Prime Human Podcast

Tired all the time? The blood tests I’d run firstIf you’re tired all the time and you’ve been told your blood tests are normal, this is the list I’d ask your doctor for next. I’m a doctor who works with founders and executives who can’t slow down, and “everything is normal” is where almost all of them start.Normal means you’re inside a statistical range built from whoever walks into a lab. It doesn’t mean enough for the way you live. The standard panel is designed to find disease, not to explain why you’re underperforming.What I check, and the targets I use in my practice (not medical advice; your doctor interprets your results):Metabolic storage: vitamin B12 (I want at least 800 pg/mL), folate (at least 15 ng/mL), B6, B3, homocysteine (6 to 7 µmol/L), magnesium (upper part of the range).Vitamin D (at least 80 ng/mL in my practice; check your lab’s unit, many report nmol/L).Cortisol, ideally the cortisol awakening response in saliva over the first two hours of the day, plus DHEA-S.Testosterone and estrogen, and the balance between them.Full thyroid: TSH, free T4, free T3, thyroid antibodies.Inflammation: hs-CRP and ESR. Mildly raised is still a finding.Metabolic health: fasting glucose, fasting insulin, HbA1c.If all of this comes back ideal and you’re still exhausted, the next layer isn’t blood: organic acids in urine, then your wearable (HRV and resting heart rate as a trend over weeks). That’s where most of the answers are for the people I work with.Dr Miguel Damas, MD. Performance medicine for founders, executives and high-achievers. Fully remote. primehumanperformance.com

A client asked me a simple question: do you think I'm tired, or am I burning out?Nobody asking that wants a label. They want to know one thing - will this pass, or am I starting to break?I've been answering that question for founders and executives for over a decade, and the answer starts somewhere most people don't expect. Burnout isn't a mental health problem. It's a metabolic one. Use more battery than you recharge and eventually you run out. Nothing is wrong with the phone.So I look at three layers.Data. What your wearable says about heart rate variability and resting heart rate. What a broad blood panel says about inflammation, blood sugar, thyroid, and the raw materials your body runs on. And what precision testing - salivary cortisol, urinary markers of dopamine and mitochondrial function - says about whether there's anything left in the tank.Context. What happened in the months before this started. Finish a marathon and you'll be wrecked for a week. That's not burnout, that's the price of the race. Same after a brutal funding round, an exec team walking out, or a newborn.Mind. The layer almost everyone skips, and the biggest lever of the three. Perfect data, clean context, still stuck. Because the limit on performance was never effort. It's perceived effort.Same symptoms, different data, different answer.If your bloods came back normal and you still know something's off, this one is for you.Sign up for the Founder BriefApply to work with me: primehumanperformance.com/founder-programBook mentioned: How Bad Do You Want It? — Matt Fitzgerald

Supplements are everywhere. But which ones genuinely deserve a place in the routine of a founder, executive or high performer?In this episode, Dr. Miguel Damas shares the five supplements he believes are most relevant for supporting energy, cognition, recovery and long-term health in people operating under sustained pressure.He explains why supplementation should not be used to compensate for poor habits, but why even a strong diet may not always provide everything the body needs.Modern food systems, limited sun exposure, demanding lifestyles and higher physical and cognitive workloads can all increase the gap between adequate nutrition and optimal performance.In this episode, you’ll learn:Why a healthy diet may still leave important nutritional gapsHow stress, training and demanding workloads can increase your nutritional requirementsWhat makes a supplement genuinely useful rather than simply popularHow to think about dosage, quality, testing and individual needsThe five supplements Dr. Damas considers most relevant for founders and high performersThis is not about building an enormous supplement stack or searching for shortcuts. It is about understanding where targeted supplementation may help strengthen the biological foundations behind consistent performance.For founders, executives and ambitious professionals who want to protect their health while continuing to perform at a high level.Work with Dr Miguel Damas - FOUNDER PROGRAMhttps://www.primehumanperformance.com/founder-program

A founder emailed me after last week's Founder Brief with a question I couldn't answer in a reply: when your capacity to handle stress is already gone, can you get it back?Short answer: yes. Long answer: this episode.I take a flip chart and walk through the model I use with every founder, executive and investor I work with - why burnout isn't a mood problem, it's a load problem, and why the most common medical advice given to high performers ("you just need to stress less") is not only useless but actively makes things worse.What we cover:→ The destruction/construction graph - why you need damage to grow, and what happens when the damage never stops→ Allostatic load, and the four buckets it splits into: neuroendocrine, cardiovascular, metabolic, inflammatory→ Why it all goes into one bucket - your body doesn't care whether the strain came from a board meeting, a bad diet, or a chronic infection→ The 105-out-of-100 problem: how a typical founder is running a load their recovery can't cover→ What we actually measure (cortisol awakening response, DHEA-S, ApoB, homocysteine, IL-6, CRP, urinary neurotransmitter markers) and why guessing is flying blind→ Non-negotiables vs. everything else - the pressure, the travel, the decisions stay. Nearly everything else is negotiable.→ Push vs. recovery, and how HRV and resting heart rate tell you which side of the line you're on→ Whether regulatory bandwidth can be rebuilt - and what the evidence saysThe paper that started it: "Regulatory Bandwidth: A Theoretical Integration of Present Multisystem Stress-Regulatory Capacity" (Psychoneuroendocrinology, 2026) — https://pubmed.ncbi.nlm.nih.gov/42407406/THE FOUNDER BRIEFThe weekly newsletter where I break down the science worth your attention. No spam. Sign inWORK WITH MEFounder Program - ApplyEverything in this episode is for educational purposes only. It is not medical advice. Do not change your treatment, protocol, or medication without consulting your doctor.Music licensed through Soundstripe.Code: SXVRV1TMR4ECROBG#Burnout #FounderHealth #AllostaticLoad #HRV #Longevity #HumanPerformance #ExecutiveHealth

Download my Prime Stress Protocol, a 30 page fully reference ebook with all the strategies I give my founders and executives to minimize the negative impact stress has."We are what we eat." It’s a lie. Actually, we are what we digest, absorb, and utilize without causing internal chaos.In this episode, I break down the 3 Levels of Nutrition that every founder needs to master to make the most of what they eat and max out on health and nutrition.What’s Inside:Level 1: The Damage Audit. Why "healthy" vegetable oils are rusting your mitochondria and causing brain fog.Level 2: The Macro Pivot. Why protein is non-negotiable for neurotransmitter production (and why you should eat your carbs at night).Level 3: The Behavioral Secret. The shocking data from prison studies - how micronutrients can reduce "violent behaviour" by 25% and what that means for your mood stability.The One Rule: If your food is causing Level 1 damage, it doesn't matter how "perfect" your macros are. You're still losing.

Longevity is a Trap: Why You Should Focus on Performance Optimization InsteadMost people are obsessed with living to 100. They’re following "Don’t Die" protocols, taking 90 pills a day, and letting algorithms dictate their joy. But if you’re a founder, executive, or high-performer, this defensive approach to health is actually a trap.In this episode, Dr. Miguel Damas explains why he built Prime Human Performance to challenge the longevity hype. If your goals involve building a company, traveling the world, or training for an Ironman, "pure longevity" science will tell you to stop. We do the opposite. We use Applied Longevity to make your mission possible.Learn how to stop adapting your life to your health and start adapting your health to your life.In this episode, we discuss:The Bryan Johnson Critique: Why the "algorithm life" is unsustainable for 99% of high-achievers.Performance vs. Longevity: Why your biggest goals are inherently "anti-longevity"—and why that’s a good thing.The Dubai Case Study: How Dr. Miguel managed a high-pressure 72-hour international mission and landed sharper than he started.The Tactical Playbooks: Specific "Applied Longevity" protocols for long-haul flights, social drinking (The 6 Rules), and high-intensity training.The 4 Non-Negotiables: The foundational pillars of health that you can’t skip, no matter how busy you are.Stop playing defense with your health. Start playing offense.[EPISODE RESOURCE] 📘 Download the Prime Stress Protocol: If you want the exact strategies Dr. Miguel uses with his executive clients to mitigate stress and increase resilience, grab the 30-page, fully referenced ebook for free at: primehumanperformance.com/stressprotocol[CONNECT WITH DR MIGUEL] 🌐 Website: primehumanperformance.com 📸 Instagram: @biohackingmd💼 LinkedIn: @biohackingmd

Most high-achievers aren't depressed. They’re just empty.If you’re a founder or executive who has lost your "edge," you’ve likely been told it’s a mental health issue. You might have even been prescribed antidepressants that did... nothing. In this episode, Dr. Miguel Damas breaks down the metabolic reality of burnout and why your "biological battery" is the real culprit, not your mindset.Inside the Episode:The "One Question" Test: How to instantly tell the difference between clinical depression and burnout.The Benzo Trap: Why "sleeping more" with medication is actually destroying your recovery.The Metabolic Battery: Why burnout is a physiological crisis, not a workplace stress problem.The 4-Step Diagnostic Framework: From HRV to Organic Acid testing—how to measure your resilience.Download the Prime Stress Protocol (30-Page Ebook) Resources: 📘 Benzodiazepines and Sleep Impact, 2023 Systematic Review - link Judged effectiveness of strategies to recover from burnout, 2025 - linkTimestamps: 00:00 - The Senior Executive Misdiagnosis 04:15 - Depression vs. Burnout: The "One Question" Test 08:30 - Why Antidepressants fail for Burnout 12:45 - The 2025 Study: What actually works? 15:00 - The 4 Areas of Resilience: Signs & Symptoms 18:20 - Using Wearables (HRV & RHR) to track depletion 21:40 - The "Critical Six" Blood Markers 26:10 - Precision Medicine: Saliva & Organic Acid Testing30:00 - Why this is liberating for founders

Is burnout actually a "work problem"? Dr. Miguel Damas argues that the World Health Organization’s definition is not only narrow - it’s scientifically flawed.In this episode, we dismantle the myth that burnout is purely a mental health issue or an "occupational phenomenon." Using the "Cell Phone Battery" analogy, Dr. Miguel explains why burnout is a total-body metabolic depletion that strikes the most ambitious among us. If you’re a high-performer waking up sluggish or losing your mental edge, this episode is your roadmap to recovery.What you’ll learn:Why the WHO definition limits your recovery.The "63 Apps" Analogy: How life, not just work, drains your system.Why telling a founder to "stop stressing" is borderline insulting.The 5 Red Flags: How to tell if you’re burning out (including HRV and sleep patterns).How to recharge your metabolic battery from the inside out.Connect with Dr Miguel Damas on Linkedin and Instagram

Is Vitamin D the most undervalued tool in your health arsenal? In this episode of the Prime Human Podcast, Dr. Miguel Damas explains why Vitamin D is much more than a simple supplement—it is a powerful steroid hormone that influences up to 25% of your DNA transcription.Dr. Damas breaks down the staggering statistics: from a 67% increase in all-cause mortality risk associated with low levels to the "statistical mistake" that led to modern-day dosage recommendations. Whether you are looking to optimize your immune system, banish brain fog, or increase your VO2 max, this episode provides a masterclass in personalized biology.In this episode, you’ll discover:The Hormone Secret: Why Vitamin D behaves differently than any other vitamin.The Longevity Link: How Vitamin D levels impact mortality risk more than smoking.Precision Medicine: Understanding SNPs (genetic variations) and the Coimbra Protocol.Performance Gains: The impact of Vitamin D on muscle strength and aerobic capacity.The PTH Connection: Why testing Vitamin D alone isn't enough to see the full biological picture.Disclaimer: This episode is for educational purposes only and does not constitute medical advice. Always consult your physician before changing your protocol.

In this episode, Dr Miguel Damas makes the argument on why you probably should be doing saunas daily, hooking it on 3 areasHealth and LongevityExecutive performanceSports performance