# TruMed CEO on Health Economics and Prevention

**Podcast:** a16z Podcast
**Published:** 2026-11-08

## Transcript

There's no shortage of advice about how to optimize your health.
Justin Mayers thinks most people would be better off focusing on a much shorter list.
In this episode, A16Z's Daisy Wolf sits down with Justin, co-founder and CEO of TruMed, to unpack what he actually does for his own health.
We get into food, exercise, supplements, blood testing, sleep, sauna, and which changes he thinks offer the highest return without turning health into a full-time job.
And we discussed the idea behind TruMed.
If so much health care spending goes toward managing chronic disease, why don't we make it easier for people to spend their own health care dollars on prevention?
So I'm Justin.
I'm the CEO and founder of TruMed.
TruMed basically makes it possible for individuals to spend tax-free HSA and FSA dollars on medical interventions that are more lifestyle in nature.
So things like exercise, food supplements, sleep aids, things like that.
And so the high level is if you qualify, if you're working to treat, reverse, or prevent.
a specific disease, you can invest in a gym membership or an 8 Sleep or a Peloton or something like that using tax-free HSAF and Safe Fund.
I would love to just understand a day in the life of Justin.
I want to understand everything about how you eat, sleep, exercise, supplements.
So maybe we can just start with a very typical day in the life.
Let's start in the morning.
We'll end with the nighttime routine.
How do you wake up in the morning?
Great.
So first thing I would say is like at a very high level, I think that a dynamic that you see often on the internet is basically like every health influencer is incentivized to say like the craziest shit because that's what gets a lot of attention.
And so people like Brian Johnson, who bless him, I think doing amazing things, he is like almost incentivized to talk about, oh, I injected my son's stem cells into my body and, you know, did this crazy therapy with my grandpa.
He does all that stuff.
I think is very interesting.
I'm glad people are doing it.
I like don't do almost any of that.
So like my routines are pretty boring or consistent, but I think that there's a couple areas that I've gone deep that I really care about, which I'll kind of talk about.
So I basically think from a normal day, like we'll wake up, call around like 7, 7.30, wake up, go outside.
I try and spend like the first 30 to 60 minutes of every single day outside.
Often I'll go for a walk like first thing and either listen to a podcast or call somebody.
that I just have to call and chat with.
So I definitely will say, I think that circadian rhythm and circadian biology is pretty, it's pretty under-invested in or under-utilized.
People don't really respect that idea.
And I think it's a very real phenomenon.
I feel much better.
I sleep better.
My days are better.
I have higher energy when I'm outside in the morning for the first 30 to 60 minutes.
So do that every morning, hang outside, then have coffee.
I basically do one to two cups of coffee all before 11 a.m.
I'm actually currently trying.
something.
Have you heard of Ray Peet by chance?
No.
Okay.
So I wrote about this in a recent newsletter, but recently I have started doing, I have one big cup of bone broth every morning and then I basically only eat fruit and occasionally honey until like noon every day.
And I've been feeling really good, which is kind of interesting.
So I'm like on sort of a high sugar diet, like a much higher sugar diet.
I saw you right about running this experiment.
And it's kind of the opposite of what we've been told recently, which is balance your glucose only have sugar after it's had protein and fat.
Yeah, 100%.
I mean, I am like increasingly of the opinion that we just lose a lot when you sort of try and like over-optimize on one specific metric.
But I think that like over-optimizing and say the human body should never have glucose spikes seems just like...
incorrect to me.
If you look at how any tribe basically has existed, people have a desire for sugar, for carbohydrates, for all these sorts of things.
And I did a ketogenic diet.
I started a keto company several years ago.
And I think that keto, like I found, was very effective for a while.
After a period of time, it like kind of impacted me.
And so I think that if you are not working to lose weight or you're not dealing with metabolic dysfunction or other sorts of things, I think that eating fruit is like, especially fruit, honey.
is like totally fine and probably very good for you.
So I try and do it earlier in the day and then I'll get a workout in ideally between 11 and 2 p.m.
And then for the rest of the day, I'm sort of like on calls, doing work, whatever.
Another big thing that I did recently is I got a treadmill desk, which I strongly recommend.
It's really, really amazing and has been a great way to get anywhere extra between four and 5,000 steps a day.
I kind of try and walk after every, calorie that I consume.
It's again, it's super easy on the treadmill desk or just like all internal calls that TrueMed, I basically take on the phone, like walking around the office or my house.
And so that has actually been a very, very useful thing.
And I think something that is a very easy upgrade to make generally.
What do you eat for lunch on an average day?
Yeah.
So normally it is, it's one of two things.
It's either like ground B, often what's called like an ancestral blend.
So with organ meats blended into it.
So that, plus carrots and then often a side salad or side vegetable and maybe, maybe some fruit if I'm feeling like it.
So that's sort of like a standard lunch.
And then again, potentially like another bone broth.
And then a dinner is normally like a higher protein, lower carb kind of thing.
So like a fish and vegetables or ground beef and vegetables.
I have a fair number of tacos and stuff like that too.
Just it's easy to put together.
But yeah, nothing like too, too crazy.
We just have, my wife and I have like, very, very high sourcing standards in terms of the foods that we buy.
And that is where I put most of my energy is just making sure that almost all of the foods that we bring into our house are like very, very high quality.
Because I think that is like the most important thing when it comes to a lot of health and nutrition stuff.
I've noticed you didn't say chicken.
And I've seen you write before about some of the perils of chicken.
Can you tell us about that?
Yeah.
So I think that the average American gets way too much of their caloric intake in the form of what's called polyunsaturated fatty acids, PUFAs.
So PUFAs are the primary fatty acid found in a lot of seed oils.
They're very high in nuts.
They're like in everything, basically.
And what's key is they actually, these PUFAs will, they make up a lot of the meat concentration in chickens specifically.
So chickens have, they're monogastric, they have one stomach.
So it means when they eat, what they eat goes directly into their meat tissue, whereas cows have two.
And so they basically can actually eat things like grass.
They have a rumen, they process it, and it gets integrated in their muscle tissue differently.
And so in the U.S., most chickens are fed corn and soy almost exclusively.
And so you have these chickens, basically, that have the muscle and fat profile of something resembling a seed oil.
And so I think that, like, chickens basically, I think, used to be much healthier.
I think that if you're trying to cut down on poo feds, which I think is broadly just a very good idea, especially if you live in the U.S., eating chicken every single day, changing that is probably a very easy way to lower your Pupa intake, which I think has a whole host of benefits from inflammation and other kinds of standpoint.
But yeah, I'd avoid it.
Avoid it.
Oil is like universally bad.
Can you give us a few thoughts on that?
Yeah, so this is a, what I would say is a contested area.
I think that the evidence is fairly clear personally.
I think at the very least, even the people that are most pro-seed will say things that will agree, that these are among the most highly processed things that you can put in your body.
They're basically, if you think about what is a seed oil, it's extracting very, very small amounts of oil from a soybean or a sunflower or the canola plant.
Think about a soybean.
Where is the oil in a soybean?
You never eat a soybean and you're like, oh wow, this is such an oily thing, the way that you experience an olive or an avocado or something like that.
And that's because there's barely any oil in that.
Same with corn.
There's not a lot of oil in these sorts of things.
And so, It takes something like the equivalent, I think, of 98 years of corn to get five tablespoons of corn seed oil.
And so what that means is because there's so little oil, they have to go through a very chemically intensive process to extract those small amounts of oil at very high heat to turn them into what we call a seed oil.
There is this multi-crazy step process to take something from corn or soybeans and turn it into the seed oil.
Like if you think about how you make olives, you pull them, press them, that's olive oil.
That is not at all the process that we go through to make seed oil.
And so I think that the evidence is quite clear that this process, in this process, these oils oxidize.
They have a fatty acid and linoleic acid composition that I think is very unfriendly to human health.
There have been a lot of studies where they've basically taken rats or other mammals and they've swapped out sunflower oil for coconut oil and seen metabolic diseases basically go up.
inflammation, fatty liver disease, all these sorts of things massively go up.
And if you think about like the average in, I think it was 1970, soybean oil made up almost to 0% of the average American's caloric intake.
We said we had much lower rates of obesity, inflammation, chronic disease, things like that.
Today, the average American gets 20%, almost 20% of their total caloric intake in the form of soybean oil.
And we have this record chronic disease crisis.
And so I think in a best case scenario, you could say, These are highly processed things that are maybe okay to not.
That's not where I land, but I think that's like a best case scenario.
In the worst case, I think you could make a very compelling argument that seed oils are among the chief reasons for the massive and rampant chronic disease crisis that we see today.
So yeah, I think they're like very, very smart to avoid.
But I really, really do think that like for so many of these things, the lens that the average person does not.
have and think about the food system is the quality lens.
And like we say, is gluten with bread good or bad?
Or is sugar good or bad?
Is chicken good or bad?
I really think that the thing that people are not thinking about is the quality of this stuff matters a tremendous degree.
Freshly milled, well sourced, like all this sort of like bread like that is a totally different product than buying Wonder Bread from the center of the grocery store.
Yet we call them both bread and say like categorically you should avoid Wonder Bread.
which I think is kind of a mistake.
What's the most indulgent thing or thing that's like bad for your health that you do with some regularity?
Oh man, I think so again on the quality thing, like I've recently been totally into this.
It's called Alex, A-L-E-C-S, A2.
They have this like regenerative ice cream that is insanely good.
And so my wife and I have been having like having that a couple of days a week recently.
And it's, you know.
Phenomenal.
Like incredibly well-sourced, incredibly high quality, but definitely an indulgent.
I forgot to ask you about protein.
Yeah.
Do we all need 100 grams a day of protein?
How many grams of protein do you get on an average diet?
I think that this is one of those things that is really person-dependent.
Like a man's needs are different from a protein standpoint than a woman's needs.
A pregnant woman's needs for protein are different than like someone who's not pregnant.
And so, and also like it varies often by activity level.
And so if you are like active weight training, trying to get some movement in, all these sorts of things, I think that you should, you know, improve, increase your protein requirements in line with that.
Like I probably have, I don't track it super, super tightly, although I probably should.
But I probably get somewhere in the neighborhood of like 120 to 150 grams of proteins a day.
Like I will have.
Most days, some sort of protein powder shake.
And then every day I'll have like one to two cups of bone broth.
And so that's like 50 grams right there.
And that's not very calorie dense.
And so that's outside of like eating any other food.
The other thing that I think is very important from a protein standpoint is everyone is eating the same types of protein.
And so when you're thinking about eating protein, you're like almost always getting your protein from cuts of muscle meat.
So like ground beef, steak, chicken, you know, salmon, whatever.
What I think that most people miss, and if you look at like hunter-gatherer diets or ancestral diet, they would sort of get a full spectrum of amino acids and many different types of protein in their diet and get a lot more collagen, a lot more gelatin, a lot more glycine, a lot more of these other sorts of proteins and amino acids that are so key in building a very healthy gut, skin, joints, and the like.
That is almost entirely missing in the average person's diet today.
And so I think that...
Something that people get a lot of, like a very high ROI thing to introduce into your diet is some sort of like glycine, gelatin, and collagen supplementation, either in the form of whole foods, which would be like, honestly, like bone broth and stuff like that.
Or you can get like very, very high quality gelatin and collagen supplement.
Talk to us about supplementation.
Yeah.
What do you take every day?
When do you take it?
Why do you take it?
Yeah.
So I think that this is...
It very much depends on the person and what you're trying to work on.
Like if you get function or superpower, like you can understand your blood work basically and look at what are the things that you're trying to, you know, treat, reverse, prevent, whatever.
And so for me, I think that there's a couple buckets that are really important.
We talked about protein.
I really do think that like from an ROI standpoint, increasing your gelatin and collagen intake is going to be one of the highest ROI health inventions that almost anyone can make.
Because almost everyone is like clinically deficient in these sorts of protein.
Secondly, I think that there's something called the NTHFR mutation.
It's a mutation that 30 to 40% of people have.
That means that you have a harder time like methylighting and sort of breaking down, clearing compounds from the body.
So I have that mutation.
So I take what's called a methylated B vitamin complex.
That seems to help a lot in terms of not feeling like brain fog or, you know, allergies or anything like that.
I take that every day.
I take now I knew that deer company that I talked about earlier.
They have a organ blend basically.
That's a blend of like liver, kidney, spleen, I think organs basically just dried up.
I take that every day.
It's some people call it like nature's multivitamin.
It's incredibly nutrient dense.
It tastes horrible.
And so I tend not to eat liver, although some people do.
And then what else do I take?
And then actually, I recently started in the last couple months taking a, I spent a lot of time on a screen.
You know, I know it's like not the healthiest thing, but it's, we're building a company and that's what it takes.
And so I take this Thorn product for, that helps with like macular degeneration.
It's basically like to improve your eyesight and that helps a lot, which is kind of interesting.
And then lastly, for almost everyone, You know, people get very concerned about their lipid, their like heart markers, you know, cardiovascular disease, number one kill over American.
And so many people have, especially if they get their blood work back, they're like, oh, my LPA or my ApoB or my LDL are high from a risk standpoint.
I think that that is like a very, very smart thing to manage.
And so I actually, I take this supplement.
It's an enzyme called natokinase.
It's basically like, it's an enzyme that comes from fermented soybeans.
It's a very popular food called natto in Japan, which is very popular.
And so this is, I think for me, like one of the highest bang for your buck kind of supplements that you can take generally, especially if you're concerned about heart health.
And so it really matters the efficacy and the dosage.
And so I take this brand called Toku that has T-O-K-U, which has like the effective dose that research has shown works like slightly better than statin.
for preventing and breaking down arterial plaque, which ultimately is what leads to heart attack.
So that's kind of my life supplement stat.
I really think that the right thing to do is basically look at, get your blood work done, look at areas that you're deficient.
Also, frankly, like how do you feel?
How's your energy?
If your energy is bad or your cognition is slow, maybe you want to take like a certain set of supplements that would help with that.
If you want to improve your digestion, like there's TEDCA and like other sorts of things that you could kind of experiment with taking.
But I think it's very, very personal.
And the biggest thing that I would do, frankly, is like, get your labs done, put them in chat to BT or something and be like, hey, based on this, what supplement intervention should I consider running for the next 90 days, 180 days, and then retest.
And so I've kind of done that loop a while and now just take supplements mostly for maintenance and trying to like, feel good and either prevent things that I'm aware of.
or just general risk factors or, you know, work on things like improving my methylation.
Cool.
Okay, that's a good transition to our next topic, which is like, what is your approach to preventative care in general?
You've mentioned blood work.
What kind of blood work do you do?
Do you do imaging?
Talk to us about like, do you go to your doctor for...
you know, an annual checkup.
Talk to us about like, you know, everything you do in healthcare from a preventative perspective to monitor your home.
Yeah, it's a great question.
So I have gotten labs done every like six months for the last couple of years, five years, I would say.
And I think that that is probably one of the best places to start.
Like I think that if you sort of qualitatively are tracking, how do I feel?
What are areas that I feel I can improve?
What are things that like don't feel right?
That is a very interesting data point.
There's a ton of experiments you can always be running in the background around.
Does X, Y, and Z help with my sleep?
Do I feel better after doing this?
And so I really do think it is a very personal thing where you just look at what are your labs?
What markers do you want to make better?
And then you do a couple interventions to try and work on them over the next six months.
From a scan standpoint, about once a year for...
I guess it's been like once every 18 months, like my labs are very good and I'm pretty healthy.
And so I don't like overly obsess about getting like an annual scan or anything like that.
But about every 18 months, I will do like a calcium test, which tests just like calcium buildup in your arteries.
And then also go get like a, I did like an Ezra scan 18 months ago.
That's just like looking for precancerous growths and things like this.
Which I think is smart, especially if you have risk factors or like a family history of these things.
Totally.
I mean, I think what you're saying is a real thing where it's like for people who are really interested in health, who are taking health into their own hands, their annual physical is often like quite underwhelming.
Totally.
You're so in this every day that it's like you're already probably doing a layer beyond what you're going to do.
And like the average PCP spends something like 40 minutes with a patient per year.
I mean, so if you have a primary care physician, they're just not, they don't have like the context.
They often don't know or like have not gone deep on a lot of the chronic conditions that people are likely to work with.
You know, if I, if I talked to them and said, hey, I'm concerned with my like APOBE or LPA markers, should I go on a statin?
Like many of them would be like, I don't really know what those markers are.
I'm not really, I'm not really up to date on them, but like probably you should go on a statin, which I just like clinically don't think is the right intervention for someone that is.
you know, younger, healthier, and like has a pretty low risk profile.
So yeah, I generally am like, I think that the way medicine is done today is going to change a huge amount in the coming decade or so.
And I think that a big piece of that is going to be people are taking health into their own hands, and they're going to do so armed with a bunch of information about their labs and other stuff that traditional doctor didn't get, didn't have, didn't just historically have not cared about.
Talk to us about like the rest of your physical environment.
How is cleaning?
Like, how do you avoid toxins?
What should we care about?
I know in this, like we're all existing in this world and there's only so much we can do.
But what do you do?
And if you're giving advice to like, you know, an average person to make a few changes, what are the things that, you know, you would actually?
Yeah.
So I think that the two highest leverage thing, like intervention that people can make on their health day.
is basically like maximizing nutrient density.
So making like massively improving the quality of food that you're sourcing and then minimizing toxin exposure.
And a big source of toxin exposure is in the home.
And so I think that like if you are not installing a whole house filter or like, you know, at least getting like a reverse osmosis system or like very high quality countertop system that like drink better water is such a such an easy leverage point.
And it's such it's going to have like such positive impact on people's health.
Like if you look at tap water databases across New York, San Francisco, Austin, like any major city, it's astounding how bad like the chemicals are and the exposure to a bunch of things that we know are carcinogenic.
A bunch of chemicals that we know are have a huge impact on your hormone.
So I think that cleaning up your water is really a big first step.
And then secondly, like putting air filters in your house, I think it's a very high leverage intervention.
You can get a lot of ROI from that.
It's very cheap.
They just run all the time.
It's easy.
And then lastly, I think that using clean materials, like good cleaning material, we buy from Branch Basics is a really easy way to do it.
And then upgrading your Tupperware and making sure that you're not like getting Teflon, you know, chemicals in your eggs or whatever it is on a daily basis.
is a really, really smart thing to do.
Awesome.
Obviously, you've been able to devote your life to this and then your, you know, every kind of your serial entrepreneur, every company you've built is empowering people to live healthier lives.
Yep.
Do you want to tell us a little bit more about TruMed and how it's helping with that?
For sure.
Yeah, I mean, so one of the things that I think is just so broken about the American healthcare system today, is if you look where to spend go, 90% of healthcare spend goes towards treating or managing chronic condition.
Yet less than 3% goes towards anything resembling prevention or anything resembling lifestyle intervention.
And so I think that we can argue about like, what is the right amount that society should be spending on prevention?
I think we can all say like 3% is not the right amount.
Like that's not like the perfect amount of prevention.
And you see it in the healthcare outcomes.
They're all bad.
One of the reasons that, you know, that I believe that Americans are so sick today because we have this very strange system where someone who is at risk of type 2 diabetes or obese or something like that can get sicker and sicker and sicker.
And basically no one in the existing healthcare system is incentivized or will spend a single dollar helping prevent that person from getting type 2 diabetes.
And yet the minute that they get type 2 diabetes, the system activates and they'll spend an average of $3 million managing that person's type 2 diabetes for the duration of their lifetime.
That is like...
Totally crazy.
And so the one area of the entire healthcare system where an individual has choice and they're actually incentivized to spend their own money basically on things that can treat, reverse, or prevent disease is HSA and FSA accounts.
Like tax-free accounts, it's your money, you can spend it how you want.
And if you go through a company like TruMed, the IRS has explicitly said that things like exercise, things like food interventions, things like sleep interventions or supplements can all count.
for tax-free HSA FSA spending if accompanied by a doctor's note.
And so what we've done is we've built a platform that helps facilitate access for people that are qualified to spend their HSA and FSA dollars on things like exercise, supplements, food, healthy food, sleep aids, and the like.
And our goal is basically to incentivize and make it slightly more affordable and slightly lower friction for someone like you or me to invest in preventing obesity, preventing or treating heart disease, preventing or treating The myriad of chronic conditions that are just decimating American health.
And so I think that like affordability is a key component of the healthcare crisis.
And I think that if every American maxed out their HSA account and, you know, everyone that qualified was able to spend these dollars on effective lifestyle interventions, I think it would change the trajectory of American healthcare.
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