Molly Maloof, MD joins the Evolution of Medicine podcast to discuss a shared vision: connection as a critical pillar of healthcare.

Dr. Maloof recently authored and released a book called The Spark Factor, which teaches readers how to personalize biohacking strategies for better energy and health. Dr. Maloof wrote portions of the book to fill the information gaps in biohacking for women, but 80% of its content is also applicable to men.

If you listen to this short yet powerful episode, you’ll quickly recognize how well-aligned Dr. Maloof is with our year of connection. She discussed how loneliness and lack of connection—either social or connecting with your own body and health—is a leading crisis, especially post-pandemic.

Please listen to the full audio to learn more about the following:

  • How The Spark Factor helps readers personalize their journey to improve their mitochondrial energy
  • How the Functional Forum will be even more critical in the age of digital and medical censorship
  • The seriousness of the loneliness and mental health crises
  • Some practical tips for women to better align with their cycles
  • Tips on fasting and exercise for different patient groups
  • And much, much more!



Dr. Molly Maloof: Really not surprising that there’s so much mental illness emerging, because people need social connection to thrive. Fundamentally, it’s just as important as water or food or air to live.

So, when I discovered that loneliness was a primitive pain signal, similar to hunger and thirst, designed to drive people closer to their tribe, and that loneliness, if left unattended to, is worse for your health than smoking 15 cigarettes a day, than being sedentary and being obese, I was like, “Oh, hold on a second. Why are we ignoring this? Why are we ignoring this massive elephant in the room?” This is clearly a problem. We have to pay attention to this. This is important.

And so, I started studying social connection because I want to understand why this works. Why does this help people? Why do we need to be connected? I discovered that basically social connection is the greatest factor that we know in longevity and happiness.

And so, it’s pretty much the frontier of medicine in a lot of ways because it’s not even paid attention to. It’s like a vital sign. Anything else that doctors are looking at, they should be asking every single patient at every single appointment. And yet, I actually think a lot of the reasons why people go to the doctor is because they’re lonely, is because they’re disconnected, because they’re scared, because they’re alone. If you actually look at the ERs, they tend to be particularly heavily flooded during the Christmastime when people are the most alone, and they have no one to turn to.

So, we have to start taking it seriously. This is going to require a massive public health campaign. I really love what you guys are doing at Evolution of Medicine, really trying to put a stake in the ground around connection and the importance of connection for improving health.

James Maskell: Welcome to the Evolution of Medicine podcast, the place health professionals come to hear from innovators and agitators leading the charge. We cover the latest clinical breakthroughs and health technology, as well as practical tools to help you transform your practice and the health of your community.

This podcast is brought to you by the Lifestyle Matrix Resource Center, who provide a range of options to help you deliver successful, effective functional and integrated medicine. To find out more and to get started, go to goevomed.com/lmrc. That’s goevomed.com/lmrc.

Hello, and welcome to a very special episode of the Evolution of Medicine podcast. We are super grateful to have here today someone who’s been on the show a number of times. You may know her as an expert in technology and the sort of cross-section of technology and functional medicine. But Dr. Molly Maloof has many arrows to her quiver, and we are going to be talking about some of those here today. It is the year of connection. And great to have you here.

First and foremost, I’m excited, Molly, because for those people who are in the know and live in and around this area and know what you’ve been up to in Silicon Valley, you’ve been a central figure in that connection between functional medicine and technology. But now you are stepping up onto news channels and so forth with talking about your new book, The Spark Factor, which I’m excited to get into. This is the year of connection here at the Evolution of Medicine. I’d love to just get your thoughts on how connection applies to what you are talking about in your book.

Dr. Molly Maloof: Yeah. So, I have an entire segment of the book that’s multiple chapters on the power of connection and health, but also peppered throughout the book is a lot of technology that helps you connect to your own personal health. The book’s largely on biohacking energy, and there’s really four pillars of health discussed in the book. There’s movement, metabolism, mastering stress and maintaining connection. So, I really try to teach people about how to get their spark back because a lot of people are feeling like their spark was dimmed by all of the stress in the last few years. I really wanted to give a book that would be a really strong overview of how to have better energy for better health.

James Maskell: Yeah, that’s so cool. Okay. Well, we’ll get into some of the tech stuff down the road because I know you’ve always got your finger on the pulse of what’s going on and what’s new and exciting, and maybe ways to measure that, but I’d love to just start with the baseline thesis because over the years on the Evolution of Medicine, we’ve had Bob Naviaux talking about the cell danger response.

Dr. Molly Maloof: Oh, I love him.

James Maskell: That kind of topics. But how are you making that information… What kind of information are you bringing to the public that you think hasn’t been brought before, and in what way?

Dr. Molly Maloof: Yeah, when you go to the doctor and they say, “Well, you’re just stressed.” Or, “You should eat right and exercise more.” We know that. Everybody knows that they should do these things, but one of the biggest problems is people are like, “Well, how do I do it? How do I incorporate this into my life? How should I eat differently? What should I do for my body and my life? Well, how do I get started on an exercise regimen? What do you mean by stress? Where does my stress come from? Which sources of stress? There’s so many different stressors.” So, I try to really break down each of these really important topics into an understandable framework so that you can actually have a guidepost, a way to take your body forward through a biohacking manual.

So, biohacking is actually intentionally manipulating your body to optimize your health. So, the question is, “How do you want to optimize your health? What do you need to do to optimize to get healthier?” Some people may find that stress is their biggest problem. Maybe they exercise, maybe they eat well, but stress is their biggest issue. So, that chapter would really appeal to them. Some other people, maybe they exercise and eat right, but they’re totally disconnected. The chapters on connection will really, really help them. And then for all the women out there who are like, “Well, biohacking seems like a man’s sport. What about me?” I have multiple chapters just dedicated to female hormones and understanding the female biohacking journey. That’s really what I’m trying to do to teach people about how to optimize their health.

James Maskell: Yeah, it’s interesting because it feels like seeing a functional medicine provider can be a pathway to starting to biohack because now there are numbers that you can see and that you can see if you could improve. Have you found that in your practice as you engage a woman into understanding some new numbers, they’re now activated to go on and improve them themselves?

Dr. Molly Maloof: Absolutely. I think one of the reasons why my practice has actually worked for people is because it’s been so designed around doing testing and doing labs and actually running the numbers on your body to find out what’s going on inside you. I do talk about labs in the book. I talk about wearable technologies like Oura Ring and my CGM I’m wearing, and the importance of knowing your blood sugar, your sleep, your movement and your stress levels. Because to me, if you can check those on a day-to-day basis, you’re really far along in optimizing your health because those are the biggest drivers of disease. But I also talk all about gut testing and micronutrient testing and hormone testing and the importance of these markers for really taking a deeper dive into what’s going on under the hood.

James Maskell: Great. Well, one of the things I’ve really appreciated in the last couple of years is following you on Instagram and seeing you taking up the mantle of talking about disconnection, loneliness, sexual connection, some topics that have been a little bit taboo even in functional medicine. Do you want to just share a little bit about why that’s a pillar, and what drew you to talking about that?

Dr. Molly Maloof: Oh my gosh, totally. When I discovered that… The pandemic taught us a lot. We all just went through this major experiment where we had an isolation of our lives. We were all isolated. Some of us had more interactions than others, but generally speaking, when you put animals in isolation studies, those are typically designed to induce mental illness. It’s kind of funny to me that we didn’t realize the same thing would happen to us when millions of people were isolated and alone during s pandemic. It’s really not surprising that there’s so much mental illness emerging because people need social connection to thrive. Fundamentally, it’s just as important as water or food or air to live.

So, when I discovered that loneliness was a primitive pain signal, similar to hunger and thirst, designed to drive people closer to their tribe, and that loneliness, if left unattended to, is worse for your health than smoking 15 cigarettes a day, than being sedentary and being obese, I was like, “Oh, hold on a second. Why are we ignoring this? Why are we ignoring this massive elephant in the room?” This is clearly a problem. We have to pay attention to this. This is important.

And so, I started studying social connection because I want to understand why this works. Why does this help people? Why do we need to be connected? I discovered that basically social connection is the greatest factor that we know in longevity and happiness.

And so, it’s pretty much the frontier of medicine in a lot of ways because it’s not even paid attention to. It’s like a vital sign. Anything else that doctors are looking at, they should be asking every single patient at every single appointment. And yet, I actually think a lot of the reasons why people go to the doctor is because they’re lonely, is because they’re disconnected, because they’re scared, because they’re alone. If you actually look at the ERs, they tend to be particularly heavily flooded during the Christmastime when people are the most alone, and they have no one to turn to.

So, we have to start taking it seriously. This is going to require a massive public health campaign. I really love what you guys are doing at Evolution of Medicine, really trying to put a stake in the ground around connection and the importance of connection for improving health.

James Maskell: Absolutely. Yeah. I totally get it. I see the same thing that you do and am engaged every day in trying to deliver a standard of care that involves reconnection. Reconnection to yourself, to your best practices, to your own health practices, but to each other and to other people who have conditions the same. So, I’m really glad that you share that.

I guess, go a little bit further into the disconnection with themselves because this is a book for women. I see that on that. How does that particular issue relate to women? Why is that such a critical area for them?

Dr. Molly Maloof: Sure. A lot of women still don’t even track their periods to be honest with you. They have no idea what’s going on inside their bodies. And they’re flying blind. Women were the original biohackers. We have to biohack our fertility, our menstrual periods, our pregnancies, our postpartum, and our menopausal ages and perimenopause. There’s so much biohacking that you have to do as a woman to really optimize your health.

And I wanted to create a book that would at least give a broad overview of a woman’s life cycle so that she can understand how to connect with her body, how to actually understand what’s going on in different life stages, what’s going on in different parts of her menstrual cycle, and how can she biohack different phases of her menstrual cycle to optimize her energy levels. So, I used to just work out however I wanted throughout the month. And now, I really respect my hormones, and I work out harder in the gym during my follicular phase, and then I work out more easefully during my luteal phase.

When my body’s burning fat more effectively, I do more moderate intensity exercise and I eat lower carb. During the beginning of my menstrual cycle, when my body’s burning carbs more effectively during the follicular phase, I do higher intensity exercise. So, there’s a lot that you can do to really understand your body and make changes in your lifestyle to have better health outcomes.

I also dig into sexual connection in this book because sexuality is such an important part of our lives as women and men. And we often overlook it, and we often forget how important it is, how powerful of a tool it is for increasing oxytocin. Orgasm’s one of the best ways to get oxytocin. Oxytocin is the hormone of safety, trust, love and connectivity. There’s a bunch of ways to biohack oxytocin; spending more time with your family and your friends, as I mentioned, orgasm, massage, cuddling, holding babies and petting dogs and cats, listening to music. There’s so many ways that you can start to feel better that are super simple and free.

James Maskell: Yeah, that’s great. I’m glad that side of things is coming in, because I think personal medicine has the potential to be quite impersonal. It’s just other labs that we’re looking at, and then there’s other solutions there. One of the things that we’ve seen from running this group medicine now for three years is that if you have someone who finds eight new friends who all think like them and are all searching for the same goal, the power of that versus like diet…

Dr. Molly Maloof: That’s so true.

James Maskell: It’s so significant.

Dr. Molly Maloof: Yeah, absolutely.

James Maskell: It can reinforce those healthy behaviors too, with accountability and structure. Let’s go deeper into the energy stuff because I really feel like the understanding of energy is sort of this next frontier in the functional medicine space. What drew you to that as a focus for the book? What do people need to know about energy, mitochondria, energy production, and its importance in treating patients and being healthy?

Dr. Molly Maloof: In terms of mitochondria, they really are the seat of life and our death. Basically, when we get born… When the sperm meets the egg, there’s a zinc spark that activates the cellular division and really starts powering… It’s essentially… It’s this weird chain reaction that just begins when the sperm meets the egg.

The sperm’s mitochondria get thrown away and the female mitochondria, they start turning on and they start powering the cell division. So, this is why energy is so fundamental because if you don’t have functioning mitochondria, you do not get cell division. Basically, without energy, you don’t transcribe any of these genes. The genes are just the plan. Mitochondria are the epigenetic regulators of gene expression. Not only are they producing energy, they’re deciding where the energy goes and what it’s going to be used for.

Your mitochondria are always trying to decide, am I here for biosynthesis? Am I here for producing sex hormones, stress hormones, neurotransmitters? Or am I here to help protect you and keep you alive? A lot of what people don’t understand about mitochondria is that they’re also signaling organelles. They take this information in from the outside world, and they’re always deciding, “Okay, well, do I need to mount an immune response?” They activate the immune response, they activate inflammasomes, they actually play a role in inflammation. They play a role in the production of reactive oxygen species, which are meant to be cellular smoke signals to send signals throughout the cell. But when those go awry, that can cause damage. If damage happens bad enough inside the mitochondria, they’ll blow up and release mitochondrial DNA, which is a marker of mitochondrial dysfunction. Very important cells, if things get really bad in a cell, then they can cause apoptosis, which is called cellular suicide.

If you do things like what are called toggling mitochondrial stressors, let’s break that down a little bit. That means switching back and forth between mitochondrial stressors that can make you stronger. Things like fasting and feasting, carbohydrate metabolism, fat metabolism, exercise and recovery, light and dark cycles, sleep and wake cycles, hot and cold cycles, saw it on cold plunge, high pressure and low pressure cycles, HBOT and normal pressure. All of these switches create the conditions where your body can actually become stronger with stress. But keep in mind that you have to have a good baseline before you start doing a lot of these biohacks all at once because if you do too many biohacks at the same time, you can cause problems on a cellular level. You can actually cause hormone dysfunction, which is why I try to teach women, be more careful with your hormones. You cannot biohack the same as men. You have to be more gentle with your body. Oftentimes, women try to do too many things at the same time, and they end up breaking their metabolisms and causing hormone dysfunction. So, that’s one of the things we’re trying to avoid by teaching people about really monitoring your stress and really focusing on different facets of optimizing your health, not just trying to do everything all at once.

James Maskell: Yeah. Is the mechanism that you just discussed there one of the reasons why the metabolically unhealthy did worse with COVID?

Dr. Molly Maloof: Yes. In fact, the metabolically unhealthy are the people that are set up and at risk for chronic fatigue. So, if you don’t have a good metabolic baseline, your energy production is going to be not super great. If that’s the case and you get hit with a major metabolic stressor like an infection… Keep in mind, infections hide inside the cell and hijack your metabolic machinery to make themselves. So, when you get sick with a virus, or Lyme disease, or intercellular infection, you’re actually further cutting the power. So, if you’re already running a low power and the power gets cut, we’re going to have a broken immune system. We’re going to have an immune system that can’t be activated properly to fight off from that infection, which sets you up for further inflammation, sets you up for mitochondrial dysfunction, which is really what chronic COVID is all about. It’s a chronic inflammatory condition combined with a broken mitochondria.

James Maskell: That makes a lot of sense. Well, awesome. Well, look, I do want to switch gears a little bit. It’s really an extension of what you were talking about a minute ago. In the book and in your work generally, you do encourage the use of gathering information about the body all the time. You mentioned that your Oura Ring and your continuous glucose monitor. For the doctors out there and the practitioners who are trying to build exceptional practices, and also for the people out there who are trying to be healthy, it seems like a lot more of this is a lot easier to do than it once was. You had to be pretty committed to. When you’re working with people and in the book, how do you recommend for people to get the most out of this for the least effort?

Dr. Molly Maloof: Sure. First and foremost, your phone has a lot that it can do for free. So, your phone can measure your steps. If you’re pretty sedentary, the first thing you should be focusing on is getting more movement in throughout the day. Secondly, there’s a lot of free fasting apps out there. I’m not necessarily recommending fasting for everybody. To me, fasting is really good for people who are metabolically unhealthy, for people who are metabolically inflexible, who basically, if you read the book, there’s a whole sequence of learning how to fast. But it’s one of the better ways to learn to flip the metabolic switch, especially after a period of ketosis and getting fat adapted. Fasting is free for us. Fasting is very cheap and very free.

Again, you’re going to want to focus on going into ketosis and eating whole foods and not snacking as much before you start with fasting, and not being super stressed out. It’s definitely not for people who have eating disorders or who exercise excessively because exercise and fasting do a lot of the same things, but it’s really good for people who are sedentary and for people who don’t want to do much and maybe don’t move their bodies very much and are willing to do things like maybe eat less often.

But again, you have to be the right person for the tool. I really outline who’s best suited for fasting in the book. It’s definitely not for everybody. Women with perimenopause can be great candidates because their estrogen levels have declined, but I wouldn’t necessarily recommend it for a healthy, young, fertile female who has a normal metabolism. She probably doesn’t need to do as much fasting.

James Maskell: If you had to stack in order, what information is the most broadly relevant for someone to get in real time from their body? Where would you put like glucose, HRV? Where would you stack all those kind of information as far as what the most important one is, and go from there?

Dr. Molly Maloof: Yeah. Well, first and foremost, really the number one thing is how do you look and feel? If you wake up every day, your skin is gray and sallow, and you look and feel terrible, you probably have low energy. You don’t need any bells and whistles to know that. If you’re not feeling good every day, if you’re not waking up in the morning having energy when you get out of bed, then you may have lower energy output. Let’s get real.

But I personally think that putting a glucose monitor on and an Oura Ring, yeah, they’re a little bit more expensive, but man, they’re going to be so normalized in the next five years. I’m just early to this game. I’ve been using these since, I guess the CGM, since 2014, and Oura Ring maybe a couple years later after that. But I’ve been using wearables like this for a long time. I want to know how much is a patient sleeping. Because if you’re not sleeping properly, you’re really never going to be healthy. You can’t be fully healthy without proper sleep.

And then, HRV is usually a good indicator of your sleep and also of your stress levels and your stress management. I’m really obsessed with optimizing HRV right now. It’s one of my main goals for this year is HRV optimization. But for CGM and glucose, everybody should put one of these on at least once a year, if you can, just to get an idea of what’s your blood sugar look like, what does your fasting blood sugar look like? What does it look like when you wake up in the morning? Ad then what happens after you eat meals? So, so important for people not to ignore this biomarker. You can also obviously go get hemoglobin A1C, fasting glucose from your doctor, but I like CGM because it gives you so much more data. It’s a better reflection of what’s going on in your life.

I do think that movement, steps. I like that… Certain Garmin products, your Apple watch, your Oura, they’re going to let you know your fitness level. How much fitness activity are you getting in daily? That’s an important tool to think about too, is how much am I actually moving? Movement, stress, sleep and blood sugar. To me, these are the biggest drivers of mitochondrial dysfunction. And then getting your labs done, your micronutrients, your microbiome. If you don’t get proper nutrient density and your gut is not functioning properly, you’re never going to have enough substrate and nutrients for your mitochondria to function properly. That’s a pretty important one too is getting your gut checked.

James Maskell: I’m sure there are people with Oura rings and CGMs walking into functional medicine doctors’ offices across the country and saying, “Help me out, doc.” Seeing as you’ve been doing this for maybe some of the longest out there, in the same way that maybe a functional medicine doctor might interpret a conventional lab differently than a conventional doctor, are there things that you look for in CGM data, Oura Ring data, that maybe a conventional doctor wouldn’t really understand because you’ve been looking at this the whole time?

Dr. Molly Maloof: Absolutely. Well, first and foremost, most doctors don’t know the proper ranges. They’ll say, “Well, your fasting blood sugar is right below a hundred. Post-meal blood sugar, it’s around 140, 150. You’re maybe on the line of pre-diabetes.” I would say, “You’re pre pre-diabetic. You’re probably insulin resistant, and you don’t even know it, and/or you’re very stressed.” Stress alone can cause blood sugar dysregulation. I have a lot of different ranges that I recommend for people to look at for their blood sugar, and it’s all in the book, really.

Not only do I have these special ranges, but I also have recommendations for what to do for all of these different markers. Also, a lot of doctors wouldn’t look at the glycemic variability, but I can tell you that on days when I’m very stressed out, my glycemic variability is all over the place. On days when I’m calm and relaxed and I exercise and I meditate, my glycemic variability is very different. You can do a lot with the CGM. It can tell you so much about your world. You can also see when someone’s sleeping, how much they’re fasting, how much they’re eating, how often they’re eating. It’s a really, really great toolbox of optimizing health.

James Maskell: Awesome. Well look, high recommendation for all the practitioners out there. Get some of these copies of The Spark Factor, get them into your practice, give them to the women coming into your practice. It will really reinforce what you’re trying to do and maybe give the women in your practice something to shoot for. Thank you for making this whole thing cool and accessible.

Dr. Molly Maloof: Yeah. I want to add a few more things. First and foremost, the book, 80% of it’s still applicable to men. It’s definitely great for people who have men in their practice. Also, I have an online course called Your Healthspan Journey. It’s currently on sale. I’m happy to do a discount for your audience, by the way, maybe half off. For doctors out there that really want to learn to optimize the health of their clients, I’ve got a comprehensive curriculum on health optimization and lifestyle medicine that I taught at Stanford. So, I’d be happy to offer that as a perk to your audience.

James Maskell: That sounds good. Awesome. Well, look, I’m excited for you, for the book, for getting the word out there. I know that you moved away from San Francisco to Austin, and for different reasons, we haven’t had a chance to hang out for a while.

Dr. Molly Maloof: Yeah, where were you living?

James Maskell: I wanted to ask you a question actually. I’ve been wanting to ask you since the pandemic, but I haven’t actually seen you. Do you remember that at the very beginning of the pandemic, March, there was a thread, there was a Facebook thread, and there was a bunch of doctors on there from the San Francisco Bay area. Daniel Schmachtenberger was on there.

Dr. Molly Maloof: Yeah.

James Maskell: And for a minute, there was a citizen science moment happening, where everyone was sort of in real time sharing what they were seeing working and connecting. Brett Weinstein has talked a lot bit on this podcast. For a moment, the peer review process was broken, everything was live, it was all in real time. I took a lot from that. I really enjoyed that conversation because it was just smart people who I would trust with my health in real time going over it. I just wanted to ask if you had an experience with that, because ultimately, within a few months, COVID was politicized and having an opinion about anything was putting you along…

Dr. Molly Maloof: We are not allowed to have opinions on COVID. If you do, you can get your license taken away in California. I am extra careful about talking about COVID these days because the last thing I want to do is get in trouble with the California Medical Board. But suffice to say, there’s still doctors having these conversations. They’re just not having them online. A lot of us are still having these conversations about… There’s so much out there, so much controversy right now still about the way to handle COVID. From what I can gather, there’s a lot of scared doctors from within the system that don’t really know what to do anymore.

So, I do think that we definitely still need to figure out these forums for physicians to talk about things and compare the evidence and discuss the science because that’s what medicine’s supposed to be about. It’s supposed to be about peer review. It’s supposed to be about discussing what’s best for patients and doing what’s best for patients.

James Maskell: Well, look, you’ve just given the best plug ever for the Functional Forum meetup groups, which are happening around the country where doctors can get together, speak face-to-face, speak their mind. I hope that that infrastructure can be part of the renaissance of medicine, maybe a little bit of death and rebirth, which is probably healthy given where we are heading. Thank you for your leadership. Thank you for writing the book. Thank you for being part of the community. Look forward to spending some time in person sometime soon.

Dr. Molly Maloof: Yes. Thanks, James.

James Maskell: All right. This has been the Evolution of Medicine podcast. We’ve been with Dr. Molly Maloof. Check out her book, The Spark Factor. We’ll have all the details in the show notes about her program and the other things that she mentioned, but the book is out now. Go check it out. Thanks.

Thanks for listening to the Evolution of Medicine podcast. Please share this with colleagues who need to hear it. Thanks so much to our sponsors, the Lifestyle Matrix Resource Center. This podcast is really possible because of them. Please visit goevomed.com/lmrc to find out more about their clinical tools, like the Group Visit Toolkit. That’s goevomed.com/lmrc. Thanks so much for listening, and we’ll see you next time.

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