PoH VII: Tools

Everything Is a Tool — The Question Is Whether It's Worth Using

Almost everything in life traces back to health. Your career, your relationships, your ability to show up for the people you love — none of it works if you're not functional. So when I think about health interventions, I think about them the way you'd think about a toolbox. The more tools you have, and the better you know how to use them, the more efficiently you can get through this project called life.

That raises the obvious question: what does "health" actually mean? The textbook definitions — free of disease, absence of illness — are useless. They tell you what health isn't, not what it is. The concept I keep coming back to is flourishing. A plant flourishes when it has the right soil, sunlight, water, and a reasonable amount of stress — wind, rain, temperature swings — to make it resilient. Not enough stress and it stays fragile. Too much and it breaks. Starve it of nutrients and it dies. Humans aren't that different.

The Toolbox Is Bigger Than You Think

When you set out to improve your state of flourishing, there are an almost infinite number of interventions. Lifestyle changes. Nutraceuticals and supplements. Surgery. Pharmacology. Devices. Therapy. Most of these get filed under "healthcare" and treated as if they belong to the healthcare system — but that framing is a trap. Your sleep, your training program, your social life, and your diet are tools too. Arguably the highest-value ones you own.

The other trap is siloing. People pick a team — I'm a natural medicine person or I'm a conventional medicine person — and then defend that identity like a sports fan. This is a bad way to make decisions. The tool should fit the job. Sometimes a pharmaceutical has fewer side effects, a more targeted response, and costs less than the nutraceutical equivalent. Sometimes it's the other way around. Neither category is categorically superior. The question is which tool delivers the best result for this person, in this context, right now.

Value = Quality ÷ Cost

When I'm evaluating an intervention, I'm really asking one question: what's the value? Value is quality of outcome divided by total cost. And "cost" here isn't just dollars. It's side effects, time, effort, and opportunity cost — the things you're not doing because you're doing this.

Surgery is a good illustration. We used to do enormous, invasive procedures that caused real collateral damage to the patient. Over time, most of those have become minimally invasive, with shorter recoveries and better outcomes. The quality went up, the cost came down, and the value went way up. That's progress.

Cost is also relative. Five hundred dollars a month on a supplement stack means one thing to someone clearing a million dollars a year and something very different to someone living paycheck to paycheck. For the second person, that stack might be pushing them into a monthly debt cycle for a benefit they can't even measure. That's not a good tool. That's a drag on the rest of their life.

Dose, Frequency, Intensity

Every intervention has a dose, a frequency, and an intensity. Get any of those three wrong and a good tool becomes a bad one. What works for your neighbor may not work for you. What worked for you at 35 may not work for you at 55. Some people need to move more. Some people need to move less — they're already overtrained, underfed, and running on fumes, and another Orangetheory class isn't the answer.

The same is true of diet. The same is true of supplements. The same is true of medications. Context is the most important variable, and it's the one people most often ignore.

The Check-In Most People Skip

The useful framework here is a routine check-in. Once or twice a year, you sit down and ask: is what I'm doing still working? Is it still necessary? Has my life changed in a way that means this tool doesn't fit anymore? Almost nobody does this. Instead, we have legacy bias — the assumption that because something worked for us in the past, it'll keep working forever. It won't.

We're also heavily influenced by our social network, usually more than by subject matter experts. If it worked for your cousin, it has to work for you. If the guy at the gym swears by it, you try it. You end up optimizing for social proof instead of fit.

The FOMO Problem

There's a specific flavor of bad decision-making I see constantly: fear of missing out on the cutting edge. Patients come in convinced they need peptides, hormone replacement, the newest trendy diet, a continuous glucose monitor, a sauna, a cold plunge, and a red light panel — right now — or they're falling behind. The premise is that if they don't adopt the latest tool, they're losing ground. That's not how any of this works.

Most of the cutting-edge stuff is marginal on top of the fundamentals. If your sleep is broken, your training is nonexistent, and you eat like you're still in college, peptides are not your problem. Fix the fundamentals first. The fancy tools exist to squeeze out the last 5% once the first 95% is handled. This is the Buffett rule applied to health: you don't get rich chasing the latest hot stock. You get rich by consistently doing the boring thing for decades. The same logic applies here.

Pick one or two interventions. Run the experiment. Evaluate honestly. Then decide if it earned a spot in your toolbox.

Known Knowns vs. Unknown Unknowns

A common objection I hear in the weight loss space is that we don't have enough long-term data on GLP-1 medications, so people defer. That's a coherent concern until you compare it to the alternative. We do have excellent long-term data on untreated obesity: higher mortality, more comorbidities, worse quality of life. The bariatric surgery literature shows that patients who have the surgery and maintain the weight loss live longer than those who don't. Every intervention has a side-effect profile. So does every non-intervention — we just don't call it that.

You can't make a decision against a future that doesn't exist yet. You can only make a decision with the information available today. Sometimes orthopedic surgeons will tell patients to hold out on a joint replacement as long as reasonably possible because the technology keeps improving. That's legitimate advice. But it's a judgment call — not a universal rule — and it assumes the cost of waiting is lower than the cost of acting. That's not always true.

If you make the best decision you can with the information you have, and something better comes out five years later, you don't get to kick yourself. That's not a bad decision. That's just how time works.

The Bottom Line

Think of your health the way you'd think about building a portfolio. Cheap, boring, consistent tools — sleep, movement, nutrition, relationships — are your index funds. They compound quietly and do most of the work. Specialty interventions — medications, surgeries, peptides, devices — are individual positions you take on when there's a specific thesis and a clear expected return. You don't load up on speculative bets before you own the basics. And you review the portfolio periodically to make sure it still matches the life you're actually living.

Everything is a tool. The question isn't whether it exists. The question is whether it's worth using — for you, right now, given everything else on your plate.

3-Point Summary

• Health is flourishing, not the absence of disease — and everything that moves you toward flourishing is a tool. Lifestyle, supplements, medications, surgery, devices, relationships. None of these categories is inherently superior to another. The tool should fit the job, not the identity.

• Value = quality of outcome ÷ total cost. And "cost" includes side effects, time, effort, and opportunity cost — not just dollars. A $500-a-month stack is a very different decision for two different people, and chasing cutting-edge interventions before the fundamentals are in place is almost always bad value.

• Decisions age. Your toolbox should too. What worked five years ago may not fit your life now. Routine check-ins protect against legacy bias. And if a better tool comes out after you've already made your call, that doesn't retroactively make your decision wrong — it just means the field moved.

3 Practical Takeaways

1. Audit your toolbox twice a year. Pull out everything you're currently doing for your health — supplements, medications, routines, subscriptions, memberships — and ask honestly whether each one is still earning its keep. Cut anything that isn't. Most people accumulate tools and never subtract them, which is how a reasonable routine turns into a bloated, expensive mess.

2. Fix the fundamentals before buying the cutting edge. Before you spend money on peptides, hormone replacement, a CGM, or the latest trendy protocol, grade yourself honestly on sleep, movement, nutrition, and social connection. If any of those is a C or worse, put your money and attention there first. The fancy tools exist to optimize the last 5%, not to paper over the first 95%.

3. Run one experiment at a time. When you do add a new tool, add one — not five. Give it a defined window (usually eight to twelve weeks), track whether it actually moved the needle on something you care about, and then decide whether to keep it. Stacking five new interventions at once tells you nothing about what worked.