In this episode of The Curious Cardiologist, Dr. Sanjay Bhojraj MD sits down with pharmacologist and genomic medicine specialist Dr. Tyler Panzner to unpack how your genes shape your response to diet, medications, and supplements.

They explore the difference between genetics vs genomics, why one-size-fits-all nutrition advice (keto, carnivore, vegan) can be dangerous, and how polygenic risk scores and pathway-based genomics can guide truly precision nutrition and precision medicine. From vitamin D that never budges, to oxalate kidney stones, to why berberine may not be as “innocent” as Instagram says, this episode pulls back the curtain on the wild west of supplements.

If you’ve ever wondered why your labs don’t change, why one cup of coffee wrecks you, or why your “clean” supplement stack makes you feel worse, this conversation is for you.

Guest: Dr. Tyler Panzner

Dr. Tyler Panzner, PhD is a pharmacologist specializing in genomic medicine and supplement pharmacology. He helps individuals and clinicians use comprehensive genomic data to personalize diet, lifestyle, and supplementation—focusing on bottom-up molecular pathways rather than fear-based, top-down disease labels.

• Website: drtylerpanzner.com
• Instagram / TikTok / YouTube / LinkedIn: @DrTylerPanzner
  
  
• [00:00] Welcome to The Curious Cardiologist & Guest Intro
  Dr. Sanjay Bhojraj MD introduces pharmacologist and genomic medicine specialist Dr. Tyler Panzner.
  [01:20] VHS, Blockbuster & the Hallmarks of Aging (Fun Cold Open)
  Light banter on VHS, rewinding tapes, and joking about “hallmarks of aging.”
  [02:25] Genetics vs Genomics: What’s the Difference?
  Tyler explains genetics (single variants) vs genomics (your entire genetic “book”) and polygenic risk scores.
  [04:30] Why One-Size-Fits-All Diets Fail: Keto, Carnivore, Vegan & Your Genes
  How saturated fat response, ancestry, and LDL genetics change who thrives or crashes on keto/carnivore.
  [08:40] Oxalates, Kidney Stones & Carnivore as a Tool (Not a Religion)
  Oxalate sensitivity, kidney stones, and why some people truly struggle with spinach and plant “defense chemicals.”
  [10:45] Vegan Fatigue, Conditional Amino Acids & “Have a Steak and See”
  Why some vegans feel amazing for 6–12 weeks, then crash when conditional amino acids run low.
  [12:35] Creatine, Carnitine, Iron & Taurine: When Your Genes Can’t Keep Up
  9,400+ mutations tied to creatine production; why some people need more animal foods or very targeted supplements.
  [14:40] The Myth of Willpower, Food Noise & Micronutrient Deficiency
  How hormones and micronutrient gaps drive cravings, “food noise,” and self-blame.
  [17:40] “Loaded Gun vs Pulled Trigger”: Propensity, Transcriptome & Proteome
  Genes vs gene expression vs proteins—and why genotype ≠ destiny.
  [20:55] Bottom-Up Genomics: From Molecular Pathways to Real Symptoms
  Tyler’s “bottom-up” approach: focusing on linear pathways like glutathione, vitamin D, neurotransmitters, etc.
  [23:35] The Vitamin D Puzzle: CYP2R1, Low Levels & Why Your Labs Never Budge
  Chronic low vitamin D, CYP2R1 variants, gallbladder issues, and why megadoses sometimes don’t work—and may backfire.
  [28:25] Pharmacogenomics 101: COMT, MAO & Why Some People Hate Caffeine
  COMT and MAO variants, adrenaline sensitivity, and why some folks overthink, get anxious, or “overflow” on stimulants.
  [31:15] Supplements That Secretly Spike Adrenaline: Curcumin, Rhodiola, Berberine & More
  How “healthy” supplements (curcumin, resveratrol, quercetin, rhodiola, berberine, methylene blue) can trigger anxiety in sensitive people.
  [34:35] Berberine, CYP3A4 & Statins: Hidden Supplement–Drug Interactions
  Why berberine can affect CYP3A4, statin metabolism, and cardiometabolic patients.
  [35:55] Stacking 30 Supplements: Liver Strain & the Dark Side of “More Is Better”
  Tyler’s story of massive supplement stacks, elevated liver enzymes, and why “liver support” can still stress the liver.
  [47:50] Purity vs Pharmacology: The Two Sides of Supplement Safety
  Clean manufacturing vs how a supplement acts in your body: iron chelation, neurotransmitters, hormones, liver enzymes.
  [50:20] Big Pharma vs Big Wellness: Who’s Really Regulated?
  Comparing drug oversight to the “wild west” of AI-generated wellness brands and TikTok supplements.
  [57:00] How Tyler Actually Uses Supplements: Audits, Subtraction & Lifelong Bottlenecks
  Full supplement audits, using fewer products, and when something is truly lifelong (e.g., pre-activated vitamin D).
  [01:00:20] Supplements as Catalyst, Lifestyle as Foundation
  Using targeted supplements to get people out of a rut—but never as a replacement for sleep, movement, and real food.
  [01:01:55] Lightning Round: Favorite Food, Favorite Place, & What Keeps Tyler Curious
  Surf & turf, Tampa memories, and why he sees music as “acousticeuticals” and real epigenetic medicine.
  [01:04:40] How to Work with Dr. Tyler Panzner
  Where to find him online, plus how to think about genomic testing & interpretation.
  [01:06:30] Sanjay’s Final Thoughts & Call to Action
  How to choose good genomic testing, why interpretation matters, and where to subscribe and leave comments.