Tonya Gray, MD

11/06/2025

Here is a good podcast episode from a trusted source on the use of GLP1 agonist medications (Ozempic, Wegovy, Mounjaro, Zepbound, etc). We prescribe these for diabetes and obesity, mostly. There is a lot of education and monitoring that comes along with these medications, and we often can’t do that justice in our busy office days. My patients get a 5 page handout I developed on everything I need to tell them but might not have the time to do. This podcast touches all the points I review. Give this a listen if you use these medications or are thinking about using them. The biggest barrier remains the cost.

https://podcasts.apple.com/us/podcast/cleveland-clinic-health-essentials-podcast/id1322659480?i=1000735391576ts

Podcast Episode · Cleveland Clinic Health Essentials Podcast · 11/05/2025 · 46m

10/29/2025

Linked below is a good introductory podcast on longevity. This is incredibly important and if you want to discuss this with your physician, I would suggest making an appointment to discuss longevity. If your personal physician sees your reason for a visit and doesn’t feel comfortable discussing it, hopefully they can direct you to someone who can discuss it with you. I feel fairly up to date in longevity medicine…a lot of it really is our bread and butter….but I generally do not have time to discuss it with patients when they are coming in for something else. A dedicated visit would discuss cardiovascular disease risk, cancer risk, neurological disease risk (dementia, etc), and metabolic disease risk. The visit would involve discussion about labs/bloodwork, medications and supplements, exercise, nutrition, sleep, mental health, etc. It’s all important to understand if you want to live a long life but also a life where you are doing the things you want to do for as long as possible.

Podcast Episode · The Peter Attia Drive · 10/27/2025 · 1h 25m

10/20/2025

The Mayo Clinic has a podcast series called the Human Optimization Project. My sister, an internal medicine physician, recommended this podcast to me. The audience is physicians but the content applies to everyone. There are many good episodes in the series that I encourage you to check out. Here is one on calories.

Podcast Episode · Mayo Clinic Human Optimization Project · 04/08/2025 · 53m

10/11/2025

If you haven’t been checked for elevated lipoprotein a (little a), be sure to ask your physician to check it. Even my patients need to ask as we just have too many things to remember to do at each visit. Twenty percent of us have this. It’s genetic, so those with the healthiest lifestyles can still have this significant risk factor for heart attacks and strokes. It’s important for your first degree relatives to be checked if you have it. There isn’t a treatment right now that’s readily available, but we’d double down on making sure your other risk factors are closely managed…..blood pressure, cholesterol, diabetes/insulin resistance, increased weight, poor diet and inactivity, etc. Watch this 3 min video. Ask your doctor to check it.

Is there an easy way to see if you’re at increased risk for heart disease? It may have a lot to do with a little…

07/27/2025

I think everyone should be checking their blood pressure at home. Home values are the most important values when making treatment decisions. You might also pick up on a problem that isn't present during a yearly office visit. High blood pressure can harm the brain, heart, and kidneys. Very rarely will you be able to tell your blood pressure is high. That's why high blood pressure, or hypertension, is called the "silent killer".

Get an arm cuff, not a wrist cuff. Check validatebp.org for examples of good cuffs to buy. I set up a loaner blood pressure cuff program in my office, where patients can take a cuff home for 1 week and get readings. Your doctor might have something similar, so ask. If you can, its good to have your own at home so you can periodically check.

How often should you check? You can do it when you have time and think about it or you can set designated times. Ideally, pick 1 week every 3-6 months and check it twice a day that week. Check once in the morning and once in the afternoon or evening. Write those values down and always bring your values to your doctor's appointments. We may always look at them, or we might look at them if our office reading is high. For me, if you put your paper with home readings right on the exam rook desk, I'm going to see it and review it. Some patients will email, mail or drop off their readings for me to look at between office visits. Look below for reminders on how to check your blood pressure. The graph below also lists normal and abnormal blood pressures.

Lifestyle changes are recommended for any elevation in blood pressure. Medications might also be recommended. We take into consideration how high the blood pressure is, how long its been high, your other medical problems, and your confidence with making lifestyle changes. Sometimes it's a good idea to get your blood pressure down with medication while you work on nutrition, exercise, sleep, and stress just to prevent damage to your blood vessels from occurring while you are working on making changes.

https://www.heart.org/-/media/files/health-topics/high-blood-pressure/how_to_measure_your_blood_pressure_letter_size.pdf

07/16/2025

Menopause. How do you find a doctor who can help?

Social media influencers, including some very well-respected physicians, will direct you to the Menopause Society's website to locate a physician trained in menopause. In a 50-mile radius of my area, there is one physician listed.....me. Now, I feel like I could open my own practice and be very busy doing only menopause! Afterall, every woman will deal with menopause at some point. Every year, a new group of women enters the conversation, and once you're in, you're in for the duration. I can't see everyone, and it does bother me that so many people reach out and say they can't find anyone to help. Here's some advice that might help.

1. Some physicians are very well trained in menopause but didn't do the official training and won't be listed on the site.
2. Some physicians are very well trained in menopause, did the training, but didn't take the test. The test costs money and many physicians feel they don't need that extra certification. They may not be listed on the site.
3. Some physicians did the training and took the test but asked to have their names removed from the website as they became too overwhelmed with women seeking appointments. I know a few physicians in this category.
4. Some physicians are up to date, but menopause is not their passion, and they would like to save their time for things they are passionate about. They will refer you to someone who can help.
5. Some physicians are not up to date and do recognize this and will try to refer you to someone who can help.

So, bottom line is that you must ask your physician if they can help you navigate menopause. If they are unable to help, ask for a referral to someone who can. This might mean additional travel and expense, but there probably isn't a way around this until we get more trained physicians. This will likely take many years. Time is critical with menopause management. Don't rely on the Menopause Society as the only source of physicians who can help you. Those listed there are definitely those who are trained and have an interest, but there just aren't enough listed there for everyone seeking help.

There are lots of books and podcasts that will educate you and prepare you for what to think about and what questions to ask. Physicians in the menopause space have had good things to say about the podcast linked below. I've finally had the chance to listen myself and pass along to all of you.

Rachel Rubin is a board-certified urologist & one of the nation's foremost experts in sexual health. She shares her deep expertise on the topic of women’s se...

05/01/2025

This page was started in January of 2017 as a way to reach my patients with information they needed to know outside of the 20-30 minutes we had together in the office once a year. I originally tried to use the patient portal, but that was not easy to navigate and not many used it. The good news is that at the end of May, I will be using Epic electronic health record and MyChart will be the new patient portal. This portal is much easier and will allow me to reach all my patients with MyChart messages. By the end of the summer, my patients should have as a goal to have their MyChart accounts set up. You will receive periodic letters from me through MyChart that will replace the information you got here. It won't be near as frequent, no more than 3-4 times yearly, unless something big and urgent comes up. This page will cease to function as a way to reach my patients and has been reset. Most of the people on this page are not my patients, but I was happy to have you all along! Going forward, this page will be my personal page as a physician and not affiliated in any way with any relationship I have with any hospital system. For my patients, expect your first MyChart welcome message sometime in the next 3-4 months!

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