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Dr. Dan Troha, MD | Troha Performance Medicine

@trohaperformancemed

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Dr. Dan Troha, MD
Performance & Longevity Medicine
Strength | endurance | metabolic health
Advanced labs | hormones | recovery
📍Charlotte + virtual

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Comment what number you think I threw down for our V02 Max Test this week ⬇️

Big s/o to the doc @dtroha for making this happen! by @trohaperformancemed

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3 months ago

Most people know their weight.

Very few know what their body is actually capable of:

- their VO2 max
- whether they’re strong enough for the demands of older age
- their cardiometabolic risk
- how their physical capacity is changing over time

In medicine, we’re really good at reacting once disease shows up.

I’m interested in measuring performance and physical trajectory before things start breaking down.

That’s the idea behind Troha Performance Medicine.

Physician-led performance and longevity medicine based in Charlotte, NC, with virtual consults available.

#Longevity #PerformanceMedicine #VO2Max #PreventiveMedicine #HealthOptimization taken in Charlotte, North Carolina by @trohaperformancemed

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5 months ago

Know your numbers. Train with better information.

VO₂ max testing is live at CCT.

Through our partnership with Troha Performance Medicine, members can get a deeper look at their aerobic fitness and use that information to train with more intention.

Performance today. Capacity for the long term.

CCT × Troha Performance Medicine taken in Cross Conditioning Training by @trohaperformancemed

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2 days ago

187 bpm. Highest heart rate I’ve ever recorded. But the interesting part was how my legs felt.

I took bicarb about 90 minutes before this treadmill interval session. It was still hard and I was breathless and needed the recovery between reps. But the leg burn that usually makes me back off just wasn’t there.

Bicarb helps buffer acidity during hard exercise and can delay fatigue. My theory is that my legs held on longer, which let me push harder. That doesn’t prove I reached my true max, but it’s an interesting possibility.

I especially love @bicarb.shop Bicarb 3.0 for these sessions.

Pro tip: you may not need the full serving. You can trial half to assess tolerance, and it might still give most of the performance benefit.

And please test it in training, not for the first time on race day. It can be rough on your stomach, and the sodium load is substantial. This is not something to casually add when you’ve been told to limit sodium.

The goal isn’t a higher heart rate. It’s getting more out of the workout.

#running #sodiumbicarbonate #endurancetraining #performancemedicine by @trohaperformancemed

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2 days ago

What does your engine say about your future?

VO₂ max is more than a performance number. It shows how efficiently your body can take in and use oxygen during exercise, giving you a clearer picture of your aerobic fitness.

That matters for training today, but it also matters long-term. Strong cardiorespiratory fitness is closely associated with better health over time.

The goal isn’t just to perform better now.
It’s to build more capacity for life.

Train for today. Build for the long term.

Proud to continue working alongside @trohaperformancemed to bring VO₂ max testing and more useful health data into the CCT community. taken in Cross Conditioning Training by @trohaperformancemed

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4 days ago

Prenuvo full body MRI is now in Charlotte, and I’ve had three people ask me this month whether they should book one. I’m an ER doc, so I see cancer found late far more often than I see it found early. Here’s my honest take on full-body MRI. 
The critics are right that no trial shows it saves lives, that a lot of scans find something that needs follow-up and turns out to be nothing, and that it doesn’t replace the screening that actually works. Only four cancers have proven screening tests: colon, breast, cervical, and lung if you smoked. We need better. 
The critics miss that kidney, pancreas, ovary, and brain have no screening test at all, and that stage I and stage IV are different diseases. 
So for the right person, it’s a reasonable addition to conventional screening, especially when they have a doctor who’ll help sort out what comes back. 
I order and interpret it for clients, along with Galleri, the blood test that screens for over 50 cancers. 
If you’ve been thinking about booking one, send me a message first. 
#cancerscreening #prenuvo #performancemedicine #longevity #charlottenc by @trohaperformancemed

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9 days ago

Didn’t qualify for Boston.
Ran it anyway. taken in Boston, Massachusetts by @trohaperformancemed

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16 days ago

His Garmin estimated 63. We measured 66.6. 👀

@bell.naim has his sights set on sub-2:30 at @runcim262 . Pretty fun getting to deliver this result.

Tested at @charlotterunningcompany in the @topoathletic Specter Elite.

🎥 @twanflipjr @spankyproductions_

#vo2max #marathontraining #charlotterunning #performancemedicine by @trohaperformancemed

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17 days ago

Your VO2 max might be about to get a fall boost.

And your Garmin, Apple Watch, COROS, or other smartwatch may give you some extra credit.

Cooler weather means less cardiovascular strain. At the same pace, your heart rate is lower than it was during the heat of summer.

Your watch sees that relationship: Same pace —> lower heart rate —> better efficiency —> higher estimated VO2 max.

So don’t be surprised if your VO2 max starts climbing quickly as the weather cools.

That doesn’t mean your summer training didn’t work. Just remember that your watch is estimating fitness, and the conditions you’re training in matter.

If you want an actual measured VO2 max and training zones based on your physiology, you need a validated test.

And if you want that, you know who to call. 👊

#vo2max #running #garmin #endurancetraining #performance by @trohaperformancemed

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21 days ago

My dad’s story is why I take this seriously.

Exercise is incredibly good for your heart. It just isn’t your entire prevention plan.

A study of middle-aged male endurance athletes found plaque in the arteries supplying the heart in 44% of athletes versus 22% of similarly low-risk, less active men.

A newer study of 222 men found plaque in 75% of the highest training-load group versus 36% of the lowest. Nearly 6x higher adjusted odds of having plaque. NOT 6x the heart attack risk.

These observational findings don’t prove training caused plaque or increased heart attacks, and also shouldn’t be generalized to women or younger athletes.

Exercise also may not lower LDL as much as you expect. A review of 148 randomized trials found an average reduction of about 7 mg/dL. Helpful, but training alone may not get your cholesterol where it needs to be.

And this isn’t just an issue later in life. A 2016 US analysis estimated half of first cardiovascular events in men and one-third in women occurred before 65. One-quarter in men occurred before 55.

The takeaway is not to train less. It’s to look beyond your mileage.

Talk with your doctor about family history, blood pressure, cholesterol, Lp(a), and whether ApoB would help clarify your risk. Include nutrition, training load, recovery and any symptoms in that conversation.

Not every active adult needs a scan or medication, but every active adult deserves more than “you exercise, so you’re fine.”

My dad is the reason I want you to have that conversation.

Keep training, but know your risk.

#hearthealth #enduranceathlete #preventivemedicine

Sources:
Merghani et al. Circulation. 2017.
Pauwels et al. Circulation. 2026.
DeFina et al. JAMA Cardiol. 2019.
Smart et al. Sports Med. 2025.
Sniderman et al. JAMA Cardiol. 2016.
ACC/AHA Dyslipidemia Guideline. 2026. by @trohaperformancemed

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24 days ago

22 marathons in, and she’s still a student of the sport.

Siobhan and I have spent the last 16 weeks training for Chicago, and one of our biggest focuses has been slowing her down.

This girl LOVES an 8:20–8:30 “easy” pace. 😂 I kept telling her, “I want to see more 9s.”

She got better about it, and we saw changes in her heart rate, but I still wondered: Are we actually going easy enough?

So instead of guessing, we booked a VO₂ max test with Dr. Dan at Troha Performance Mecicine.

The results were fascinating.

First of all, Siobhan is freaking FIT for 43 with a Vo2max of 53 ml/kg/min And surprisingly, her Garmin estimates and actual testing were pretty dang close.

But we learned two really valuable things:

Her easy days still weren’t quite easy enough. Based on testing, we want her at 155 bpm or below, which may mean running closer to the 9:30s at times.

And maybe even more valuable, we got data we can use to build her Chicago race-day strategy.

I’m a huge fan of negative splitting, and after looking at the testing alongside everything I already know about her, we landed on a starting pace that gives both of us confidence.

Because data is valuable, but it’s only one piece of coaching.

I know this athlete. I know her training. I know how she responds when things get hard.

Now we get to take everything we’ve learned over the last 16 weeks and put it together on race day.

Chicago, here we come.

#wahoorunning taken in Charlotte, North Carolina by @trohaperformancemed

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a month ago

First mile. Last mile. A lot happened in between.

Couldn’t have asked for a better crew waiting for me. taken in Hanging Rock State Park by @trohaperformancemed

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a month ago