Come on.

strong and powerful. Peter koshland has returned to lifeblood. Welcome back, Peter.

Peter Koshland 0:17
Hey, thanks, George. Good to be back.

george grombacher 0:18
excited to have you back on Peter is the President and CEO of koshland. pharma, they are accustom compounding pharmacy, Peter, refresh our memory tell us a little bit why personal life’s more budget work and why you do what you do.

Peter Koshland 0:33
Yeah, well, I’m I’m a pharmacist by training and started this pharmacy about 12 years ago, because basically want to just be able to offer our patients different options, and what I was presenting them at a traditional retail pharmacy. And what we do here is basically to make customized prescription medications really tailored to individual patient specific needs. And when we started digging into it, you know, we just found that there were so many areas of people’s health that needed this extra attention, extra customization, and really got excited about the possibilities around really dedicated my career more to helping people get well than just giving them drugs. So it’s been a very fruitful and rewarding career in that and just continue to be very cringed by, you know, just what we’re seeing with our patients and just helping them be healthy and believe that they can be healthy.

george grombacher 1:30
Nice. So, so many, I think there’s so much important stuff here. How important is it to just have that belief that I am somebody who can be healthy and feel good

Peter Koshland 1:42
100%. And that’s something we find really consistently, actually, at least in my own practice is, I think there’s a certain cynicism on the part of the medical establishment, I certainly saw that when I was kind of in training, and in my kind of more traditional career, which is, oh, people just want to take a pill, they don’t want to fix their diet, they don’t want to do the things that they need to do to get healthy. So that’s kind of why we do what we do, because people won’t do it. And I find that to be absolutely not true at all. In fact, what I find more is not so much that people are apathetic about doing the things that they need to do to be healthy is that they’re confused, because they get so much information, lots of it contradictory. And really, I think it kind of creates almost like, paralysis around like, I don’t know what to do. So I’m just gonna, like my doctor said, my cholesterol is high. So take this pill, so I guess I’ll just do that. But I’m not sure what else is really going to help. And I think a lot of what we do here is like really trying to say, Okay, well, there is a lot of information out there. But there’s also some really key core stuff that you can definitely do that we know helps, and really help direct people towards that. And sometimes it’s in conjunction with pharmaceuticals. And sometimes it’s not at all sometimes it’s completely lifestyle, or maybe there’s some supplement taking that goes along with that. But when we finally get people with some clear, solid advice, I feel like they just take the ball and run with it because people want to take charge of their own health is what we find is I find that to be true. I know it’s true for me personally. And I find that to be true with our patients as well.

george grombacher 3:11
Success is is available to us at it seeming like like I really think at every level and I with you, I think that people do want to be successful. But making that choice, choosing to have a certain perspective about something choosing to take ownership of it. That That makes sense that that is key to your healthcare as well as your financial and everything else. Exactly. I was listening to an interview lately, or recently, and the person said, it’s not enough to know you have to know how. And I thought, well, that’s interesting, but it struck me that you need to take that one step further. You have to know you have to know how but then you have to actually make it sustainable and make it part of your life. How do you think about that?

Peter Koshland 3:52
Yeah, it’s really important. And I think there’s a certain aspect of perfection kind of being the enemy of the good in some ways where it’s like, well, you need to you know, you need to exercise three times a day, and you need to be no sugar and you need to just overall I mean, it’s like yeah, well that’s all great, but am I going to be able to do that in a sustained way. And so I think a lot of what we do is like well let’s just do one thing that you know, you can do and like you said, sustaining that’s really key. So for example, you know, eating less refined sugar that is a very important way to gain better health, better sleep quality, that our energy level, but it’s you know, we have a lot of us guilty as anybody else, you know, we eat sugar, you know, it’s like part of, you know, it’s like a cookie after dinner, whatever. So just being aware of that and making some small changes. And then I think what happens is if you really do that, I’m gonna eat I’m just gonna be conscious about how much sugar I eat less, you. It’s not an overnight success, but within a bit of time, you start to feel the effects of that, like, Oh, I actually do have more energy, and I do sleep better, and all those things. And then I think that starts to kind of give you the encouragement to like, well What else can I do? You know, and I think there’s that incremental approach, just start with something that you know is going to make a difference, stick with it, and then start to realize that acknowledge that it’s working. And I think that’s that self reinforcing positive feedback that you can get from activities like that. So definitely sticking with it’s important,

george grombacher 5:19
one of those virtuous cycles that that

Peter Koshland 5:22
it’s not an instant thing, sometimes, you know, if you stop eating sugar for a day, you probably aren’t going to get all the benefits. But if you do it for a couple of weeks, then yeah, you probably will start seeing some benefits. And I think that also validates that Oh, yeah, this isn’t all just, you know, one person’s opinion, this stuff really works. So I think that helps reinforce that as well.

george grombacher 5:41
Yeah, it is. You just never know where where people are at. People might not realize that, that a soda has 50 grams, or whatever of sugar in it, people might not realize that sugar is in, essentially everything that we eat that is processed. And so giving that little piece of education and helping them to be aware of that. So now that you know, make let’s try and make better choices throughout the course of the day of the week.

Peter Koshland 6:14
Exactly. And don’t take my word for it, see how you feel when you do that. And I think that also is a big part of that. Be aware of what you know, perfect example, certainly in the labels, Minnesota, maybe drink less, maybe eliminate that altogether, and then see if it’s really making the difference. And I think that’s that important feedback, as well. So definitely, very important part of it. Yeah, that awareness. Now,

george grombacher 6:38
interesting. The the cynicism that you encountered from the, for lack of a better term, sort of that medical apparatus of people are not interested in this. That’s why they come to us. So we can try to fix it just with a pill. But your experience has been the opposite of that. How? Wanting to meet people where they are not wanting to shame people, but at the same time, give tough love? How do you how do you sort of think about?

Peter Koshland 7:06
Yeah, I think a lot of it is really, I think part of it in the medical establishment is not very good at giving lifestyle advice. And I actually have encountered this even recently, where I was at a dermatology conference, and one of the doctors who was there treats a lot of acne was saying, I used to not talk about diet when I had patients with acne. I mean, we all know diets really important, but I just didn’t know a lot about it. So I just never brought it up. So that patients only seen that doctor, and they’re not talking about diet, the patient’s never getting that kind of authoritative conversation from a medical professional about how important it is. And it is clearly important. And we see this across lots of different types of health conditions, diabetes, you know, all sorts of stuff. So I think there’s a, there’s a lack of really emphasizing these lifestyle choices in the medical establishment, even though the data is extremely good for its impact, and lots of different health areas. So how we get around that. So this is I think it’s first of all, sometimes say I don’t really I know diets really important. I’m not a dietitian or an expert, but I have some people that really are good at this. And I want to I want you understand how important this is. And I can give you a drug to help you with your acting. But nothing’s going to be as impactful as you understanding how your diet affects this. And I think that part of that conversation really, at least puts it back into the the world of options. As opposed to being like, well, there’s the drug option. And then there’s all this like Hocus Pocus, like styling stuff, which is like no, no, the there’s a serious lifestyle, things that we do that are as powerful an impact on our health as the drugs stuff. And kind of putting those in the same group, so to speak. And then if I don’t know how to handle the, the diet or some other parts of that, I have a network that I can refer to because there certainly are many, many people who really do understand that and just bringing that awareness to the patient, I think is the first start. So that citizens Unfortunately, sometimes takes away that impetus to have that conversation and that so that didn’t ever even get started.

george grombacher 9:19
Why and I certainly empathize. I, you know, physicians, doctors of all kinds, dentists, professionals, attorneys, financial people have just a lot on their plate. And it’s challenging to have the right answers and the right information for every scenario that you come to. So I get it. And

Peter Koshland 9:41
sometimes it’s unfair for the doctors to because we expect them to know everything and they kind of and therefore they expect themselves to have all the answers and no one person can have all the answers. We talked about this a little bit last time but you’ll health people’s health status is very complex. It’s integrated throughout all of our habits, you know, our sleep cycles and our diet and our you know, our how we manage stress and all of these things are have huge profound impacts on our health in and beyond all the stuff that doctors talking to you about. And so we expect one person to kind of be just to know all of this, and it’s just too much to ask one person, I think, we put so much on the doctors to have all the answers, and they put a lot on themselves to have all the answers, but it’s clearly not possible for one person to have all the answers, especially when it comes to something as complex and multifaceted as our health and how it intersects so many aspects of our lives. So I think as patients, it’s helpful to acknowledge that, and then on our own, you know, kind of find people who can help us at areas that maybe go beyond the scope of what our physician is an expert at, to help us, you know, we’re really motivated to find lifestyle options and other things that can help us be healthy, to kind of seek out, you know, other advice around that from people who are really knowledgeable, and in other areas of how to be healthy.

george grombacher 10:57
So certainly, there are folks that, that that are your clients, and, and they take the ball and and they run with it. And that probably means that maybe they are not as good of a monetary client of yours, maybe it means that they’re better. For those folks who just say, you know what, I’m just I tried, but this isn’t going to work out this whole diet and exercise thing. How do you how do you? How do you think about that from from an ethical standpoint? If that’s an appropriate question?

Peter Koshland 11:27
Yeah, it’s a great question. Because, you know, we, we’re here to be advisors and encouragers, and providers of health care and help, you know, my job I feel like is to help people achieve their health outcomes, whatever that may be. And if they’re feeling a certain way, about their health journey, I have to, you know, I can’t enforce my own system on them, if they’re not going to adopt it. I do think, though, you know, you can’t opt out of some of the truth about health, you know, you can’t just say, Well, you know, I don’t want to eat healthy, but I want to be healthy, there’s some of those things that are just facts, you know, you know, food is the cornerstone of good health. And so, you know, if you really want to be healthy, you’re going to have to think about how you eat just no way around that. So, I mean, I might say something like that, like, it’s your choice, but I want you to be fully informed that these choices, you know, some, here’s some of the consequences, I believe, are impacted by these choices. So you know, again, it’s it’s about you know, it’s a they’re a system of are we going to be in like a disease maintenance system where you know, you have a patient has diabetes, and so I’m gonna give them a pill that’s going to maintain their blood sugar, so that I can stave off the inevitable, you know, heart attack, stroke, or foot amputation, versus like, Am I going to really try to find ways for this patient to understand how they can really go beyond just the maintenance of their disease to really try to find ways to kind of overcome it or find even greater levels of health of that. So I think there’s some of that is where, again, it’s a person’s life, it’s, it’s how they want to their choice. And I feel like it’s my duty to inform about the consequences of those choices, and hopefully encourage them to, you know, once you feel healthy, it’s very good, like, affirming process, because it feels good to feel healthy. So we can get people to that point where they start to feel that virtuous cycle, like we talked about, I feel like then you know, that we can kind of work with that.

george grombacher 13:27
Yeah, it certainly does make sense, there’s always gonna be some folks who just sort of keep them exactly where they are, and they don’t deteriorate so that they don’t deteriorate further, some folks that that come to you, and they’re in the red for lack of a better term, and you get them back to even and then you can help them to be proactive, and those probably really healthy people that are coming to you because they just want to just just just just do better, and they want to sort of do the whole Tim Ferriss hacking kind of a deal.

Peter Koshland 13:56
Yeah. And that’s, that’s a whole nother thing. And I think I, in some ways, you know, there’s a, I mean, I think being healthy is a great destination, the idea of like being beyond healthy, I’m still a little skeptical of, I think being healthy is great, and that’s where we want to get people. I also feel like we’re aging as well. So the idea of like, maintaining health as we age is also a really important aspect of this because the older we get, the more we have to do to kind of maintain a higher higher level and a higher quality of health status. So that’s also part of it as well.

george grombacher 14:35
Yeah, that’s a whole nother animal right there, Peter.

Peter Koshland 14:41
So how integrated Yeah.

george grombacher 14:45
What are are there some really common areas that that that your clients come to you for? Or rather, or perhaps that and is other things you say, you know what I wish I don’t get why more people aren’t Ask me this.

Peter Koshland 15:01
Yeah, I mean, the biggest area that comes to mind is hormone replacement. Because we’re in a situation right now, you know, in the United States where people are living longer than they’ve ever lived in the history of humankind. And, you know, we’re expecting to have very high quality of life, you know, well beyond our 50s 60s 70s and 80s. And hormone replacement has a very important role to play in the maintenance of the body, as we age into those ages. And there just is a lack of understanding and kind of acknowledgement about how the idea of showing up someone’s hormone status as they age, really has an important impact on that, that goal to have a high quality of life as we age. And so that’s something we’re always talking about, and wanting to raise more awareness about.

george grombacher 15:57
Yeah, I would say that that’s probably how do you think about that, I mean, if we’re talking about like, not fundamental, not intermediate, that’s probably pretty advanced.

Peter Koshland 16:12
Yeah, I just again, it kind of goes back to the idea that there’s some of these health these truths about how healthy that healthy living that you know, you just kind of can’t go around. They’re just, they just are facts about, you know, the way the body works. And the way I always describe it, when I give lectures on this, or train doctors is like, just being hormone deprived is just not good for the body. And when women go through perimenopause and their 40s, to 50s, or as men age, their testosterone levels decline with age, there’s a certain point where that decline, that low level of hormone status really has negative impacts on very found foundational fundamental aspects of how the body works, like maintaining bone density, and protecting the brain cells from damage, things like that. And I think it’s, it’s kind of a paradigm shift in how we think about this stuff. Again, because we haven’t really lived this long. I mean, our great grandparents never had to worry about this, because longevity wasn’t really the same as it is now. So I think the generations that are aging now are really having to rethink about how all this all fits in with our life goals at these ages, and the importance of establishing a baseline hormone status, so that the consequences of hormone deficiency don’t undermine our life quality.

george grombacher 17:37
That’s an interesting thing, right? Because if like, came to you, when I was 25, versus 45, a winner, we really wouldn’t have a sense of what my assuming that my optimum hormone level was what it was at 25? Or does it depend?

Peter Koshland 17:53
Yeah, it’s important. I mean, if you could have that for everybody, that would be really nice. Most people at 25, don’t think about the hormones, because they’re really high. 20s is kind of where hormone levels peak for most people. But yeah, I mean, that would be really helpful. Because then we can even individualize somebodies hormone regimen in their later years, you know, knowing that where they’ve been, but we don’t always have that for everybody. So we tend to look more at population based information and kind of generic, General physiologic type data that we have around people’s production of hormones. But yeah, I think again, it’s it’s kind of the, the idea that we’re, we’re going to utilize kind of this idea of healthy aging, and bringing hormones in as, as part of a plan to kind of keep the body functioning as best as possible. I think what’s happened, our old paradigm, or our medicalized paradigm is more, let’s wait until you get osteoporosis. And then we’re going to give you some drugs that make the bones harder. They also have a lot of consequences and side effects and don’t actually, in a lot of cases work that well, versus the idea that we know what’s happening when, say hormones decline. And instead of waiting for something bad to happen, let’s look at how the body functions and shored up for the prevention of these conditions.

george grombacher 19:18
So where can I get that? My my baseline hormone status?

Peter Koshland 19:23
Well, it’s something to talk to your physician about. It’s also interesting, we didn’t learn about this stuff when I was in pharmacy school. And a lot of physicians don’t learn about this stuff, either. So you want to find somebody who’s knowledgeable and has done the extra work to Sorry, go right in the middle.

george grombacher 19:40
Okay.

Peter Koshland 19:43
Can I find a physician who’s knowledgeable, but about this kind of stuff? But yeah, they can certainly do blood tests. There’s different types of testing you can do to look at your hormone status. And yeah, just finding a practitioner who’s knowledgeable and this would be a great place to start.

george grombacher 19:59
And I’m assuming that you do that

Peter Koshland 20:01
we do to some extent, I think mainly our function here is the pharmacy is to work with doctors to help them kind of fulfill the hormone replacement side of it so that the patient has the actual medication. I mean, I do have some tests here, I really don’t, I only do that more as a courtesy or to you know, if somebody’s just not able to get a test, we have some here that we can kind of send home with the patient. But in general, we’re trying to get people to see their doctor because we want them to do they want to help, we want them to have that doctor patient relationship, as well as their relationship with us. And it’s really, when we really get the pharmacist and the physician and the patient, all working together to help the patient have the best possible health status. That’s what we really have the really the secret sauce for success, and in our world of trying to help them.

george grombacher 20:51
Yeah, it seems. Okay. So questions for me to ask my, my primary care physician is, Hey, I’m interested in determining what my baseline hormone status is, just because I want to make sure that my levels are as optimal as possible. Can Yeah, is this something you can help me with doctor? And they say yes, or they say, No, that’s perfect.

Peter Koshland 21:11
And at this point, you know, like, you’re saying, if you’re in your 20s, and you’re just trying to find like, where you’re at, the only thing I do is check a few boxes on your on your lab form, you know, so this shouldn’t be something that the doctor would be unwilling to do. And if they are, then I think I would just kind of keep looking around until I find somebody who has a better understanding of what you’re asking for. But again, it would just be a basic blood test, you know, or, or some sort of test just to look at your levels at that stage.

george grombacher 21:38
Got it. I love it. I love it. Peter, the people are ready for that difference making tip, what do you have for them?

Peter Koshland 21:45
Well, based on this conversation, I would say, you know, look into hormone replacement and see if that’s right for you. And, you know, understanding, you know, healthy aging has a very important hormone component to it. So if that sounds something like is interesting to you, then I would definitely encourage you to explore that.

george grombacher 22:04
I think that is great stuff that definitely gets come up. Come on. Peter, thank you so much for coming back on. Tell us again where people can engage with you.

Peter Koshland 22:14
Yeah, you can check us out on our website. It’s www koshland Farm calm. And if you want to leave a testimonial about your experience with content and hormones, we actually have a really great site called compounding calm where you can learn more about compound hormones and leave a testimonial. We’re trying to compile those to, you know, take it to legislators and the FDA to show how important this therapy is in people’s lives.

george grombacher 22:40
Love it. Well, if you enjoyed this as much as I did show Peter your appreciation and share today’s show with a friend who also appreciates good ideas go to koshland Farm calm, it’s k OSH la MD ph arm.com. And like Peter mentioned, if you’ve had a positive experience with compounding, go to compounding.com and leave a testimonial and tell your physician Hey, Doctor, I’m interested in determining my baseline hormone status so I can optimize and let her know that and then if there’s any deficiencies get in touch with Peter. Thanks. Good, Peter. All right. Thank you. Great to be with you. Likewise. And until next time, keep fighting the good fight. We’re all in this together.

Transcribed by https://otter.ai