5HT: 5 Healthyish Things, including hot water and understanding my HRV level

The hottest new H2O trend? Hot water 😎. 

After sharing Morning Water in last week’s edition, reader Sarah M. tipped me off that hot water is having a moment—backed by a spike in Google searches and TikTok creators pushing it as a metabolic hack. 

This trend isn’t a new supplement or an expensive longevity protocol. It's just, er, hot water. Orrr hot water with lemon 🍋 or honey 🍯 or whatever you want to add to it 🤷‍♂️. I like that it's trending because it's sort of an anti-biohack hack. It’s disarmingly simple. It’s low-effort. And it’s basically free. 

Worth saying: there’s very little hard science here. But proponents claim hot water can help with:

Annnd obviously, keeping you hydrated (another shocker). 

The benefits aren't magical, but they're practical. And while most of them are based on anecdotal reports, it makes sense. Water is good for you. This is just a heated (rivalry🏒?) edition, and I’m into it.

As most 5HT readers know, I’m reallyyy into Lineage Provisions’ beef sticks. Original (Salt) is my go-to flavor, but I'm also a huge fan of the Spicy Southwest. (I know, very Texas of me 🤠.) 

One of the biggest reasons I always keep these in stock is how stupidly simple the ingredients are. They’re made with 100% grass-fed beef, plus heart and liver for nutrient density, and for the flavored sticks, organic spices. That's it. No seed oils, no fillers, no preservatives, nothing weird. They taste amazing, and I really dig them. 

I’m also really pumped because Lineage typically only offers 10% off, but they're giving the 5HT community an exclusive 15% off. That's rare for them, so if you've been on the fence, take a bite, and let me know what you think.

Last week, I shared how my HRV tankeddd after my heart surgery—dropping from an average of ~80 pre-surgery to the low 20s.

I assumed I understood HRV well enough. High = good. Low = bad. But over the weekend, I was talking it through with a friend, and once I was pushed a bit, I realized I didn’t actually understand the concept as well as I thought 😬. So this is me owning that.

I went back and did the research. And now, I think I finally have a clearer read.

At a basic level, HRV (heart rate variability) refers to the tiny variations in time between each heartbeat. Those variations are normal—and important. 

Basically, a heart that beats less consistently (more variability) is usually a good thing. It’s a bit counterintuitive, but it essentially signals your body is flexible, adaptive, and responsive to its environment.

HRV is largely controlled by your autonomic nervous system (ANS). A higher HRV ⬆️ generally means greater resilience and parasympathetic (rest-and-recover) activity. A lower HRV ⬇️ often shows up during periods of stress, inflammation, illness, poor sleep, heavy training, or recovery from procedures.

Ultimately, what matters here isn’t avoiding stress altogether—but how quickly you recover from it. As Marco Altini (really the preeminent voice on HRV) told our friends at InsideTracker, “Stress can be good, and sometimes it's essential. The point is not to avoid all stressors, but rather to put yourself in a state where you bounce back very quickly." I also like how this rando put it on Reddit:

Now, you probably don’t want your HRV to be spiking too high. In fact, mine probably was in part due to my arrhythmia. There’s a sweet spot in between that’s the goal. And you can see below, my HRV is now rising and getting back into that middle zone 2 weeks post-ablation:

It’s worth saying HRV isn’t about chasing a single “perfect number.” In fact, it’s highly individual, and what’s “good” or “bad” only makes sense relative to your own baseline. Hormones (including the menstrual cycle), age, illness, and even the seasons can influence it. It’s a finicky metric—but a useful one if you know how to read it.

Anyway, if you also thought you understood HRV… but wouldn’t volunteer to explain it in public 😆, I hope this helped.

I’ve had a lingering suspicion I have silent reflux, and I wanted to find a non-medication way to deal with it. So, for the past month, I’ve been testing alginic acid—a naturally occurring polysaccharide derived from brown algae (aka seaweed). And… so far, I’m into it!

If you’ve never dealt with silent reflux (also called laryngopharyngeal reflux), it’s basically acid reflux without the classic heartburn. Instead, it shows up higher in your throat. For me, that meant a sore throat when swallowing at night (especially when lying down), or waking up with throat irritation in the morning—most noticeably after red wine 🍷. 

After doing a bunch of research, I added Esophageal Guardian, which contains alginic acid and potassium bicarbonate, to my evening supplement stack. I chew two tablets ~30 minutes before bed. Fair warning: the taste is… strong and awfully sticky. Buuut all the alternatives sound way more gross (the most famous one is Reflux Gourmet, a spoonful of gel which comes in Mint Chocolate and Vanilla Caramel—not flavors I want before bed). Anyway, I just follow it up with my oral care routine 🤷‍♂️.

Here’s what makes alginic acid interesting: Unlike PPIs or H2 blockers, it doesn’t suppress stomach acid. Instead, when it hits stomach acid, it forms a floating gel “raft” that sits on top of your stomach contents. That raft acts as a physical barrier, preventing acid and pepsin from splashing up into the esophagus while you’re lying down. Think of it like a dam in the river. 

Four weeks in, I haven't woken up with a sore throat. There’s no more burning feeling at night. No irritation in the morning. So in that sense, I think it really works. I was half hoping it would also help my PVCs, since there’s some connection between reflux and heart health ❤️. It didn’t, but that’s fine. So far, it’s done exactly what it was designed to do.

Would I take it every night forever? IDKID. My plan is to use it for another month, then shift to a situational tool—late dinners, travel, heavier meals, red wine—rather than a daily ritual. It’s not a miracle. But for silent reflux, I think it’s been surprisingly effective.

If ever there was a time for a stewery, it’s now. It literally snowed in Florida last week! 

If anyone opens one of these, hit me up. I’ll be first in line for a soup flight.

Directions: Copy and paste the below prompt into your AI platform of choice to blend up your perfect smoothie recipe.

👋 Who are you again? I’m Derek Flanzraich—founder of two venture-backed startups in Greatist (👍) and Ness (👎). I’ve worked with brands like GoodRx, Parsley, Midi, Ro, NOCD, and Peloton. I now run Healthyish Content, a premium health content & SEO agency (among other things).

Every Thursday, I share 5 health things I feel strongly about so you can live healthyish. (Disclaimer: I’m more your friend with health benefits. None of this is medical advice.) 

And oh, you also feel strongly about some health things? Hit reply—I’d love to hear it.