr. Gabrielle Lyon at:

1. Instagram:@drgabriellelyon
2. TikTok: @drgabriellelyon
3. Facebook: facebook.com/doctorgabriellelyon
4. YouTube: youtube.com/@DrGabrielleLyon
5. X (Twitter): x.com/drgabriellelyon
6. Apply to become a patient – https://drgabriellelyon.com/new-patient-inquiry/
7. Join my weekly newsletter – https://institute-for-muscle-centric-medicine.ck.page
8. Pre-order my new book - https://www.amazon.com/exec/obidos/ASIN/1668085623

Disclaimers: This episode includes paid sponsorships.

The Dr. Gabrielle Lyon Podcast and YouTube are for general information purposes only and do not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast, YouTube, or materials linked from this podcast or YouTube is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professional for any such conditions.

Timestamps:

0:00 - FDA Lifts Blackbox Warning on HRT

1:08 - Definitions: Viralization & Androgens

3:08 - The New Landscape of Women's Health

4:46 - Gold Standard Testing: Mass-Spec

5:52 - Finding the Estrogen Sweet Spot for Men

8:07 - Testosterone Lab Ranges for Women

10:16 - Is Testosterone Safe for Women?

13:30 - Anabolic vs. Androgenic Steroids

16:56 - HRT Red Flags: Who Should Not Start

18:19 - Longevity Benefits of HRT

21:23 - Estrogen's Role in Brain Health

24:32 - Performance Impact in Young Women

33:03 - Type 2 Muscle...