123. Best of Metabolic Health: Why Metabolic Health Changes Everything

Dec 23, 2025

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Metabolic health is the foundation that determines how your body produces energy, manages inflammation, regulates hormones, and protects you from chronic disease. When it breaks down, problems show up years later, long after the real warning signs were missed.

This is a special Best Of episode of Extend, where I've compiled the most important insights from conversations with leaders in metabolic health and longevity, including Cynthia Thurlow, Ben Azadi, Dr. Mark Hyman, Casey Means, Josh Clemente, and Karan Rajan. These selected clips highlight why waiting for diabetes is far too late, how insulin resistance can quietly develop over years, and which biomarkers reveal metabolic dysfunction long before symptoms appear.

You'll hear how glucose and insulin regulation influence gut health, inflammation, muscle mass, hormone balance, and brain and skin health. By pulling together these key moments, this episode reflects the patterns I see every day in clinic and across these expert discussions, offering a clearer framework for protecting metabolic health early, when intervention has the greatest impact.

What's Discussed:

Cynthia Thurlow, nurse practitioner and metabolic health expert, explains why waiting for diabetes is far too late, how insulin resistance develops years before diagnosis, and which early biomarkers reveal true metabolic risk.
Ben Azadi, metabolic health educator and author, breaks down why type 2 diabetes is preventable and reversible, how insulin resistance can exist for over a decade without abnormal blood sugar, and why fasting insulin is one of the most important labs to track.
Dr. Mark Hyman, functional medicine physician and longevity leader, explores why insulin is rarely tested, how muscle loss accelerates metabolic decline, and why chronic disease shares common metabolic roots.
Casey Means, physician and metabolic health advocate, connects metabolic dysfunction to modern lifestyle stressors, explains the core markers of metabolic syndrome, and shares why fewer than 7 percent of Americans meet optimal metabolic criteria.
Josh Clemente, health technology innovator, discusses why continuous glucose monitoring offers real-time insight into metabolic health and how glucose regulation shapes long-term disease risk.
Karan Rajan, surgeon and gut health educator, explains how the gut microbiome influences systemic inflammation, insulin sensitivity, skin health, and metabolic stability across the entire body.

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Learn more about Dr. Shah:

Website: https://www.drshah.com/

Clinic: https://www.next-health.com/

Instagram: https://www.instagram.com/darshanshahmd/

Learn more about Karan Rajan:

Instagram: https://www.instagram.com/drkaranrajan/

Website: https://www.drkaranrajan.com/

Learn more about Josh Clemente:

Instagram: https://www.instagram.com/josh.f.clemente/

Website: https://www.levelshealth.com/

Learn more about Dr. Mark Hyman: