Use These DAILY HACKS To Prevent Disease & LIVE LONGER! | Rangan Chatterjee

The four things that I think affect our health in general, what we're eating, how we're moving, the quality of our sleep, and our stress levels.

So Dr. Chatterjee, you're on an extraordinary mission in the UK, and you've created a show called Doctor in the House, a BBC show, where you go into people's homes and help them transform their lives using functional medicine. Tell us why are you doing this and what do you expect to get out of this?

This show, Doctor in the House, is a series of documentaries that's gone out on BBC television. And I think what my aim with the show is, is to demonstrate to people that actually no matter what condition you have, there are things that you can do with your lifestyle every single day that are going to improve it. Now look, sometimes you can reverse disease, you can absolutely prevent disease, but you know, even if you don't have a label or a disease, actually making changes to your nutrition, making changes to your lifestyle can actually improve the way you feel, you know, whether that's just your mood, your energy levels, fatigue, all these things. I don't think people really realize that. So I've been very lucky to actually have this opportunity. And whether it's type 2 diabetes, which I helped a lady reverse in 30 days, which two years on she still does not have type 2 diabetes, or whether it's fibromyalgia, fibromyalgia pains went in six weeks, or anxiety attacks went down by 80% in six weeks, right? I used a different approach. You know, WellMark, functional medicine, I used that framework to help me look at these problems in a different way.

So it's really kind of extraordinary when you think about the show. It's called Doctor in the House and you literally go into people's homes, you stay with them, you watch them, you explore their house, you understand the patterns that are going on there. What exactly do you do? You go into the house and just like hang out and look in their fridge or like cook with them or like tell us about how this all works.

Yeah, well, it really depends on what that family's complaint is. So the first thing to understand is that I don't know when I knock on the door for the first time, I don't actually really know what's going on there. Okay, so I'm not involved with choosing who that patient is and what their problem is. My job is, like it is with every patient in my clinic, is to do the best that I can for them. So in this last series, there was quite a Pretty complex cases actually, much more complex than the first series. But you know, when you strip these things back and you look at what are the factors in that person's life that is contributing to the way they feel, you can always do something, always. So look, what do I do? Well, in the lady who had type 2 diabetes, you know, what's amazing about going into someone's house is that you start to see things that you would never see in your clinic, right? So in clinic, we ask patients questions, right? And they give us answers. But the thing is, is that often they won't tell us the truth. And that's not because they want to lie to us, it's because they will filter the information that they think you need to hear. So what was happening in their house? I was seeing breakfast, lunch, dinner, nighttime snack, you know, what is in their fridge, what are they really eating, rather than what they tell me they're eating. So on a personal level, you- did.

You do a fridge biopsy?

I did a fridge biopsy. Yeah, absolutely. But not in every case, right? Not in every single case. But there was a few cases where I had to go in and actually really re-educate them on what should be in their kitchen.

So when you went in there, what were you finding? You know, we often as doctors don't get that window.

Yeah.

But it's extraordinary to actually see how people are living, their stress levels, whether they're exercising, how they manage their lives, what they're buying, what's in their cupboards, you know, how they're cooking, when they eat. You know, you get to see an extraordinary amount of information that tells you something.

So what were the things that you found? Yeah, well, it's the things we know well, Mark, the things we talk about all the time, but, you know, it's always comes down to the same sort of things in people's kitchens. There's too many refined and processed carbohydrates, breakfast cereals, you know, refined breads that have sugar as an ingredient.

It's like a Duh, whammy. flour and sugar.

Yeah, ready meals.

It's like bread that doubles as cake.

Yeah, exactly. And then you open the cupboards and you see all the soft drinks, the carbonated drinks, even the diet drinks. There is so much in there that I think sometimes we, you know, in the health world, we talk about these things. We assume that actually, actually the message is getting out there, but actually you go out there in the real world and people still don't know how toxic these foods are for the way that they, their bodies feel, but also how their brains feel. So food was a big thing and it always, you know, it never ceases to amaze me how simple changes to someone's diet within days can impact the way they feel.

Days, right?

Within days.

And you know, as a doctor practicing medicine, we prescribe drugs.

Yeah.

And we rarely see drugs have that big an impact in such a short time.

Yeah.

Even in a long time.

Yeah, well, I think what's interesting for me, because I am on a mission in the UK and I'm on a mission to help Transform the way that the public view health because I think we see, you know, we talk about the brain health, right? I think we see the brain as separate from the body and I think we see the heart as separate from the liver as separate from the gut and what we're realizing now is that the body is, you know, this interconnected being, you know, everything your hormones influence your brain, you know, your gut microbiome influences your brain, everything interacts with each other, right?

You're talking about going to people's homes and noticing things that cause brain damage. What were the things you found that were most affecting people's brains and cognition and ability to focus and be present?

I think there's four key things that I saw in people's houses that were affecting their brain. And they're the four things that I think affect our health in general and the four things that I think we've all got control over. what we're eating, how we're moving, the quality of our sleep and our stress levels. So the top two for me that I saw would be food and stress.

Yeah.

Okay. So I think stress is something that people often don't think about with their brain health. And I think it's a big problem these days. You know, we're living in a society where we're overworked, we're under, you know, we're under slept. We've got a constant stream of emails, tweets, Facebook. We're never switching off and you know, for me, I find my email inbox stressful, okay? And we know that this kind of psychosocial stress raises levels of our stress hormone cortisol and cortisol damages our brain, you know, or you know, if cortisol is too high for too long, it can, you know, damage the cells in our hippocampus, which is where we lay down our memory, right? So I think if people really understood that and we can help people understand that, that actually The stress in our lives is impacting our brain function. And, you know, I always talk to people, you know, get 10-15 minutes of me time every day, something, you know, switch your devices off, just sit there, you know, read a book, meditate, do some yoga, something, but just focus on that one task. I see that having profound impacts all the time. And I make it simple, Mark, for people, you know, I have made deals with my patients before. They say to me, oh doctor, you know meditation, yeah, I've heard about that, but I don't have time to meditate.

Yeah.

I said, okay, can you commit to two minutes a day? And they're shocked, right? Because they think I'm gonna say they have to do 20 minutes a day. And I remember on the first series of Doctor in the House, I had a lady with menopausal symptoms, right? And her doctor wanted to prescribe hormones for her. She didn't want that. And again, in four weeks, we got her menopausal symptoms down from 15 out of 17 on the British Menopausal Society Questionnaire. down to two hours of 17. And a critical component of that was this kind of 15 minute relaxation in the evening. And I made a deal with her. I said, look, you have four minutes to brush your teeth every day, right? She goes, yeah. I said, why is that? And she said to me, well, because, you know, it's been prioritized since I've been a child, right? So that's just my normal habit. I said, let's make that meditation your normal habit. But let's start with two minutes a day. if you start with two minutes, that becomes five minutes. That becomes 10. But if I start with 15-20 minutes.

Yeah.

They do it for two days. They don't manage to do it the third day and they give up.

Yeah.

So that's powerful.

Yeah.

No stress.

That's very powerful.

It's meditation.

People don't realize. I think it's just a way of relaxing, but it actually reprograms your biology. It increases stem cell production. It decreases inflammation and boosts your immune system. It helps regulate your hormones. It improves your blood sugar control. I mean, it's got massive effects. And I think one thing people don't realize about stress is that it causes a leaky brain. We talk about leaky gut, but there's a barrier in the brain that protects the brain. And when there's stress, that barrier breaks down, and a lot of outside influences can harm the brain.

Yeah.

This is quite extraordinary. So tell me more about this gut issue, because I know that, you know, you focus a lot on the gut. You were sharing a story about an obese who had gut issues allowed him to sort of fix those and ended up helping him lose a lot of weight. How do you approach the gut from a point of view of functional medicine within these patients?

Yeah, look, I think this is something I didn't learn at medical school, but this has been part of the training with the Institute of Functional Medicine and all the additional education that I now do. I've learned that the health of the gut is critical, yes, for the health of the brain, but also plays a critical role in things like obesity. mood problems, all kinds of things. So how do I approach it? Well, first of all, I want to understand what that patient is eating, okay? Because we know that the biggest and the fastest way to change the health and the composition of your gut bugs is by changing your diet, right? So, you know, there is so many tests you can do. You know, I sometimes run stool tests to have a look at, you know, what is the combination of bugs inside us. And I think, you know, a lot of people still don't understand that we've got trillions of bugs that live inside us. And actually, it's the combination of those bugs and the community that is probably more important than actually the individual components. And one of the biggest measures I look for now is the diversity, you know, how diverse is your gut? And depending on what I find, that will also dictate what I then do with the patient. So this 11 year old boy you mentioned, who was obese, he was extremely obese and he was struggling with his weight. His fasting insulin was 33. Now, depending which doctor you ask, we want to see a fasting insulin under four, certainly under six. So 33 was off the charts. Off the charts. And in six weeks, we got it to nine and a half. you know, from 33. But we did it with two measures. Yeah, we cut out refined and processed carbohydrates. So things like your refined breads, your cereals, the sweet drinks, the muffins, the donuts. Okay. And we increased healthy natural fats, a lot of avocados, a lot of nuts, a lot of good quality meats and fatty fish. But also we, we put a rainbow chart on this little boy's fridge and. all the colors of the rainbow were there. And I said, you have to tick off every color every single day. Okay?

And he did it.

Not by eating Skittles though. Not buying Skittles. So, you know, you've got, you know, you've got the lycopene in tomatoes, right? Or as you guys say, tomatoes. We've got, you know, you've got the blue, purple pigment and blueberries, right? And, but what people don't realize, I think, is that there is communication between our gut and our brain, right? You know, when our gut makes chemicals and those chemicals via the vagus nerve actually attach to receptors in our brain and that can change the way our brain operates. So it's very, very powerful to understand that by changing what you eat, changing the health of your gut, you change the health of your brain. And fiber, I think, is very, very key. So I'm not talking about all brand.

Yeah.

You know, I'm talking about, you know, the fiber from plant foods. Like, if you eat every color of the rainbow every single day, you're gonna get lots of different sources of fiber. So the fiber comes down, your gut bugs feed on that fiber, and they make short chain fatty acids. So these are chemicals, really, that are anti-inflammatory. They help our immune system. Some studies are showing they're anti-cancer. So it's really incredible just by increasing plant-based fiber in your diets, not only are you getting all these polyphenols, not only are you getting all these lovely phytonutrients, but you're also making compounds in your gut that influence your brain. It's remarkable.

It's interesting you mentioned the sort of short-chain fatty acids. Most people don't know what those are, but they're basically the fuel that the bacteria make to feed your colon cells. So it's really a very symbiotic relationship. And we know that, for example, like you said, all these fibers help one of the most important compounds called butyrate. But when you eat wheat flour, which I don't mean whole wheat or regular wheat flour, flour is treated with a compound called calcium propionate, which is another short chain fat that's very toxic and can cause ADD behavior problems, autism, inflammation. In fact, in animal models, it induces autistic behavior when you inject it into the animals. So why eating all this bread and processed food? Not only are we getting the sugar, but we're getting some of these really adverse compounds. So, you know, a lot of people suggest that, you know, this approach, functional medicine, is expensive, it's difficult, it's hard to do. If you don't have resources, how do you get it done? The testing, the supplements. But the truth is, you and I know that it actually isn't that hard. That with basic principles, like you mentioned, food, sleep, exercise, stress reduction, most of which are either free or food you have to buy anyway, just change what you buy. You can actually have an enormous impact on your health. So how do you do this if you don't have resources?

Yeah, Mark, that's a great question and it's something that people always say and even when I went around the country in the UK filming Doctor in the House, I would stay with families from all different socioeconomic backgrounds. So cost would sometimes come up, but what I've realized, you've already mentioned, is that 80%, I would say, is free. 80% of what we need to do with our lifestyles for most people is freely available to us. So if we talk about these four pillars, food, sleep, movement and relaxation, okay, what can people do in their diets? Well, very simply, if you reduce, refine and process carbohydrates, breads, muffins, pastas, you know, these ones that are highly processed, and you increase healthy natural fats like avocados, nuts, fatty fish. That's something you can do immediately with your food that's gonna have an impact on your health. That's true. Movement, okay? Whatever someone is currently doing with their movement, they can self-assess and go, am I moving enough? If not, maybe something simple like just putting an alarm on your phone once every hour to remind you to get up and walk around the block. Or, you know, a tip I say is drink more water because if you drink more water then you have to get it regularly to go and pee, right?

But it gets you up, okay? If that's really exercise, go to the bathroom.

I think you're in trouble. Hey, I agree but look it's about meeting people where they're at, right? And it's all very well for me to say you need to do X amount of exercise every day. And that will work for some people but I like to break it down and make it simple. Whatever somebody is currently doing if they move more, that's gonna have an impact on their physical health, on their brain health. And I like the 10,000 step that you target. I think it's a really good, easily measurable target for people. I've seen it with patients. They can get to the evening, they've only done six and a half thousand steps, and they're like, you know what, I'm gonna go for a quick walk before dinner. So it's something measurable for people. But the other thing with movement is I think we've really neglected muscle and strength training. And I always talk to my patients, whether they're, you know, 20 year old patients who want to get fitter and stronger, or whether it's a 75 year old patient, I go through, and I'm there in the consultation room with them, showing them exercises. Because what I've realized, Mark, is that You can refer out to various specialists, but there's something powerful in that interaction with that patient. If I then take my jacket off and say, Hey look, what about this? Can you do this? And I will do that in the consultation room with them to inspire them because our job, I believe, is to inspire a patient when they walk out to make them feel I can do this.

So you drop down to 50 push-ups in the exam room?

Hey, I have done that, but no, sometimes I've got patients, let's say, a 72 year old lady I had in clinic a couple of weeks ago. And she was nervous. I said, okay, well look, I've got this thing that I call a five minute kitchen workout, right? That I teach people to do in their kitchen. So I try and remove the obstacle of paying for a gym membership.

Yeah.

Getting a personal trainer. Hey, look, I love the gym. And people like having a personal trainer. That's great. But I'm saying you can do a five minute strength workout in your kitchen every single day. And a recent couple I treated, right? They are, I think they were in their early 60s. They hadn't done any form of strength training for maybe 20-30 years and they were concerned about their brain health. Okay, and they said, well, you know, Doctor, what can I do? And I explained to them how strength training is very important for their bodies and how, you know, exercise in general, but strength training also increases levels of BDNF, brain-derived neurotrophic factor, which is like- Miracle growth for your brain. Exactly, miracle growth for your brain. Who doesn't want miracle growth for your brain, right? And they were nervous. So I showed them what they could do in their kitchen. Just five simple exercises, a wall press up, a kitchen worktop dip, right? And I showed them and I talked them through it. And when they came back a few weeks later, they said, Doc, you know, we were scared, but we started doing it in the kitchen. And within two weeks, they were doing it seven days a week. in their landing upstairs while their evening bath was running. So this is a couple in their 60s, no strength training at all, but by showing them that it is free, it is simple, and it is doable, they felt great and they started doing it every day. And I think every single patient has the ability to do that.

It's true.

I mean, I often do what I call the seven minute workout, so two minutes longer than five. And all you need is a chair.

Yeah.

And your own body, and it's powerful, and it's a high intensity workout, it's strength training, and it's portable, and you can do it anywhere. And it just, it's extraordinary the power of that. I, myself, I hadn't done a ton of interval training, and I do this bicycle loop where I do it in about, you know, usually, you know, 55 minutes. And all winter I didn't ride my bike, and, and I did this, seven minute training. And when I started riding my bike in the spring, I was riding five minutes faster day one, which was sort of striking to me that my body responded that easily and quickly. So it's very powerful.

But I was going to say, Mark, sleep is something that I don't think people realize how important sleep is. And, you know, we're talking about, if we talk about brain health, are we talk about the beta amyloid protein, this protein which accumulates in our brain in conditions like Alzheimer's disease? We know that when we sleep deeply and we sleep for long enough, actually our body processes a lot of this waste that builds up, including beta amyloid protein, and clears it out.

So if waste- and your brain only detoxifies at night.

Exactly. And what I think is so powerful about that is if you explain that to a patient, so you give them the science that they need to understand how important that sleep is. So it's not just about, hey, you need to sleep more, right? Because everyone knows that. Okay, but how are we gonna help our patients sleep better? The first thing is we have to explain to them why it's important for them. Okay? If we've done that, then often all someone needs to do is prioritize their sleep. Okay? For many people, that's all they have to do because in the world that we're living in today, okay, if we're not prioritizing sleep, sleep tends to fall by the wayside. You know, there's too many temptations, you know, with Netflix or whatever. There's so, you know, and I'm as guilty as anyone, right? of being tempted. So sometimes all people have to do is, and I say to them, I say, look, what about for the next seven days? All you do is you go to bed half an hour a night earlier and tell me how you feel in seven days. I'm telling you, more often than not, people feel better. They make better food choices the next day because they've slept better. They've got more energy. They feel sharper in their brain. Their brain fog has gone down. Now these are simple free interventions that people can do. It doesn't cost money, right?

No.

It doesn't cost anything.

And you know, the food thing is interesting because we often think that eating well is expensive. And you don't have to get the most expensive cut of meat or the most expensive rare vegetables. But eating just real food doesn't have to be that much more. In fact, I went to this family, part of the Dr. Oz show that I was on where we went in Florida and they they lived in a kind of a very small little house, family of six, very poor. And we got them eating real food. And I went down to their house and visited them and I saw coconut oil and almonds and avocados and I said, wow, isn't this expensive for you? And they were like, no, it's actually cheaper than what we were eating before because we bought a case of soda for each of our family every week. And you start cutting out all the stuff that they're buying. and the processed food, which is actually pretty expensive when you think of pennies per nutrient. You know, when you actually look at how nutrient poor it is, you're getting not very much for your money. You're getting a lot of calories, but not a lot of nutrients. And so, they actually felt better. They lost, I think, 300 pounds as a family. And they loved it. And they started spreading to their relatives. And it was done on a budget. And I think there's a big myth about how it's expensive to eat real food. It's really not.

Yeah, the first family I ever went to as part of my documentary series, Doctor in the House, I remember really clearly the very first day I met the family, okay? And I had not diagnosed type 2 diabetes at that point because I hadn't run bloods, hadn't done anything yet, and they didn't know what was going on with the hell, that's what I came in. And the evening, the father of that family said, Hey Doc, come on, let's go, let's, you know, I'll tell you what we normally eat. So I went in the car with him and we drove 15 minutes out of town to a fast food restaurant and we went through the drive-through and he ordered four meals, but each family member, it says four people in the family had two meals each. Right? And this cost 48 pounds. Okay? So we're talking about, you know, $65, something like that. That's just for one evening meal and they were doing this about five nights.

That's right.

A week.

People don't realize, yeah.

Yeah.

And it was amazing because what was interesting about that, though, is he said, Doc, I feel a bit embarrassed that you're gonna see all this. I said, Hey, don't look, I just want to observe what you, you know, the more I know about what you're currently doing, the more I can help you. And what was interesting is that A, that's a lot of money and when I moved them over to eating real, fresh, whole food, they were saving money.

Saving money, right?

But the other thing was he felt bad in front of me that he was eating this. So actually on one level intuitively as a family they knew that actually what they were eating wasn't particularly good for them and I'm interested as to I think a lot of people around the country, around the world know that fast food and junk food is probably not good for them. So the question is, why are they not changing?

Because they don't know what to do.

Exactly. And that's the key. That's what we need to help them see what else they can do.

Yeah, it's powerful.

And I think that's true.

I observe the same thing. And they actually don't know what to do.

They know what not to do.

They sort of try not to do it. But if you take a rotisserie, I mean a chicken, a couple of chickens, chickens, throw them in the oven, make a salad, roasted sweet potatoes. That's much less expensive to feed a family of four than going to fast food and spending $60.

Yeah, absolutely. I agree. And I think it's really important that message gets out.

And by the time he gets there, comes back, it's about the same amount of time of spent, actually.

Yeah, I said that to him. And then there's the gas cost of driving 15 minutes there and back. That's half an hour of driving. and a $65 meal, that's a lot of money if you're doing that five nights a week. So it's really remarkable. I think a lot of time in the wellness community, we often don't think that actually, we don't have that realization that there's actually a lot of communities out there who don't know this and need help and understanding. I'll tell you what, something I feel incredibly passionate about, I don't know what it's like in the US, but in the UK, A lot of doctors will say, ah, you know, patients don't listen. They don't listen to what we tell them. And I've got a problem with that because I genuinely believe that people don't want to be unwell. And if we can explain it to that patient in a language that they understand that it means something to them, I find by and large people want to make that change.

They do.

But if we do this, right? If you've got 10 minutes with a patient, right? Or 15 minutes or 20 minutes and you say, to someone with type 2 diabetes, right? Which we know can also affect your brain, your blood sugar, right? But if you say to them, you talk to them about medication, about what you need to do and what drugs you're going to need to be on, and right at the end you say, yeah, but also if you can just change your diet, lose some weight, that's going to help you. That's very different from starting off and saying, hey, you've got this condition, right? Yeah, we've got some drugs, but look, there's plenty you can do with your lifestyle. I'm going to teach you, I'm going to show you what you can do. Are you interested? I tell you, people say yes, right? So I think it's the way that we don't prioritize it as a profession. We assume patients won't do it.

Yeah, sure we say, well, I told them to lose weight and eat better and exercise and they didn't do it. I'm like, how helpful is that? Eat better, exercise, I'll see you in three months. If that doesn't work, we'll use drugs.

Well, that is not good medicine. Exactly. So I think we can make a difference. We can change people's health and people want to get healthier. People want their brains to function. Who wants to wake up with brain fog? Nobody wants that. Because it impacts not only their health, but it impacts their relationships with their spouses, with their children, with their work colleagues. That then causes more stress. Stress raises cortisol. Cortisol starts to damage your brain and you're in this vicious cycle. So what we need to find is the lever to turn for that patient to start instead of a negative cycle, let's start a positive cycle that helps feeding more and more health.

Yeah.

So Dr. Chatterjee, how do you keep your brain healthy? What do you do every day to maintain your health? I mean, you work hard, you travel, you're on a TV show, you have a clinic. I mean, it's not easy, right?

It's not easy. Family, two kids. Yeah, you're right, Mark. It's not easy, particularly when traveling, because when you're in your own environment and you've got everything surrounded by you that actually helps you stay healthy, it's okay. But, you know, obviously I'm traveling at the moment, traveling out here to see you and you know, and do our filming and it is incredibly difficult. So what do I do? Okay, first of all, I'm prepared. Okay? I remember you saying it a few years back about don't get yourself in a food emergency, right? And I think you're spot on because if you're not prepared, you're gonna find yourself hungry, tired, craving something and if you're in an airport often you know, there's nothing but sugar or processed foods.

Right?

So how do I keep myself healthy? Because I do live and breathe this myself. Okay. So again, I talk about food, movement, sleep, relaxation, food. I will eat whole real food pretty much every day, even when I'm traveling. Did I do that six, seven years ago?

No.

Okay. It was a slow process. Was it hard at first? Yeah, it had its challenges. But now it's normal for me. It's automatic. It's automatic. I'm not even tempted anymore. My taste buds have shifted, right? I've retuned them in to what whole natural food is. So I will eat that every day. You know, I will carry with me, you know, I'll take tins of wild salmon with me when I'm on the road. It'll be in my backpack just in case I'm hungry. I can peel it open and have something, right? I will make sure that I work out every day, even if it means from my bed if I just hit the deck and do push-ups and tricep dips and squats.

Right?

Sometimes that's all I'll do. But that it all helps. You know, it doesn't have to be a one hour gym workout. You know, little bits can really help. I will prioritize sleep.

Okay.

That's something that changed for me maybe two or three years ago.

Yeah.

As doctors were trained, who needs sleep?

Stay up all night, be on call, look at babies. But I would genuinely Switch off at home, I will switch off maybe at sort of 8:30. That's my cutoff. I will put my computer off, I won't answer emails, I often won't take calls after that time, and I will get to bed early. Because I find when I do that, everything else gets easier. But my weak spot, the one area I struggle with is the stress piece. Because, you know, running around, trying to do multiple things, I find it tricky. But I tell you, when my son was three years old, sorry when he was a bit younger, I remember he wouldn't sleep very well. He would be up several times a night. But I disciplined myself to get up early and do just five minutes of meditation every morning. And I tell you, I felt like a different person. My energy went up, I was less reactive in the day. Recently that's fallen off again. okay? And I've, that's the one area I struggle with, you know, is trying to discipline myself to do that. And for me, if I do it when I get up, it happens.

Yeah.

If I don't, it doesn't happen.

Simple as that. Yeah, it's powerful. You know, I, people say, well, I'm too busy to meditate. Well, I find I'm too busy not to meditate.

Yeah.

That just taking that time in the morning, I can do it in the car, on a plane, I can do it in a subway, even at the end of the day, I always try to do it 20 minutes twice a day. And I think, well, 40 minutes, who has 40 minutes in a day, but it's made everything else so much better. It's made me more focused, more ability to think, have more energy, better sleep, less anxious, less reactive, better able to be present for what I'm doing. And it's kind of magic. And I never would have imagined it was that powerful. And I think people underestimate the importance of hitting the pause button and stopping the stress response, which happens automatically, but the profound relaxation and healing that comes with meditation or some similar practice is just not something that happens automatically. It actually has to be an active process.

Yeah, I agree, Mark. And I think one thing we have to do as a community is demystify meditation because I think lots of people have lots of hang-ups about it. You know, is it religious? Is it deeply spiritual? Is it, you know, do I need to sit and chant a No, like, you know, they've got all these kind of misconceptions.

It's like exercise for your brain.

Yeah, exactly, but it can be, let me give you an example. So, my wife, she cannot stand the thought of plugging into an app and having someone guide her through a meditation, right? Because she can switch off naturally and so she doesn't like that. Me, for example, I struggle a bit with that, so I like the act of plugging into my app and pressing play and someone talking me through it, right? Two different ways of doing it, but they suit different people. So I think there are many ways that people can meditate and or be mindful, you know, and as you say, it's simply about pressing that pause button and it doesn't matter how you do it. And actually with some patients I say, you know what? Maybe for you it's as simple as finding your favorite bit of music Right? Putting it on and immersing yourself in it, but don't be scrolling your phone at the same time. You know, put the lights off, close your eyes and just listen intently to that music. That is a form of meditation, right?

Sure.

So it's about finding the right one for that patient, I think.

Why is not sleeping so bad for you? And why is sleeping so good for you?

Probably should do that, yes. So sleep is when we're repairing the powers of both the mind and the body. Sleep is when we reduce inflammation, repair tissues. The discovery of the glymphatic system in 2012-2013 is this passive channel that runs alongside our arteries and veins in the brain that fills with fluid when we're in deep sleep and allows a washing out of debris we may have accumulated during the day.

Things like- so all those bad thoughts get washed out?

Well, not the bad thoughts. No, but the amyloid plaque that sticky plaque that we secrete in response to inflammation or injury. If it accumulates, of course, it can damage surrounding neurons and is associated with.

Neurodegenerative disease and Alzheimer's disease.

So in English, that means if you don't sleep, you're likely to get demented. It's definitely playing a role. And this concept of bidirectionality, we know that sleep disruption, circadian rhythm disruption, sleep apnea is present in two-thirds of people with insulin resistance, pre-diabetes, diabetes. And it is a chicken and the egg thing. driving the bus. We used to think, well, you get the sleep apnea because you have insulin resistance and gain weight. But if you have disrupted sleep, your insulins are higher, your cortisols are higher, your glucose is higher, you're looking for highly processed, quick energy dense foods and.

Less able to resist them. Wow, so not sleeping is a risk factor for obesity. Absolutely. And heart disease.

Yes. And cancer. And dementia. And flares of autoimmune conditions. and chronic pain and fibromyalgia and anxiety and depression. I mean, it really affects people.

Oh my God, if I don't sleep.

I'm depressed and anxious.

But the more you worry about it, the harder it gets to sleep? Yeah, it's true. Okay, so we have that chronic stress. What else is driving this insomnia pandemic.

Which is huge, right? How many, 70, 90 million people are struggling with insomnia?

Right.

So I do think that there's a need to address underlying contributors to anxiety and depression independent of their impact on sleep. talking about what's going on, bringing in some kind of breath-based practice, whether that's yoga or tai chi or meditation, just to ratchet everything down. That's another important component of it. And thirdly, you've already touched on a little bit about the dopamine with the foam, but it's also the dysregulation in our circadian rhythms. You know, we think about how, there's been a lot of research about how important it is to avoid light exposure at night, for example. But everything we do during the day and when we do it is ultimately gonna influence our ability to go to sleep when we want to and get the rest that we want to. So in other words, when we're eating all day long and snacking late at night and watching TV at night, that's signaling on our computers. Yes, and on our computers, that's telling our bodies and brain that it's day, it's day, it's day. So we want to actually reestablish a consistent circadian rhythm. meal timing. So we're having eating earlier in the day and then building in a fasting interval before we go to bed.

So don't eat three hours before bed?

No. Interestingly enough, there's, as you know, there's a connection as well with digestive function that eating late at night not only disrupts your sleep, but it's contributing to higher reflux, which can also interrupt sleep. So everything's interconnected.

It happened to me last night, actually, because I went hiking and it's summer and it's so beautiful and it stays late and light. So we were like, didn't get down from the mountain till eight o'clock at night. And I'm like, oh, let's go eat. I'm hungry. But then by the time we ate, it was like nine o'clock. And I, like, last night, I tossed and turned for a couple hours before I went to bed, which I usually don't do. Yeah, it was the, you know, it was the sleeping late at night. So there's, there's eating late at night. There's, there's circadian rhythm disruption. And this morning I went out and sat on my deck and the sunshine was out. So getting light in the morning is so important. Absolutely.

So we don't do that.

We're all, like, on our phones or computers right away. We need the natural light to reset our brain. It makes a big difference. Light is medicine, right? It is. Light is medicine. It is. And also it could be bad medicine if it's the wrong light at the wrong time, right? Exactly. So we have all this like, there's this great book called Lights Out that I read years ago, Cindy, that was really talking about the advent of the.

Light bulb driving chronic disease because of the disruption in our rhythms and so on. It's interesting, they even looked at LED.

Street lights disrupting the circadian rhythm of animals and insects too. So it's not just humans that are.

Being impacted by this. And there's some other weird stuff that affects sleep that we don't think about.

Like what else?

Well, one of the conditions is restless leg syndrome. And that's, it's hard to diagnose. It's more of what we call a clinical diagnosis. People describe this creepy crawly sensation in their legs or this irresistible urge to rub their feet together. And typically it's treated with dopamine medications. It's connected to relatively low dopamine levels in the brain. You know, dopamine, yes, revs you up, but dopamine also seems to play a role with movement. So it's treated with some of the same medications they use to treat Parkinson's disease. But it turns out that that can be more prevalent in people who have autoimmune conditions, in which case we wanna address the underlying autoimmune conditions. There are some nutrient deficiencies that are gonna make the symptom of restless legs more significant. Low iron, low vitamin D, low folic acid, low magnesium. So we really want to look at somebody's nutritional status.

Yeah.

And by the way, 80% of the population is deficient in vitamin D, 50% in magnesium, you know, like 20% iron. I mean, it's like a lot of people are deficient in the B vitamins and they don't even know it.

Right.

You know, and you go to your doctor and you have insomnia, they're not checking those things. Exactly.

And there's even weirder things in nutritional stuff, right? So if we identify a nutrient deficiency, for example, the next step is why? What's the why that somebody's nutrients might be low? And there we come back like so many other things to the function of the gut. And interestingly enough, there is a higher correlation in people who have small intestinal bacterial overgrowth also having restless leg syndrome. Maybe because it's contributing to ongoing inflammation, maybe because it's also contributing to difficulty absorbing those nutrients from your food. So we're even going to go a step further and say, is there an underlying issue with digestive function, absorption and assimilation of nutrients that are- so if.

Your gut's a mess, it can also cause insomnia.

Absolutely.

And then heavy metals are another big one that we don't really hear about. Right.

Lead, mercury, things that are under the radar for many, many people and unfortunately can be a problem.

Yeah, and I had that. We talked about it on the show, but I've had mercury poisoning 30 years ago almost, and it really totally screwed up my sleep. What happened with your sleep? I just couldn't sleep. Like I just, I was just really couldn't fall asleep, couldn't stay asleep, never felt rested, had chronic fatigue syndrome. Until I got the mercury out, got my fillings out, chelation, everything, I couldn't sleep. And it really took a long time to reset that. Okay, so we've got all these different things that traditional medicine is ignoring, the hormonal fluctuations, the gut issues, heavy metals, nutrient deficiencies. I mean, doctors know about sleep apnea, but they often miss it in, thin women because that's not the archetype of someone who actually like the Pickwickian figure with, you know, a huge belly and a thick throat and size 17 neck. I mean, you know, so there's all these issues. And, and yet, you know, this continues to be such a struggle for so many people. And the, and the traditional treatments really are just stop Gap. They don't really address the cause. So in functional medicine, the way we think about things is to look at some of these other factors. So in your practice, Andy, how do you start to dig down? What are the kinds of diagnostic things you look at differently? We talked about all these different factors, but how do you identify what's the problem in this or that particular person?

Well, I think it's the time to take a history and really understand all of the other interconnectedness that could be going on. For example, somebody with sleep concerns might also have digestive concerns, and then we might be thinking about assessing their digestive function. looking at a nutritional assessment. But I think there's a time and a place and there's tremendous value in screening somebody with a portable sleep study because that gives you a tremendous amount of information. And we're using it, yes, to diagnose sleep apnea, but also to say, how often do you wake up during the night? How much percentage of time are you spending in REM sleep and deep sleep? Are you tossing and turning all night long so it can give us a tremendous overview in terms of somebody's sleep throughout the night. And from that, we can also decide, okay, what else do we need to explore?

And then let me do some testing, right? You can look at nutritional levels. You can look at these vitamin D and magnesium and folate and iron studies. And you can look at obviously the sleep apnea test and there's home tests now you can do that are really great. We look at heavy metals, right? And the hormones, we can really get a sense of what's going on with hormones for people. If their estrogen and progesterone is all out of balance, it just happens in menopause. you see a lot of sleep issues, heavy metals, like I said, we can test. So there's a lot of ways we can diagnose using functional medicine testing that you don't really get with traditional doctors that can help get underneath things. So tell me about this patient you had because it sort of speaks to a lot of the issues that we're talking about and it gives you a little unusual approach to insomnia, something you wouldn't really get from a traditional doctor.

Right, so this is somebody that, and one of the things I want to plant the seed for is sometimes we start with what we think is the most likely issue and we gradually uncover more potential contributing issues and peel the layers of the onion. And this was a woman that I had known for years. She was pretty healthy in terms of her lifestyle. She exercised, she wasn't overweight, she ate a healthy diet, she didn't drink any alcohol, she was treated with antidepressants, she was on a serotonin reuptake inhibitor and Wellbutrin for her depression. And she started, she was also on hormone replacement therapy. She was postmenopausal in her 60s, and she started complaining of fatigue and difficulty concentrating and just felt scattered. And by Sundays, she would have the need to take a three-hour nap. So, well, that's unusual. So we did some of the usual testing for causes of fatigue. We tested her thyroid. It was okay. We looked at her iron levels or sugar levels. They were okay. So I decided to do screened her with a sleep study. And it turned out you would not have looked at her and said, oh yes, she is the poster child for sleep apnea. She turned out to have one of the most striking positional components to sleep apnea I've ever seen. When she was on her side, her sleep was normal. But when she was on her back, she had respiratory events that count as either a slowing of airflow or a stopping of airflow more than 60 times an hour.

Wow. Stop breathing 60 times a minute. Yes, yes.

Like once a minute. That's a lot. No wonder she was exhausted, right? So when you see a positional component like that, I have people who don't want to do a sleep study because they don't want to, I'd never wear that stupid mask. But for her, we said, okay, well let's start with retraining you to learn to sleep on your side. And she tried that. There's some commercially available positional devices. There are all kinds of strategies you can use.

There's a very, very sophisticated technology called the tennis ball.

Yes.

Strategy, where you sew a tennis ball into a t-shirt on the back. So if you roll over on your back, it makes you flip over to your side.

Or the fanny pack with the pillow stuffed in it. Yes. There's all kinds of strategies you could do. And of course, it's big business, right?

You can buy a slumber bump or a bumper belt.

Oh, I didn't know they had those. I was on the tennis ball track. Even more sophisticated, there's now a biofeedback device that's a strap around that vibrates when you roll on your back. So it's sort of autogenic nighttime training to get you So that's what she used, interestingly enough. And it helped a little, but she was still tired. So as we're peeling the layers of the onion, she had some digestive symptoms, a lot of bloating, a lot of discomfort, and we had done a full sleep study. She had restless legs and periodic limb movements. She turned out to have a very abnormal breath test for small intestinal bacterial overgrowth.

That means bugs growing in your small intestine where they usually- Where they don't belong, right?

Right.

Which can cause inflammation.

Absolutely. And low iron. Her iron wasn't terribly low, but one of the sidebars here, I think the other thing we do in functional and integrative medicine is understand the difference between a normal blood test, I should put, quote, normal blood test and an optimal blood test.

Yeah.

Ferritin is a classic example of that.

Ferritin looks at your total tissue iron.

And I think- How much iron is in your iron bank in your body? In your iron bank, your iron stores, right. And normal can be anywhere from 15 to 250.

Yeah.

So- It's a big range.

It's a big range.

And what we know the threshold is for somebody who's got restless leg symptoms is you actually don't want to be normal. You want to be over 100 because there's some evidence even comparing it head to head with those dopamine drugs we mentioned earlier, getting somebody's ferritin over 100 was as effective as the dopamine medications.

That's amazing.

That's amazing, right? As simple as correcting a nutrient deficiency not to the normal range but the optimal range. for that condition.

You know, it's interesting is, you know, if, if, you know, heme iron is the, the best absorbed kind of iron, but that usually comes from meat. Right. And people are vegan, then the plant forms of iron aren't as well absorbed. Right. And you often see very significant iron deficiency in these patients, especially women who are menstruating. And I think that, you know, I learned actually in traditional medicine that ferritin was connected to sleep, actually. Interesting.

I learned that in a lecture on.

Insomnia that I went to by some drug company. That's great. I was like, well, that's interesting. But, but, yeah, I think it's, it It's something that's often overlooked and it's an easy blood test to check your.

Ferritin, which most doctors won't look at. And Mark, I think from the internal medicine standpoint too, it's equally important to say don't just correct the iron, figure out the why.

You don't wanna miss colon cancer. Yeah, she got colon cancer. Absolutely. A stomach ulcer, she just menstruating heavily, does she have a bladder cancer, something, right? So I think that's really important, you're right. Just don't look at the symptom, look at the cause. 'Cause low iron's a symptom. It's not a cause, right? A little iron may cause insomnia, but what causes low iron? So that's what functional medicine does, it keeps going upstream. And you said something a couple of times that I just want to come back to, which is peeling the onion. So one of the principles of functional medicine from our mentor, Sid Baker, who is this cool old guy, Yale professor, erudite, super smart, one of the most thoughtful men in medicine, people in medicine, period. and he said, you know, we, we have the tack rules that help us sort of determine how to figure things out. One is, if you're standing on attack, it takes a lot of aspirin to make you feel better.

Right.

Take out the tack. So if, you know, the bacterial overgrowth is causing the Restless Leg Syndrome, you can take a lot of these traditional medications, but it's gonna take a lot of medication to make it away. Or if you fix the bacterial overgrowth and the, you know, that'll help. But then also, if you're standing on to tax, taking one of them out doesn't make you 50% better. So she had bacterial overgrowth and she had iron and she had the positional thing. So it's like usually three or four or five things. And the problem with medicine is we are so focused on the one thing, you know?

You know, there was one other piece related to her story that I think is also important to call out addressing all of those things. Her sleep quality was still not what she wanted to be. So we had a conversation and she relayed the fact that when she was growing up, Things were pretty unsettled in her home of origin. There were a lot of late night parties, a lot of noise, and bedtime became a time where she didn't really feel safe and quiet and comfortable. So we also talked about referring her to a life management behavioral therapist to really talk about what it meant to be safe and regaining that sense of being okay being in bed. And I think that goes hidden as well that a previous history of trauma or not feeling safe can also show up with insomnia and difficulty sleeping. keeping.

Yeah.

And I think that's a big thing for a lot of people. You know, there's a questionnaire you can do online called the ACE questionnaire. It's adverse childhood events, and you get a score. And if you have a high score, it means you've had a crappy childhood and you probably have some level of trauma. And different people respond differently to the trauma, of course. But, you know, PTSD is so prevalent and, and our nervous systems are so jacked up in general, so it's sort of like acute on chronic. Absolutely. You know, we've got, like, our acute stresses on this chronic level of PTSD, and it leads to so many physical, psychological, emotional stresses for people that, and there's a lot of ways to sort of access that. You know, I mean, there's, you, you shared about how you use cognitive behavioral therapy or yoga or meditation or breath work or, you know, Emotional Freedom techniques. There's all kinds of techniques out there, but now people are exploring, you know, psychedelic assisted therapy, MDMA, psilocybin therapy, it's legal in Oregon now. And there, you know, there's some interesting research going on, Johns Hopkins and New York NYU and others are really looking at how do we help people with some of these chronic long-term traumatic events and experiences. And I think, you know, sort of listening to, it's just interesting to hear that you're dealing with, you know, something as simple as insomnia can be quite complicated. You have to look at inflammation in the body. It's like, where's it coming from? Is it the gut? Is it heavy metals? Is it hormonal changes? Is it nutrient deficiencies? Is it maybe it's food sensitivities or allergies? Maybe it's low thyroid. There's things that we just don't often think about. And so what's so satisfying with functional medicine is we're able to actually dig into these things and look and see the why. We say functional medicine is the medicine of why, not what, not what disease you have, which is helpful, but it's not the end of the story. We go, why do you have that disease? you know, and that's the challenge with traditional medicine. It's like you make the diagnosis and you stop thinking, okay, you've got depression. Here's antidepressant. You've got insomnia, take the sleep pill. Oh, you've got rheumatoid arthritis, take the rheumatoid arthritis pill. Like not why do you have insomnia or depression or rheumatoid arthritis or migraines, but like why? And that's what's so powerful. So then you sort of, there's some basic sleep practices that are really good. We've covered some of this, but I think it'd be good to go over it. and I think, you know, and I think it's important to emphasize that everything matters, sleep, exercise, stress, you know, obviously your diet plays a huge role, nutrient status, and that's what we do in functional medicine, so we dig down into it. So talk about some of the other factors around sleep hygiene that we sort of haven't touched on in terms of diet and lifestyle and food and exercise.

Sure. I think first and foremost, we have to recognize that sleep, you and I trained in an era where sleep deprivation or how little sleep you could get by on was a badge of honor. We need to shift that internal dialogue that we all have that, oh, if I'm sleeping, I'm wasting my time and I'm not getting my stuff done. So first, honor the importance of sleep for your overall health and well-being, and even your ability to stick to your intentions around choosing healthy foods and sticking to your exercise plan. Then create a sanctuary that's really conducive for rest and relaxation. Dark, quiet, cool, ideally electronics out of the bedroom or turned off if you can. Getting rid of all of the light exposures, even your chargers, you know, that had that light. Yeah, like those like lights, like this.

Red green lights on different devices. I'm like, that drives me crazy. I used to, I had a patient.

Who told me she traveled around with black electrical tape whenever she went to a hotel and she would put it over all the little light sources. That's a great idea.

I travel with eye shades because you never know where you're going to be.

To be.

So those two quiet, calming, and I think this idea that you go, go, go, go, go, go, hop in bed and turn it off like a switch, that doesn't work either. So building in a transition to rest and relaxation. If you can do an hour, that's great. And getting off the devices, not watching TV, maybe reading a book or journaling or doing something, taking a bath, stretching in the tub. I mean, there's all kinds of wonderful ways to ease into to rest of the day.

I like the hot Epsom salt bath and lavender drops because the lavender lowers cortisol. The magnesium relaxes you and the sulfur.

And the Epsom salt helps you detox. That's my favorite as well. And then you go to your cool bedroom and you do your legs up the wall yoga, restorative yoga position and.

Bingo, you've got your transition to rest and relaxation.

So powerful. And alcohol obviously is a big part of it. Yeah, that's a tough one. That's a tough one. So the rough analogy is this. It's funny. When they asked partners of people with insomnia, how many of them were suggesting that they have a drink to go to sleep? It was about a third of them. So people think alcohol is going to help you sleep and it might make you fall asleep. But then as it clears out of your system, there's an arousal that can exacerbate hypoglycemia. It makes you wake up. It's going to make sleep apnea worse. If you're a woman in midlife, oh boy, it's a bladder irritant. It's a hot flash trigger. So it's really Affecting sleep in a lot of ways. The rough equivalent is there's about an hour of sedation followed by an hour of arousal.

Yeah.

So if you had a glass of wine at 6:00 and you go to bed at 10:00, it's probably not going to impact your sleep as much as if you have two glasses at 8:00 or like your late dinner last night, if you had a glass or two of wine. You had a beer.

Yeah. That has another impact on your sleep. I just noticed it actually. I had an aura ring for a while. I was tracking my sleep and I noticed whenever I drank, My sleep's pattern was so disrupted. Quality of sleep, the depth of sleep, the amount of REM sleep, deep sleep, snoring, you know, all that. It's really interesting.

And then caffeine also is another big one, right? Yeah, absolutely. And we're all different in terms of our caffeine metabolism ability. Some people are really fast metabolizers. Sorry, fast metabolizers. I happen to be one of those. But if you're a slow metabolizer, half of your cup of coffee from noon could still be in your system at 9:00 at night. And most of the time we're not thinking back to that noon cup of coffee. With food, it's really about quality, quantity, and timing of food. It's all three. Yet another area that's impacted with the health of the gut microbiome is sleep. And data is suggesting that people who eat a wide variety of colorful fruits and vegetables tend to have better sleep quality, whereas a highly processed standard American diet is associated with more sleep disruptions and less deep sleep. So quality matters. We already touched a little bit on the timing of eating. So eating your calories earlier in the day also helps re-regulate those circadian rhythms. So the clocks in the brain and the clocks in the body that are ideally going to be working in sync with each other, they're influenced by light, by movement, and by food. So when we line all those things up during the day, it's going to help us get the rest that we need at night.

So important. This is such good information. Let's talk about what are the challenges that you see in your clinical practice around women and sleep and what are the main reasons that you're finding and some of them aren't expected. And then let's go into how, you know, there would be traditionally approached by conventional medicine, and then we'll dive into functional medicine.

Sure. So I think the first thing is that some common sleep conditions like insomnia and restless legs, they disproportionately affect women and they can have a connection to lifestyle. Sleep apnea, interestingly enough, gets underdiagnosed for women. And there's a lot of reasons which you can dive into it, but some of it has to do with stereotypes on the part of clinicians of thinking about sleep apnea being a man's condition. Especially if they're overweight. Especially putting weight on around the world. But lean women can get sleep apnea too, and it may show up very differently. There's also the idea that when we look at times of hormonal fluctuation for women, whether that's before their periods or during pregnancy or the postpartum or the menopause transition, that can also cause an uptick in disrupted sleep. So hormone balance and regulating hormones can play a huge role in improving sleep quality. And finally, disproportionately in the past, caregiving demands have fallen on the shoulders of women. I think that really became manifest or evident during the COVID-19 pandemic when you saw a bigger proportion of women than men experiencing an uptick in insomnia, anxiety, and depression. So they're all interconnected.

Yeah.

So women take on the burden of the families. They often, especially during the perimenopausal years, become the sandwich generation between raising their kids and taking care of their older parents. And you're kind of in the middle of that a little bit towards the tail end of it, but you kind of went through that and it puts a lot of stress on women. Also, I think there's some there's some unusual causes of sleep that get missed by traditional medicine. And so, like, if you were a woman and you went to the doctors, like, I'm having insomnia.

What are they going to tell you?

They'll probably tell you to take a sleeping pill. A little Ambien. A little Ambien. Yeah.

Valium.

Right? And/or maybe they'll give you an antidepressant.

Right?

Right.

And of course, those come with side effects. They're additive. They impair cognition. They have all kinds of long-term effects. I mean, the benzos are like Valium, Lorazepam, or Ativan. They may lead to increased cognitive problems like dementia when you get older. Ambien, you know, we heard all the stories about people wandering around doing stuff they shouldn't do in the middle of the night. It's unfortunate that there are other things too that traditional medicine misses that affect sleep. You talked about the big ones, which are the stress and the sleep apnea and the hormonal issues, but there's really more that we know about sleep disruption. And the difference with functional medicine is that we tend to take a detective approach. We don't just stop at the diagnosis. Insomnia is a symptom. It's not a disease.

Right.

And so we go, oh, I know it's why you can't sleep. You have insomnia. No, that's just Just the name of it, silly, that's not the cause. And so we kind of have a different approach. And over the years, there are things we've really uncovered in functional medicine that play a role in sleep that are mostly ignored. So you shared a little bit about it earlier when we were chatting, but what are the kinds of other things.

That we see underlying the root causes of insomnia? So if we think about insomnia, about 80% of people who develop chronic insomnia, there's an initial inciting event, but it leads to a stressful event, for example, and there's something- Like a death or divorce.

Right.

Or a transition with the job. I think the pandemic has contributed to it as well. But then what happens is there's this upregulation of the HPA axis and this chronic overproduction of cortisol is hypothalamic pituitary adrenal axis.

So it's the brain's command center that.

Tells the body what to do.

Absolutely. So it's that connection between what our brain is registering as a threat and how that impacts our need to respond to that threat by pumping out these hormones that then in turn keep us ready to deal with a threat that may not be there anymore.

So basically, if you're in fight or flight, your job isn't to go take a nap.

It is not. Stay on alert and wait for the next thing that's going to threaten you.

So that activated sympathetic nervous system is huge. And our culture just does that. The phone is like a dopamine, you know, pump. It's like a dopamine pump that keeps your blood pressure up. I mean, you know, when people are dying in the intensive care unit, the drug we give them to keep their heart going is dopamine. Right? And that's what.

Great analysis.

You know?

And so, like, it's like at the very end of life, like, if you can't, if everything else, epinephrine fail, everything, you give dopamine because it's so powerful at keeping you awake and alive. And so what everything in our life is the sugar, the phones, all the new... I guess just we're constantly in a dopamine barrage.

You know, it's funny you said that because I've had people tell me, you know, I wake up at 1:30 every night. I said, well, how do you know it's 1:30? Because I look at my phone and it says 1:30. And that, again, perpetuates the cycle because then you're thinking, oh, it's 1:30. Oh, crap. I'm awake.

I should be asleep. And then it just becomes... Yeah. You know, the best thing I ever did for my sleep issues, because I've struggled with them as well, is putting my phone and my watch off, like just taking everything out and not knowing what time it is. And just letting my body do its thing.

I think that's brilliant, Mark. And even sleep trackers, for some people, it can be a double-edged sword because you're thinking, okay, what's my tracker showing me? How well did I sleep last night? So it's that learned pattern.

You want to know my secret for living a long and happy and healthy life? Well, all I have to do is check out my weekly newsletter, Mark's Picks, where I share my favorite tips for health, longevity, well-being, and lots more. Check it out and link below. When you get a good night's sleep, it's like the world just looks rosy.

And when you don't, it looks depressing. Great. And you know, that's an important thing too, if you pay attention to how you feel. So you mentioned the aura ring. People ask me, how good are these trackers for telling you about your sleep? They don't. Diagnose a sleep condition. But sometimes you can gain some insights for you. You gave a great example of this. You found, oh, look at this one. I've had alcohol. My sleep is not... My sleep is not... Sleep, heart rate variability, everything. And then you pay attention, well, how did I feel the day after? Yeah, I was more tired. Yeah, I was more irritable. I was looking for different foods. So I think the more you build that internal awareness of that connection between your sleep and how you feel the next day, that's. That's a whim.

If you love that last video, you should check out the next one for sure on getting the root cause of all disease. Our behavior is the master conductor of all our internal rhythms.

This is good news because it means.

That we are not at the mercy of our genes, our behavior and.