KYZN

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Golfer's elbow and tennis elbow usually come from repetitive strain, and the forearm tends to get no attention at all until it is the thing that hurts.

The drill in the video is deliberately low tech. A towel and about two minutes. Feet planted, hands in position, elbow resting, back straight so the effort does not travel up into the spine. Grip the towel tight and keep the knees close together.

Then the movement. Wrists up, forearm sitting a little lower, and pick up the pace. Turn the hands the other way without hesitating, same position, opposite direction. Higher, supinate, pronate.

The reason it earns the two minutes is unglamorous. Work the forearm like that and the blood gets pumped up through it, and it releases the shoulder as well, because the shoulder does not have a really great blood supply of its own.

There is a generational point sitting underneath this too. A lot of young people spend the day on a screen with thumbs and fingers going constantly, and the honest expectation is that it turns into hand and wrist problems further down the line.

Worth being clear about what this is. It is general strengthening, not a treatment for a particular injury, and it is not a replacement for having something properly looked at if it has been hurting for a while.

Which of your hands is doing more work in a day than you have ever given it credit for?

I have seen things in clinic that I cannot fully explain. Patients defying everything I understood, months after treatment. The first full KYZN podcast goes far beyond the injections: inflammation as the mother of disease, genetics versus the exposome, why mindset is probably the biggest lever, and the habits that carry everything else. Full episode this Wednesday, 10am UK, on the KYZN YouTube channel.

Dangerous or safe? Quick verdicts on the longevity treatments everyone is asking about, exactly as I gave them on camera.

Peptide stacks from the gym: definitely dangerous, I do not trust them. NAD IV drips: potentially dangerous. Young plasma exchange: no good evidence, potentially dangerous. Whole body cryotherapy: evidence not great, usually safe, can help some people in certain conditions. Stem cell tourism abroad: can be really dangerous, even a few deaths reported. Hyperbaric oxygen: reasonably good evidence, one I do trust. Off-label rapamycin: potentially dangerous, helps in limited circumstances, not my go-to.

Notice the pattern. The boldest promises carry the thinnest evidence.

Educational content, not medical advice.

The immortality guy just got sick. And no, this is not an attack on Bryan Johnson.

But chasing that level of optimisation carries its own risks. Two hundred pills every morning. Endless testing. Your health as a public performance. That is a stress generator, and stress is implicated in autoimmune conditions.

For perspective: autoimmune gastritis is not a game changing condition, whatever the headlines say, and autoimmune disease is not necessarily something you earn by a mistake.

He can spend two million dollars a year on his health. Most people cannot, and the leverage sits elsewhere anyway: stress reduction, eating better, moving regularly, and proper down days where you are not thinking about your health at all.

Obsession has a cost too.

Educational content, not medical advice.

Are NAD drips the next big thing? Simple answer, no. They have been around for a long time. What is new is the hype.

A few honest points from the clinic. For most people, drips are not the solution. NAD exists in more bioavailable forms, injections and sublingual among them, and there are stable liposomal products, though many liposomes are unstable, so be careful.

We tested ten NAD products from Amazon. Eight had no viability. A label can promise a two-year shelf life while the active molecule is long gone.

What matters is how you take it, when, in what form, and how you monitor the effect. Measured, not marketed.

Educational content, not medical advice.

Did you know the white coat was abandoned in the UK probably over twenty years ago? In Dubai and the US it is still widely used.

The UK decision followed evidence. Studies swabbed white coats and found all sorts of bacteria, carried around the ward, from patient to patient and bed to bed.

Why does it survive elsewhere? Some feel it looks cool, more doctory. And patients see a white coat and assume cleanliness. The perception is hygiene. The reality, on the swabs, was different.

It is a good reminder that in medicine, evidence outranks appearance, even when the appearance is the most trusted symbol we have.

Follow the swabs, not the costume.

Your GP can now be paid to prescribe Mounjaro. That sentence deserves a careful look rather than a hot take.

The background is straightforward. There are simply not enough people on it in the UK, and the government has introduced a financial incentive: put a minimum number of patients who meet the eligibility criteria, BMI, obesity, other risk factors, onto the drug, and the practice is paid.

Why Mounjaro specifically? I honestly do not know why they picked it. What I can say is that it is a validated drug, and its evidence goes beyond weight loss: there are diabetic benefits, heart protection and more. This is not a cosmetic shortcut being pushed onto the public. It is a legitimate medicine finding its way into policy.

But here is the part I care about as a clinician, and the part an incentive scheme does not measure. The important thing is that people go into proper programmes, doing weight loss in a responsible way. Two reasons.

First, sustainability. Done properly, when someone stops the injections, they are far more likely to keep the weight off. Done as a jab alone, the weight tends to have other plans.

Second, muscle. On these drugs you are not only losing fat, you are also losing muscle. That is why a responsible programme changes the diet, increases the protein content, and adds strength training alongside the medication.

The drug can open a window. What gets built inside that window, diet, protein, strength, is the long-term strategy that may actually work for you.

Prescriptions are policy. Programmes are what change lives.

Are biological age tests worth it? Only under one condition.

Biological age is just a number, and it changes from system to system. Your heart's biological age may differ from your liver, your kidneys, your brain. What most tests measure is DNA age, an indirect measure of the rest. Its real value is the trend.

Used that way, the test earns its place. Set a baseline, make a change, exercise or intermittent fasting, then watch the direction of travel. Rising over time is probably not good news. Dropping may well be a good thing.

If the number will change what you do, measure it. If it will only make you feel low while you change nothing, what is the point?

Measure to steer, not to worry.

The question I am asked most about PRP is why the same preparation keeps appearing in areas that seem unrelated. Skin in one clinic, a knee in another.

It helps to start with what it actually is.

We take a small amount of your own blood and place it into a specialised tube, then into a centrifuge. Spun at speed, the components separate by weight. The heaviest settle at the bottom. Water sits at the top. We take the fraction rich in platelets and introduce it to the area that is compromised.

That is the whole preparation.

Why platelets matter becomes clearer if you think about what happens when you cut yourself. Bleeding is not simply loss. It is the beginning of a tissue response. Platelets bind to one another, recognise that an injury has occurred, and release growth factors that recruit the healing process.

So the logic is straightforward. Concentrate the cells that signal repair, and place them where repair is needed. In skin the intention is rejuvenation. In a joint it is more often a reduction in inflammation and in pain.

What I would want any patient to understand is the limit of the claim. PRP is not a super serum. It is not adding a capability your body does not have. At its best it is amplifying a signal your body already knows how to send.

That distinction matters, because it sets a realistic expectation of what a good outcome looks like. Returning toward normal is a reasonable aim. Becoming better than you have ever been is not what the biology describes.

Evidence quality varies considerably by indication, and anyone considering it should discuss their own circumstances with a clinician.

There is no approved stem cell therapy for knee arthritis, or for any other musculoskeletal condition. I say that as someone who works in this field.

It is important to be precise about what that does and does not mean. It does not mean the treatment does not work. There are good studies supporting the view that these injections can help people, and I have seen them help. What it means is that the evidence has not yet reached the threshold required for formal approval, and that anyone speaking with certainty in either direction is overstating their position.

The video gives you the questions to ask. What I would add is why they are the right ones.

Ask what the evidence of effect is for your specific condition, not for regenerative medicine generally. Ask what that clinic's own results and outcome data look like, because published literature and a particular practice's outcomes are not the same thing. Ask what the alternatives are, both instead of the injection and after it. And ask what happens if it does not work, because it will not work for everybody and that conversation is much easier to have before you have paid.

A clinic that welcomes those questions is one you can work with. A clinic that becomes uncomfortable has told you something useful.

And if anyone offers you a 100% result, that is your answer.

This is general information rather than individual medical advice. Discuss your own situation with your clinician.