5HT: 5 Healthyish Things, including at-home healthcare and cold plunges being overrated

Hospitals were once the center of the healthcare universe. You got sick? Hospital. Needed surgery? Hospital. Blood work? Also hospital. Really reminds me of this bit:

After all, hospitals are where the infrastructure, the billing machine, and everything lived. And because of all that massive overhead, that care gets very expensive. 

That’s been slowly changing. Urgent care clinics were the first big disrupter, followed by telehealth. Now, companies like Sprinter Health (who just announced a fundraise) are bringing healthcare home. Their at-home preventative offerings include things like blood draws, diabetes eye checks, and colorectal cancer screenings. 

Yes, there have been other startups attempting home-based care. But part of what sets Sprinter Health apart is its logistics system, which optimizes routes and schedules, allowing clinicians to spend as much time as possible serving patients rather than driving.

There’s also a related shift away from hospitals tied to doing surgery outside in Ambulatory Surgery Centers (or ASCs), where the overhead cost is less, but the surgery quality is high (and often higher). More on that in the future. 

Now that someone’s got it down, I expect to see more companies mirroring Sprinter Health’s at-home model. Think: Vision tests from your couch, lung function tests at your kitchen table, and urine sample collection without the lab visit. (InsideTracker literally took my blood draw in the living room—more on that experience soon too.)

Hospitals aren't going away anytime soon, and they are essential for many complex, major procedures. However, for many things, they're no longer the default. This unbundling of care towards more convenient, distributed, and often more affordable solutions is exciting, especially as we continue to try to “bend the cost curve” and make healthcare more affordable.

For yearsss, I thought I had a cholesterol problem. My LDL particle counts were a little elevated. My small LDL particles were also flagged. And so I started wondering, am I headed for heart disease? 

My grandfather died of a heart attack out of the blue at the age of 40 (my father says it was because his partner chain smoked next to him for 15 years.) That’s concerning, though otherwise heart health is pretty solid in my family. Plus, I eat well and feel fine. Nonetheless, I was a little concerned and still wanted to get ahead of it.

Turns out, there may be a better biomarker for heart disease risk than counting cholesterol and evaluating their size called ApoB (or Apolipoprotein B-100). Basically, ApoB measures the number of cholesterol-carrying particles in your blood—not just how much cholesterol is floating around. That’s key because it's the particles, not just the cholesterol itself, that sneak into artery walls and trigger plaque. 

More particles = more risk. So, even if your LDL level looks low, a high ApoB level could still mean trouble. But vice versa, if your LDL level is higher than average but your ApoB level is low, you’re probably good.

In a recent blood test, my ApoB level came back at 49 mg/dL—well below the “optimal” range of <90 and even better than the <60 target some longevity docs aim for. That’s an awesome number. So, even with previously flagged LDL markers, ApoB gave me a different—and better—story, which is a huge relief. 

It’s also why I’m actually such a huge proponent of tests like Function, Inside Tracker, and others that give you insight into biomarkers you wouldn’t typically get from your doctor or a standard blood panel. While experts say it’s still early to ditch standard cholesterol tests entirely, if you’re worried about heart disease, it could be worth testing your ApoB levels.

Flight delays are the worsttt. But this person walking backward on an escalator to pass the time? Respect. 😂

Besides being legendary behavior (I guess unless you’re trying to go down it), it’s also healthyish. A recent study showed that climbing stairs is linked to improved heart health and could even help you live longer. Apparently, people who regularly climb stairs have a 39% lower risk of dying from heart disease than those who skip the stairs.

(Cue: StairMasters in every terminal.)

For a while, people have believed cold plunges accelerate recovery, alleviate soreness, and help the body reset. Plus, it looks awesome, and Instagram is into it! Buuut, according to this research, science is cooling on cold plunges. 🥶

Published in the Scandinavian Journal of Medicine & Science in Sports—aka the homeland of cold plunging 🧖‍♂️—the study found that cold-water immersion didn’t help people recover strength or performance any faster after high-intensity interval training. In fact, it slightly delayed certain aspects of muscle recovery compared to room-temp rest.

Cold plunging did offer some short-term benefits like quicker muscle cool-down and a rebound in one fatigue marker—but TBH, that might just come down to feeling better mentally.

Sooo are cold plunges worth it? IDKID. Maybeee if you’re an elite athlete with back-to-back games. But for most of us, it seems it’s probably overrated 🤷‍♂️—at least for physical recovery.

On the other hand,  I don’t think most people are doing cold plunges just for physical benefits. They’re doing it because they enjoy participating in the ritual (which can reduce anxiety), the rush of endorphins, and the calmness you feel afterward.

Cold plunging looks cool (on social). It feels cool (literally). And it’s an epic challenge and accomplishment. So, if you find it valuable, keep on plunging. Just know the scientific community is no longer quite as hot on it. Saunas, on the other hand…🔥 (Also, yes, still waiting for my sauna sponsorship.)

If you’ve been losing sleep wondering, How’s Derek’s gut doing after taking Pendulum’s probiotics? Good news: The gut update has arrived.

After three months of taking Pendulum’s Akkermansia and Glucose Control* products, I’ve seen subtle but steady improvements in digestion ✅ and post-meal energy ✅, and my gut feels better overall  ✅.

This stacks up with the results in one Pendulum consumer study, where 172 people taking Akkermansia over 12 weeks reported improved bowel movements (82%), better GI health (77%), and less diarrhea (67%).**

I also did a blood test recently and saw improvements in my biomarkers, including glucose and A1C (average blood sugar). 

Now, to be fair, I’ve done a lot of things to get healthy, so I can’t credit Pendulum alone—but it’s been part of the mix, and the timing sure lines up with when I started taking Pendulum’s probiotics. 

I mean, hey, I was so pleased with the Glucose Control product's results early on I doubled down with their standalone Akkermansia product. So, yeah, color me convinced—aaand I think you will be, too. 

See what Pendulum can do for your gut health—with 20% off. 5HT readers get an exclusive discount. 👇🏼 And, if you go for it, I’m down to compare biomarker trends.

_{*For the nutritional management of type 2 diabetes}

_{**Individual results may vary. Testimonials reflect individual personal experience and may not be representative of everyone who uses the product.}

Other things

• Healthcare startups are heating up 🔥. Shares of Omada Health, a virtual chronic care company, jumped 21% after their Nasdaq debut. (And big congrats to long-time friend Sean Duffy—just one of the best people and super deserving of this special achievement.)

• CVS says they’re shelling out $20B to create a more tech-enabled consumer health experience. The real question is: Will they innovate their receipts? 👀

• Doctors in the UK are raising a red flag 🚩that GLP-1s could affect birth control, buuut so far, the evidence is anecdotal.

• Apparently, this new AI tool from Harvard can predict biological age and estimate survival outcomes just by looking at your face. (Fun fact: I celebrated my 15-year Harvard College Reunion last week which had many of us asking, what’s our age again? 😂)

• Most clicked last week? This simple hack that made me (and apparently a lot of you) rethink storage containers.

👋 Who are you again? I’m Derek Flanzraich—founder of two venture-backed startups in Greatist (👍) and Ness (👎). I’ve worked with brands like GoodRx, Parsley, Midi, Ro, NOCD, and Peloton. I now run Healthyish Content, a premium health content & SEO agency (among other things).

Every Thursday, I share 5 health things I feel strongly about so you can live healthyish. (Disclaimer: I’m more your friend with health benefits. None of this is medical advice.) 

And oh, you also feel strongly about some health things? Hit reply—I’d love to hear it.