S7E17: How to use HRV

Do you wonder if you're the best version of yourself? This is a question we seek to answer in this podcast. We reveal information that helps you recover your health and become resilient. Modern life makes us fragile. Our diet, lifestyle, environment set us up for failure. We do not accept this. We seek optimization. We strive to become dynamic. Hey, what's going on? Dr. Chris here. Today I want to talk about HRV, what it is and how to use it. It's by far My favorite metric to track. It's very objective. It's very accurate. I use it with my patients. I use it for a ton of things. I actually believe that we could improve autoimmune disease through it because this is really— we're talking about your autonomic nervous system. It is. Well, let me tell you a quick story first. Years ago, I was in this business mastermind for physical therapists. And it was a very active group. So we, we get together first night, but we have— first of all, we have a full day of conferences. And then that night we meet up. It's very social. People having beers and wine. I had some wine, stay up a little bit too late. And then this is in Charleston too. So I'd flown there. And then like 5 or 5:30 in the morning, we all got up. We did this crazy run with sit-ups and push-ups, repeat. It was Very intense. I am not a runner. I used to be in high school. I'm nearly 50. I don't like to run anymore. I play hockey, but that's as much cardio as I pretty much do. So it was a lot of work for me. And then probably a day or two later, I got sick, like a cold, and I almost never get sick. So what happened there? I, you know, the climate was a little different. So you could say, oh, you got— you caught a cold from being in the cold. No, it's really these things are all stressors, right? Going to business conferences all day. Traveling, lack of sleep, alcohol, an intense workout, climate change too. Sure, that may be part of it. If you threw in a time zone change, it'd be more so circadian disruption. So all these things are stackable. These are stackable stressors. So let me start off with talking about stress. So when I say stress, I mean things that stress the body, not just perceived stress, stressors or stimuli. Some are good, some are bad. And basically, there is a difference between a eustressor stress and a distress. So eustress, if you've heard the term hormetic stress, kind of the same exact thing. So a eustress is something— it's the idea of what doesn't kill me makes me stronger. So think of exercise. Exercise is a perfect example of eustress. It's something you tear down your muscle a little bit, but if you don't do it too much and too intense, you come back stronger. Sun exposure is a type of eustress. Sun is good for you. You want some level of sun for vitamin D and a whole bunch of other reasons. And if you just get the right amount, of sun for your skin type, you get a tan, and that's protective for your skin. You stay out too much, well, that is then a distress. If you get a sunburn, you don't want tissue damage. That's where the issues come with the sun. So you're constantly playing this, sort of you're dancing the line between eustress and distress. Exercise again is another example. So if you haven't worked out, maybe in high school you used to curl 50-pound dumbbells— actually seen this happen to patients a lot— and then you haven't worked out in 20 years. And you're poorly slept and you're stressed and you're like, I just, I gotta do something for stress. So you go to the gym and then you go and pick up those 50-pound dumbbells again and you pop your bicep. That is a perfect example of distress, right? So you always want to be smart and do progressive overload. That's, that's the idea. All right, so back to HRV. What is it? Stands for heart rate variability. And so the idea is if you had a BPM of 60 beats per minute, it's not like your heart beats exactly on the second every second. There is variance naturally. So, under a parasympathetic or relaxed state, there is a natural rhythm to the heart. So, as you inhale, it slightly increases your heart rate, and as you exhale, it slightly decreases. So, that's the natural sinus rhythm of the heart. And sort of, it's kind of counterintuitive, but the more on point your heart rate is, the more of a sympathetic state you're in. And that's a complicated reason why, which I won't get into. Just know that The lower your HRV, the more sympathetic, and the higher your HRV, the more parasympathetic you're in. And we want to mostly be in a parasympathetic state. It's not the sympathetic state, but it's actually very useful. That's for emergency situations. The problem is that so many of us live in a sort of chronic low-grade sympathetic state just because our lives are so stressful. All right. So the other thing with Oura. Let me just talk about the numbers. So the number doesn't matter, right? People are like, I got 60 HRVs, is that good? I'm like, it just depends on you. There's variance from person to person, um, how, you know, where your numbers land. So, you know, whatever tracker you're using, it's going to take a week or two to kind of get to know you, and then it's going to establish a baseline for you. So with Oura, that's the dotted line, that's your baseline. And so you're looking to see what gets me above that baseline and what gets me below it. And also what returns me to baseline, or how long does it take to get me to baseline? So, reminder, stress plus adaptation— I'm sorry, stress plus recovery equals adaptation. That's adaptation, is whatever you want to get better at, running faster, your sport stronger, whatever it is. You have to put in the right stimulus, the right training stimulus, and then you train to recover. So the recovery is where the magic happens, and then you get the adaptation. You could also say the same equation, sympathetic plus parasympathetic equals the adaptation, right? And that's where a lot of people, if you're getting stuck in your workouts, you're not seeing progress, when you get to look at your recovery, are you spending too much time in a sympathetic state? So, okay, things that tend to increase and decrease your HRV. So I'll speak from personal experience. The biggest one that will knock it down is lack of sleep by far. Alcohol will do it. Stress from work, so perceived stress, poor relationships. If you have a lot of relationships with people that sort of what I call like energy vampires, they suck the energy out of you. You want to mitigate that as much as possible. All those will sort of tank your HRV. And then some things, so I have to converse. So A good night's sleep is definitely the best thing you can do to improve your HRV. Anything that's going to be more parasympathetic. So for me, cold plunging and sauna makes me very relaxed and in a parasympathetic state. Now, so that, that's a good one because that can be a stressor, especially if you're new to it. It could be too hard initially. So if I, you know, 40 degrees is pretty cold for me, that would probably be Stress-inducing, whereas if it's like 50 degrees of cold plunge, that's pretty easy for me. That's very relaxing. So if I cold plunge, we're in a comfort zone, that's going to improve my recovery score. Other things that can help: massage, walking in nature. Nature is very parasympathetic for a ton of reasons. Just low, like steady-state cardio, foam rolling, reading a book. This is where I wonder if a glass of wine maybe can improve your HRV, but it's just the question is how much. So those are the things to look at. And then so if you, if you had a day where you're really low, you want to— there tends to be like a 24-hour drag. So you want to go back and look at what you did the day before that set you low. And same thing on the other end, look at what things made you go up. And then also look at how many days does it take me to recover? So if you maybe just were training for a marathon and just ran your marathon, how many days does it take you to recover? That's an idea of resilience, right? So the quicker you can rebound back to baseline, the better and the more adaptable you are. All right. So that brings me to another point is the idea here is don't avoid stress. You want to— you should be going up and down with your HRV. The idea is not just better and better, better. The idea is improve your capacity over time through graded exposure, right? So that's this whole idea of the Resilient Blueprint. This, this whole program I built is you learn what your baseline is, right? So you look at your HRV scores. There's other ways to do it too, but HRV is your best one. And then find your stressors, right? And then grade the amount of stress that you apply to yourself over time. So over time you build a bigger bucket and you have more stress tolerance. So that's— it's HRV in a nutshell. I will say that rehab professionals like physical therapists is a great tool to use. We get this question all the time. How much is too much? Should I do my exercises you gave me every day? I mean, generally with rehab exercises, they're usually kind of rudimentary. Those are probably fine. But when you get people moving down the spectrum of exercise and you have them doing squats and things that are a little more compound movements, maybe you need to look at their HRV. So if an HRV is really low, maybe it's a day to take off, right? So that's the other point too, is HRV is a good way to predict what you're going to do that day. So if your HRV was below baseline and pretty low, that's a day to be nice to yourself and take it easy. That's not the day to go to the gym and get a PR. If your HRV is really high, then that's a good day to get after it. Maybe that's where if you do 2 a day, that's maybe that's the day, or maybe that's a day to do A cold plunge and a hard workout and play a sport because you can take it. Okay, I think that pretty much covers it. So HRV, check it out. Our ring, whoop strap, Garmin, Apple Watch, Morpheus. Those are all the trackers I know of currently. There's probably more coming to market quickly because it's such a cool tool. A ship in harbor is safe, but that's not what ships are meant to do. What does this mean? It means exposing yourself to difficult situations. So you become resilient. If you need help building resilience, check out our flagship program called Physiologic Flexibility. This is a 3-month do-it-yourself program that teaches you how to maximize your homeostatic regulators such as your pH, blood glucose, O2 and CO2 tolerance, and temperature. We give you specific action items through the program with the goal of becoming antifragile. If you want to become the inspiration for your friends and family, this is the program for you.