The Tummala Approach to Health and Vitality
Being alive and actually living your life are two very different things. The medical system is much better at treating the first than the second. Too often, when everything checks off from your standard physician visit, you get written off as fine, even when you know something doesn’t quite feel right. We don’t want to dismiss your concerns, we want you to help you LIVE your life to its fullest potential driven by optimizing your health with the right behavioral approaches and interventions. We’re a family of physicians and we are passionate about not only keeping our patients healthy, but helping them improve their quality of life.
The gap standard medicine doesn’t measure
Modern medicine is doing the job it was designed to do, it is keeping us alive longer but it may not be helping us live our best lives. We have done an excellent job adding years to the average life, but have been much quieter about how those extra years actually feel.
There’s a name for this in the data: the healthspan-lifespan gap, the distance between how long you live and how long you live in good health. A JAMA Network Open analysis of 183 WHO member states in 2024 found that this gap has widened worldwide over two decades, and the United States recorded the largest gap of any country studied, rising to roughly 12.4 years and higher than the global mean.[1] Just look at the figure below and where the US lies in comparison to the rest of the world. In plain terms, a lot of us are spending more than a decade of life not feeling well, even as how long we are living is increasing.
That’s the tension we started with. The system is superb at maximizing survival but not primed for “vitality” or the daily experience of energy, clarity, and having the energy to live your life the way you want to.
What “vitality” actually means, and what it doesn’t
“Vitality” gets used as a glow, an aspiration, a word on a supplement label. We want to be more honest than that. When we say vitality, we mean something closer to what researchers call subjective energy and function, and there’s real evidence it matters on its own.
Here’s one finding most people haven’t heard: severe vital exhaustion, meaning persistent fatigue and low energy, has been associated with worse lab values that are indicators for cardiovascular events in adults.[2] Read that again. How you feel carries important data points for underlying biological health.
Fatigue is a very common problem
Fatigue is not a rare or exotic complaint. It’s a very common reason people come in to see a primary care doctor. In a large share of those visits, a thorough standard workup never lands on a clear organic cause.[3]
If you’ve lived this, you know the challenge of being told “everything is OK” when you clearly feel like something is off. From the physician’s perspective, they have hopefully ruled out any “major” health concerns. They ran the panel, found nothing flagged, and sent you home relieved on paper but feeling undertreated in reality. On the other side there is a “wellness” industry ready to tell you that you’re broken in some hidden way. They may have some proprietary test or a magical supplement, usually ones they’d like to sell you.
We’ve watched this from clinics rooms, to hospitals to curbside consults and with patient after patient. People want to know how to optimize their health and they are not getting answers from the overburdened medical system focused on mean. That is why we created Tummala Health. We wanted to support a platform that would truly address and educate people on holistic health and support vitality in everyday life.
“Treating above the Mean”
We didn’t build a supplement funnel with a doctor’s photo on it like so many companies out there. We built a platform around one idea we kept coming back to. Normal isn’t the goal. Optimal-for-you is. We call it treating above the mean. Landing inside the reference range means you’re not sick enough to flag. It doesn’t mean you’re living as well as you could be. Most of the levers that move how you actually feel don’t show up on a routine panel at all.
Those levers are behavioral first. Nutrition, movement, sleep, stress, connection, and how you handle alcohol, tobacco, and other substances. That ordering is not a slogan, it’s where the evidence points, and it forms the pillars for our approach to health.
Vitality is BUILT, not bought
You don’t have to believe us when we say behavior comes first, just look at the published literature.
In a study of older British men followed for years, those with ideal adherence to seven basic cardiovascular health factors (a healthy body mass index, blood pressure, blood glucose, and total cholesterol, plus not smoking, staying physically active, and eating a good diet) were estimated to gain an additional 4.37 years of life free of heart attack, stroke, and diabetes compared with those with the lowest adherence.[4]
In three European populations of adults aged 50 and up, men and women with a healthy lifestyle lived between about 7 and 16 years longer than those with an unhealthy one, and most of those extra years were disease-free years, not just added time at the end.[5]
The individual pillars we will talk about in more detail future posts each carry their own weight. Active adults are substantially less likely to report low energy and fatigue than sedentary adults, with a clear dose-response pattern.[6] Paradoxially, the more active you are, the more energy you have. Another meta-analysis spanning 604 studies found perceived social support associated with better mental health, better physical health, and better work performance.[7] Social connection is equally as important. It shows up in the outcomes.
The honesty payoff
Our approach is simple to state and hard to fake. Everything we say is supported by science and is built on data and recommendations for real change. This is the advice we would give to our own family.
Start with behavior. Use supplements and prescriptions as matched support when they fit. Join us on this journey in optimizing your life.
Frequently asked questions
Is “vitality” just marketing?
It can be, which is why we anchor it to measurable things like energy and function and grade the evidence behind every claim, including when that evidence is weak.
If my labs are normal, does that mean nothing’s wrong?
Normal-range is not the same as optimal-for-you, and much of what shapes how you feel isn’t on a standard panel.
You’re doctors who sell supplements. Why should I trust this?
You shouldn’t trust us blindly. Our goal is to give you the evidence and help educate you on the decisions and choices that affect your health. We fundamentally believe that behavior first with medications/supplements as augments is the key to a life worth living.
This is us saying hello
Follow along. We’re walking through every pillar of the Tummala Model to optimizing your health, one graded claim at a time, and telling you when the evidence is strong and when it isn’t.
And a question we actually want answered in the comments: have you ever been told everything is “normal” while you felt anything but? Tell us about your experience.
One boundary we’ll hold to is that we can’t diagnose or advise on your individual situation in the comments. Please bring specifics to your own physician. This is education, not medical advice.
References
1. Garmany A, et al. Global Healthspan-Lifespan Gaps Among 183 World Health Organization Member States. JAMA Network Open. 2024. Tier B. PMID 39661386
2. Deshotels MR, et al. Vital Exhaustion and Biomarkers Associated With Cardiovascular Risk: The ARIC Study. JACC: Advances. 2024. Tier C. PMID 39539949
3. von Känel R, et al. Effects of a novel differential diagnosis aid for managing patients with unexplained fatigue in primary care: a prospective randomized, controlled, open and multicenter study in primary care. BMC Primary Care. 2025. Tier A. PMID 40413405
4. Wang Q, et al. Association of Life’s Simple 7 lifestyle metric with cardiometabolic disease-free life expectancy in older British men. Communications Medicine. 2024. Tier B. PMID 38834824
5. O’Doherty MG, et al. Effect of major lifestyle risk factors, independent and jointly, on life expectancy with and without cardiovascular disease: results from the CHANCES consortium. European Journal of Epidemiology. 2016. Tier B. PMID 26781655
6. Puetz TW. Physical activity and feelings of energy and fatigue: epidemiological evidence. Sports Medicine. 2006. Tier B. PMID 16937952
7. Yeo G, et al. How does perceived social support relate to human thriving? A systematic review with meta-analyses. Psychological Bulletin. 2025. Tier A. PMID 41100292
8. Puetz TW, et al. Effects of chronic exercise on feelings of energy and fatigue: a quantitative synthesis. Psychological Bulletin. 2006. Tier A. PMID 17073524
9. Herzog CMS, et al. Challenges and recommendations for the translation of biomarkers of aging. Nature Aging. 2024. Tier B. PMID 39285015
10. Kaeberlein TL, et al. Evaluation of off-label rapamycin use to promote healthspan in 333 adults. GeroScience. 2023. Tier C. PMID 37191826
Byline: the Tummala Health physician team.
Medical: Tummala Health content is for general education only. It is not medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Always consult your own physician about your individual situation, and never disregard professional advice because of something you saw here.
Financial interest: The physicians featured are founders of, and have a financial interest in, Tummala Health, which sells prescription medications and supplements.
