STORY AND PHOTO BY KAREN BOSSICK

Dr. Cory Szybala put forth a simple message to those attending the fourth annual Sun Valley Joy Summit held last week in Ketchum: Stop chasing longevity. Start chasing health span.

"Longevity doesn't mean a lot," said the licensed naturopathic doctor, who once worked as a biochemist. "It just means you're going to live longer. You can live for 20 years in a bed if you want to. But that doesn't seem like a super fun time, especially in a valley like this where everyone's out doing things."

Health span, he explained, means living independently, doing the things you love, and actually enjoying them. And the pillars that support it are not exotic or expensive. They are lifestyle, nutrition, sleep and movement, all working together.

The thread that wove through nearly every topic he touched on was inflammation.

"If we can reduce the stress on our body, that's what inflammation is causing," said Szybala, who studied at a medical school in Portland, Ore. "And it's not just cortisol stress, like ‘That guy just cut me off.’ It's the stress of not sleeping well, the stress of not working out regularly, the stress of not eating appropriate foods on a regular basis."

The GLP-1 drugs--medications like semaglutide and tirzepatide--are turning out to be far more interesting than anyone expected, Szybala said. Not because they help people lose weight, but because they hammer inflammation.

Microdoses alone drop inflammation so significantly that patients feel like themselves again, said Szybala. Microdosing GLP-1 drugs will be a major area of research over the next three to five years, with potential benefits for cardiovascular and neurologic health, cognition, and possibly even cancer, he added.

With one caveat. Szybala says he never starts anyone on GLP-1 drugs or hormone replacement therapy if they are constipated. "Because guess what Phase 3 detoxification is: You better poop it out of your body, otherwise you're going to have it in your body."

For the many women in the room interested in hormone replacement therapy, Szybala had encouraging news. The guidelines have changed drastically since the Women's Health Initiative study in the early 2000s scared an entire generation away from hormones.

The key changes: progesterone shifted from synthetic progestins to micronized progesterone, and estrogen shifted from oral to topical delivery. Both changes dramatically improved safety.

"We put everybody on it now," he said. "There's no one that should not be, because of the improvements that we're seeing." The exceptions are limited to women with blood clotting disorders or estrogen receptor-positive cancers, and even some of those patients can be treated with careful monitoring.

Szybala described estrogen as the builder in a woman's body, “making the house,” while progesterone "turns it into the home." Given his choice, he joked, he would sprinkle progesterone on everyone.

For women who are already postmenopausal, Szybala said he will not order a Dutch test until after starting them on hormones.

Asked if he saw the end of cancer in the future, Szybala uttered a hard no.

“The reason is environmental. We keep toxifying ourselves. That's not going to happen. That's not going to change."

He pointed to farming practices that have changed the soil, plastics that introduce xenoestrogens into the body, microplastics in clothing, and the reality that even organic farms cannot escape drift from neighboring conventional operations.

Idaho, he noted, has one of the highest rates of colon cancer in the country, likely related to decreasing fiber intake and increasing sedentary lifestyles.

The bright spot is early detection. The Galleri test, a blood draw that screens for markers of roughly 400 types of cancer, is now available for $800. It cannot prevent cancer, but it can catch it at stage one instead of stage four, which is dramatically cheaper and more treatable.

Artificial intelligence will spur cancer research over the next 10 to 20 years, processing genetic and epigenetic data at speeds humans cannot match.

Asked about peptides, the injectable compounds that celebrities have been flying to Europe to obtain. Szybala was blunt. Most peptides people are buying and self-injecting are research grade, not human grade, with almost no clinical studies behind them, he said. He has watched patients inject three to five different peptides for two years with no measurable improvement.

The one exception is BPC-157, which he has seen produce faster recovery when injected locally after trauma or surgery.

He was more enthusiastic about creatine, long dismissed as a bodybuilder's supplement. New research shows it helps sustain muscle as people age, which matters enormously for health span. It also shows promise for cognitive decline, with dosing climbing from 3 to 5 milligrams up to 20 milligrams for brain health.

Its popularity has surged alongside GLP-1 drugs because, since weight-loss medications do not discriminate between fat and muscle, creatine helps preserve lean mass during weight loss.

As for gut health, Szybala is part of a company that created a sterilized fecal microbiota transplant, and his wife--also a naturopathic doctor--was among the first to perform FMTs with capsules in the United States. Studies coming out of Arizona State University have shown remarkable results using FMT for autism, and researchers around the world are exploring its use for Alzheimer's and Parkinson's.

The recipe for a healthy microbiome, he said, is simple: 30 grams of fiber a day in 30 different varieties a week. Nuts, seeds, fruits, vegetables. Diversity is the single factor proven to help. Eating the same thing every day, drinking alcohol, and skipping exercise  reduce it.

And about that alcohol: One drink, he told the room, will significantly impair the microbiome. Asked about the Mediterranean diet and its glass of red wine, Szybala said the secret ingredient was not resveratrol. It’s community.

"If you eat and drink together, you're going to be healthier. If you have a glass of wine by yourself, it's going to be less healthy."

He recalled working at the Food is Medicine Institute in Portland, where students prepared meals together, did deep breathing exercises and chewed every bite 35 times until it was liquid.

"Turns out digestion doesn't start in the gut," he said. "It starts in our mouth, and none of us chew food long enough."

Allergic? Try hookworms. The introduction of hookworms into the gut has shown dramatic results for autoimmune conditions and allergies, particularly in children. Before modern sanitation, parasitic worms were a normal part of the human microbiome. Tribes that still carry them show virtually no autoimmune disease.

In the United States, doctors cannot administer helminths, but Szybala can refer patients to providers in other countries.

The supplement Theracurmin HP that has been studied alongside ibuprofen and shown to be equally effective at reducing inflammation, without the downsides of blocking the muscle recovery that exercise demands.

For long COVID, brain fog and post-viral fatigue, he pointed to mitochondrial support, including urolithin A, acetyl-L-carnitine, and a product called ATP 360 that he uses himself and considers remarkable for cognition and energy recovery.

If you don't want to spend money on a bunch of stuff, he said, buy turmeric, pair it with fat and black pepper and make something with it. Curcumin, its active compound, is a powerful anti-inflammatory that is cheap and effective.

“You are going to live a very healthy, happy lifestyle."