#84 - The Science of Non-Invasive Vagus Nerve Stimulation with Dr. Navaz Habib, Part 2

Welcome to a new episode of The Factor Podcast. I'm your host, Jessica Riddle. Welcome and thanks for listening.

Today we continue our 2-part series on vagus nerve stimulation with Dr. Navaz Habib. In part 1, Dr. Habib discussed how the vagus nerve's regulatory pathway impacts inflammation, the role of acetylcholine in modulating immune responses, and how these mechanisms can be leveraged to improve conditions such as autoimmune disorders and neurological diseases. In today's episode, we will unpack some compelling case studies and explore practical tips you can use with your patients, including diaphragmatic breathwork, dietary changes, And vagus nerve exercises. We will also discuss the promising effects of music therapy on vagus nerve activation and the detailed mechanisms involved, including macrophages, cholinergic pathways, and neurotransmitters. You'll want to be sure to stay to the end to listen to our Q&A segment, where we will go in-depth with the questions submitted by our live webinar audience. Dr. Habib will provide detailed answers and practical advice. Ensuring no stone is left unturned. Whether you're a clinician, therapist, or simply interested in vagus nerve stimulation, this episode is one you may want to bookmark to listen to more than once.

Let's dive in.

I want to go through a few cases. First one is Sandra. She's a 60-year-old mother and a small business owner. And she came to me after having a pretty severe bout of COVID for which she was in the ICU in December of 2021. She had severe brain fog and fatigue and difficulty breathing. She also had some challenges with her weight and blood sugar. So she was actually diagnosed type 2 diabetic. Her hemoglobin A1C was at 9.3 millimoles per liter. If any of you know this, this is a very high finding.

Yeah.

And she refused to go on medication, which allowed for it to become excessive. And especially it went up after having gone vegan in her diet as well, which was obviously— she was trying to do something to help and it unfortunately did the opposite for her. Her fasting glucose generally stood at 154. For those who are interested in knowing this, if you don't already know, anything over 100 is kind of on the high side.

Yeah.

We want to optimally be between 80 and 100, and this fasting glucose was at 154 for Sandra. She had regained a lot of weight that she had previously lost. I dug deeper into her history and found she had a difficult relationship with her mother during childhood, and 8 years ago, unfortunately, had lost her teenage son in a car accident. And she really blamed herself for that incident. She really had these major severe kind of episodes of negative mood and really kind of holding herself down from becoming better. And it was due to that that she started to develop these heart palpitations, especially around the anniversary of the passing of her son. And so what happened here? Well, initially we started doing some targeted probiotic therapy. I use functional lab testing to help identify what's missing. We went on to a higher protein Mediterranean-style diet. We added weight training and walking into her daily plan. She loved weight training, so she— we kept that going. We added in vagus nerve exercises. This was diaphragmatic breathing, humming, cold showers as well. And then we added non-invasive electrical vagus nerve stimulation. We did 2 minutes twice daily on the neck using a handheld device. And the results were astounding. In 4 months, her hemoglobin A1C came down from 9.3 to 7.1. That's amazing. That's a huge, huge positive shift. And even her fasting glucose changed significantly. It hovered now, rather than being at the 154 number, it came down between 95 and 116. This is a significantly positive improvement within a few months of starting this therapy. She also noticed significant improvements in her digestive regularity and any gut symptoms that she was dealing with. And she also had a significantly improved mood, energy, and outlook. And then she sent me a message out of the blue one day. She said, good morning, Dr. Habib. I just wanted to share something with you that occurred to me this morning. Normally, 1 to 2 weeks before and for a few days after the anniversary of her son's accident, I started getting heart palpitations, blah, blah, blah. She says, anyway, I realized this year I didn't have any. It was a much different anniversary this year. We still cried, looked at photos, and told our favorite stories about Ryan. I don't miss him any less. In fact, I miss him more and more each day, but my body handled it in such a different way this year. I wish I could really put it into words. The emotions or feelings are still there. My body just handled it differently. I feel like I'm finally healing. This was an amazing message to get from her. This is actually a screen grab from the message she sent me. This was a really interesting and really positive outcome so far, and she continues to improve. A lot of these data points are a little bit old now, but she continues to see improvement. maintaining a lot of the positive changes that have happened. The second case here, Gurpreet, a 33-year-old pharmacy school graduate, in 2019 suffered from multiple throat infections. She had fever, throat pain, severe headaches, was sleeping between 12 and 14 hours. Doctors recommended antibiotics and put her on prednisone, and she did not respond well during this time. In 2021, then, she had multiple diagnoses occur. She had hepatic neuralgia, T7-T8 herniated disc, a thoracic herniated disc. So that's really difficult to deal with. Severe pain came from that abdominal wall injury occurred at the same time, and she had severely low B12 as well. And we found she had multiple hospital stays for severe back pain after that T7-T8 herniated disc. And in the cyclic fashion, she was laying in bed or in a hospital bed for weeks at a time because the pain was just so severe. She wasn't able to do anything. And because of that, She was unable to complete her pharmacy licensing exams and unable to work due to her pain. She was 33 at this point. She had graduated from pharmacy school a while ago and was unable to complete anything to get any income going or really take care of herself. Well, her history also included ulcerative colitis for about 12 years. A gluten intolerance was likely based on some of the testing she had previously done. iron deficiency in waves, and difficulty falling asleep. Her family history showed a severe alcohol dependency that her mother dealt with. Unfortunately, she was living at home with her parents, and so her relationship with her parents, particularly her mother, was quite strained. Both of her siblings had moved out because the environment was that difficult for them to be in, and she had a very difficult situation there overall living at home. Well, what did we do? We recommended gluten-free, dairy-free diet. We added non-sleep deep rest because she was having a lot of trouble getting great sleep. I added a bit of a yoga nidra non-sleep deep rest protocol, plus meditation and breathing practice before bed to help her get into a state where she was able to fall asleep more easily. We added probiotics and herbal therapies based on her stool test findings. We added vagus nerve exercises, diaphragmatic breathing.

Hmm.

Short walks in nature with breaks. That was a big one for her as well. And then we added non-invasive vagus nerve stimulation, 2 minutes twice daily. So actually it was 2 2-minute stimulations, so 4 minutes in the morning and 4 minutes in the evening before bed. And here's what happened. She got up to being able to do between 4,000 and 9,000 steps per day from being essentially bedridden or stuck in her hospital bed. This was a really big change for her. She began studying to write her licensing exams. She actually wrote them just a couple of weeks ago. She's been waiting to feel capable of doing this for about 4 years. So this was a huge shift for being able to do it. She's beginning to work 1 day per week. So progressively getting to a point where she's able to work more. She was beginning to fall asleep without the use of medication every night. On the rare occasion, she would take some melatonin or something to help with it, but she didn't need to all the time. And she began waking up naturally feeling rested at 8 AM instead of it going till 11 or 12 when she did eventually fall asleep previously. And what's exciting is she finally feels like she is on a healing path. I'm speaking with her next week to hear how things are going and how she did on her exams. And at this point, she's nearly able to get back on her own 2 feet, which is really exciting for what she's able to do. Going forward, there's one last case I want to go through quickly, and that is the case of Vlad. Vlad was a 73-year-old retired film producer. 13 years ago, was diagnosed with Parkinson's disease. His first symptom was actually anosmia. He lost his sense of smell. Ended up resulting in very low energy, significant body stiffness, weakening of his voice, difficulty swallowing, and a flat affect. He just was not feeling himself. And I had a lot of calls, not only with him, but his wife was on a lot of these calls. And she used to say, this isn't the same Vlad anymore. Like, he's just become somebody different and he's just not happy the way that he is. And this was a really kind of sad occurrence in their life because they tended to be very happy and upbeat and active people. One year prior to the diagnosis of Parkinson's, this was something that came up later in history. We found that his son was involved in a very severe car accident and actually spent 8 months in the hospital. So major family stressor. But what was important here was that Vlad was almost like the glue that held the family together. He really strained himself to be able to handle this, and this may have been the final straw that broke the camel's back in creating the degeneration that led to the Parkinson's disease diagnosis. Well, we started to make some changes to things around what he was doing. He continued his medication use. He went onto an anti-inflammatory diet, just essentially more of a whole foods style of diet. He loved playing pickleball, so we had him continue, but he just didn't have a lot of energy to be able to do a whole lot early on. But we said, keep it up because it's something you love to do and I want you to keep trying. We added some vagus nerve exercises and diaphragmatic breathing, humming, and cold showers in particular, and added in electrical vagus nerve stimulation. We found 4 minutes twice daily was good, but he found that it actually affected his sleep negatively. It was too energizing for him to use this, which was really interesting. And so we shifted it so that it was 2 minutes in the morning and 2 minutes in the afternoon rather than being at night. Here are some final findings. Number one, significant improvement in his energy and affect. He just was beaming with energy and capability and able to go out there, and his mood has just shifted entirely. He got up to playing pickleball 3 to 4 times weekly. Actually like a superstar pickleball athlete. His tremor frequency had reduced. He was able to start using his breath to help to limit the severity of his Parkinsonian tremor. And he started sleeping significantly better. And then this was the coolest moment for me. 10 days into his treatment, he called me and he said, I can smell my wife cooking bacon downstairs. He had a sense of smell back within 10 days. This was a really cool experience, a really wonderful thing to hear. And since then, he's progressed significantly. Not only does he hear or smell the bacon cooking, but he's actually able to smell about 60 to 70% of the time now, which is really, really exciting for somebody who had lost sense of smell previously. So really exciting to share these cases with you. The 3 clinical pearls that I want you to take away from this talk. Number 1, assess the patient's autonomic state and resilience. I'm a huge proponent of utilizing Wearable technology where it's available. So looking at things like heart rate recovery and heart rate variability, these are important. We don't need to get into these, definitely don't have time to get into these right now. And look into GI function because it is heavily correlated not only to autonomic state but to inflammatory conditions overall. Rule out any past MTBI— these are minor traumatic brain injuries— or major stressors as a root cause. Look into these things, whether they be psychological or physical in nature, because they are major stressors linked to triggering inflammation, and a history of TBI is heavily correlated with vagus nerve dysfunction directly. Lastly, nutraceuticals, supplements, herbs— all these tools that we utilize in practice often have a much greater efficacy when a patient is in a parasympathetic state. For those who don't know, the autonomic nervous system is split into sympathetic, which is fight or flight, Then parasympathetic, which is rest, digest, and I've added recover as well. That's necessary. We can't— a car needs to stop in order for a mechanic to fix the car. In the same way, our body needs to slow down and stop so that we're able to go into a state where it can be healed. The parasympathetic nervous system is that rest, digest, recover system. When this is working, remember, it's rest, digest, and recover. That digest piece can often be overlooked. When we start to throw patients on supplements and other nutritional tools, they may not be actually getting them into the body. These nutrients can actually get into the body when the patient is in a parasympathetic state to begin with. What vagus nerve stimulation is, is a state shift tool. It's a tool to help you shift into a parasympathetic state where healing can occur. That's really key to making this whole system work. I want to share really quickly, this is my book, Activate Your Vagus Nerve. This one's a bit old now. It's a wonderful book from what I've heard, and I love the work that I did here, but a lot of new research has come out. In hearing about all of this new research and keeping up to date with it, the decision was made to write a new book. The new book is called Upgrade Your Vagus Nerve, and it will be available February 6th, 2024. I'm really happy to share this. with all of you. Pre-order if you're interested. I would love to have that occur, and I would appreciate all the support I can get.

Ready to transform your practice with groundbreaking technology? Join us for our next Faktor webinar on Wednesday, July 31st, to discover the latest advancements in whole-body electrical stimulation and its incredible impact on autonomic nervous system dysfunction. Learn from an expert clinician about the science, applications, and proven protocols that are enhancing patient outcomes, especially for conditions like Long COVID. Don't miss out on this opportunity to elevate your expertise and improve your patients' lives. Click the link in the show notes to register for free.

And I would love to share a tool with all of you. This is an infographic that you could utilize in your practice Completely free of charge, where you'll enter your email address and you'll be able to get a very high-quality infographic tool to be able to help drive your patients to understand how the vagus nerve works, how to assess its function, and basic tools and exercises that can be utilized to help improve overall vagus nerve health. And would love to answer any questions. All right.

So, thank you so much, Dr. Habib. This has been wonderful and very informative. We did have a few questions that were submitted throughout the talk today. One person was asking about one of your case studies, I believe, where you mentioned electrical stimulus 2 minutes bilaterally. Was that 4 minutes total? And— okay, perfect. So for 4 minutes total.

4 minutes total. So, There hasn't been a ton of research as to which side is recommended and if we need to do it on one side or the other. What I've found is I test it out with people. I have them choose the side that they're comfortable with first and then continue on that side. But if we're not getting the result that we're looking for, then I'll have them do it 2 minutes on one side, 2 minutes on the other. And that can be 4 minutes in the morning, 4 minutes in the evening. Or both. And depending on the severity of an issue, I'll have them do it more often. That's basically the driving consideration that I have there as to the sidedness and the quantity of stimulation that you're going to do, or duration.

Wonderful. Thank you. One of the things that you were speaking about was recommendations that you had for patients regarding yoga, kind of easy body movements depending upon where they are. Do you find that usually when you have students— or I'm sorry, patients that are in that very hyper-stress, high cortisol state, that it's best to start them out with easier ways to start with exercise and body movement?

Yeah, always. There's no question. If we're doing body movement stuff that's straining or difficult, it's just adding to the cortisol response. It's adding to the sympathetic activation. I don't want to do that. I want to do everything I possibly can to go parasympathetic first. Often, one of the first things I'll add in is just simple laying on your back, hand on your belly, hand on your chest, diaphragmatic breathing practice where we're getting a feedback tool as to are we breathing diaphragmatically or not. One of the things that is often overlooked is that A vast majority of people out there are breathing incorrectly. We're often using accessory breathing muscles, particularly upper traps, rhomboids, muscles, the intercostal muscles that are between the ribs. And we can get a lot of this tightness and rib dysfunction and thoracic spine kind of hunching because of terrible posture from being on cell phones and laptops all the time. So what I, what I recommend is let's just slow everything down, especially when somebody is in a high stress state.

Yeah.

We don't want to overdo. We don't want to push so hard that we throw them off the end of the cliff and burn them out. We don't want to go in that direction. What we want to do is really create a shift towards overall healing and overall just a positive shift towards a parasympathetic state. Again, I think the breathing exercises are often the first tool that I'll recommend, and it's just a very simple Then we can add the movement in secondarily. We want to get to simple first.

Absolutely. If you could walk us through what your typical— and I know every patient obviously is unique and different, but do you have a standard set of assessments, testing, lab work that you do with your new patients? I know I've heard you mention things like stool evaluation, different lab work that you may have them undergo. If you could just kind of give us a rundown of what that looks like in your office.

Absolutely. So not every patient will undergo functional lab testing, but it is a big component of my practice. So often one of the first tools is a very in-depth assessment of history and kind of a holistic assessment of how everything's currently going. I like to lay out all the puzzle pieces and my intake form, if we were to print it out, is somewhere between 17 and 30 pages. So it's quite extensive. It takes the patients a while to go through that. And then when we get into the actual biochemical analysis, the functional lab testing that I use is stool testing, which you mentioned. I have used a couple. One of my favorites is the GI-MAP test from Diagnostic Solutions. That's a really simple one and great research and great findings and outcomes in using that. Test for the last 7 years or so. So that's up on the top of my list. And I really like organic acid testing. There's a few really good ones out there from different labs. Organic acid testing helps to identify the breakdown processes of particular cellular processes. So when we have the presence of kynurenate and quinolinate that are very high, that means that serotonin level is quite lower. It's just not being produced in the right way. Being able to see that and under— and extrapolate certain information as to cellular function, that's top of my list. I love seeing those things. And it depends on the case, obviously, if there's more of a gut component to this patient's health versus more of a cellular energy-based metabolic component. I'll often make a decision between those 2 tests if they've got financial burden or something to stop that. But where possible, a full panel of those 2 for sure is on the top of my list. I also will occasionally utilize a Dutch test to help identify hormone function as well. So those are great options that I use in an assessment tool manner. And then depending on the severity of any psychological stressors, there are some, some tools that we'll use, things like GAD-7 as an assessment tool for outcome measures on anxiety.

Wonderful. And I know that's become so much more prevalent now within the physical medicine space is really looking at how the brain, how mental health can affect physical pain, because we're— again, I think we're just kind of on the cusp of learning more about that and how the brain really can affect so many different things within your body. There's not always a physical, or I should say a musculoskeletal cause of complaints that patients may come in with. One of our attendees was asking about the use of tapes or kinesiology tape over those vagus nerve pathways, possibly like a lattice. Tape patch of some sort?

That's an interesting thought. I love taping as a tool of proprioception and fully understanding and creating awareness as to motion patterns and movement. It's not something I've ever seen because it's not going to have a direct effect on the vagus nerve, which is deep to a lot of those tissues that are feeding back. But I wouldn't be surprised if there was something interesting that occurred there because of the awareness. I don't think it's a direct vagus nerve stimulator, but I think it absolutely could play a role in creating more body awareness that allows for somebody to enter that parasympathetic state more readily. Great question.

Absolutely. That definitely is food for thought. I know we utilize biomechanical taping in many of our courses. That's a bit different from kinesiology because not only does it provide that external input Of just the kind of the skin surface, but then also kind of shifting and offloading some movement patterns as well.

Yes.

And our practitioner was saying they've had some very interesting happenings with that technique. So we would love to, to hear more about that for sure. I should connect the two of you on email and see if you can maybe share some thoughts or ideas and, and some case studies there.

Okay.

Going back to some of the case studies that you were speaking about. specifically the patient that was in just a really difficult life situation, high-stress environment.

Yes.

What type of kind of quick-win, easy recommendations do you typically give patients that are in maybe a high-stress job or something that they can do while they're driving in rush hour traffic, while they're at their desk, just to kind of help them shift into more of a parasympathetic state? throughout their day?

One of my favorite ones, something that I think is overlooked a lot but can be very beneficial, is listening to music. And there's a really interesting set of research that's been done on particular musical types, particular compositions, to create a bit of a shift passively because it's so, it's so simple to just listen to particular music. So If you're sitting at a desk in a space where you can put on headphones and kind of sit and focus on something yourself, I would recommend listening to, in particular, classical music. Mozart and the Mozart effect are real. It's kind of cool to see. And what we found, there was a particular one that I had researched a long time ago called K.448, Two Pianos. And that composition, it's available on YouTube and Kind of anywhere on Spotify and such. And if you can listen to that, it's about a 22 or 23-minute composition. And what was found was those who listened to that composition actually had an increase in their HRV, which is a direct sign of vagus nerve activation. A great passive way to create a positive shift and get into kind of a focused state is just listening to music, and classical being amongst the top, or something that's just very calming. Instrumental music overall tends to have a bit of a calming effect. I'm not a huge fan of— I know when I'm sitting and writing my books, I don't love when there's words in the songs because I'm trying to think of words and the music is helpful, but the words kind of distract. Classical music or instrumental music is going to be kind of a quick win. Then I would definitely add in, as simple as possible, just diaphragmatic breathing in the morning and the evening. Great little bookends to the day, great ways to get the body feeling like it, it gets you moving in the, into a calming space and gets you moving as the day starts and bookend the day as it ends. So I'm a big fan of utilizing something simple like diaphragmatic breathing.

Going along that same vein, when it comes to breathing, one of the things that we often incorporate in a lot of the rehab assessments that we recommend in many of our courses is to really look at how patient breathes.

Yes.

We've done webinars about how that can affect so many different things from a movement standpoint, but it sounds like that really has a direct effect too on your vagus nerve. Is breathing something you look at with every single patient? And then how do you— or how difficult has it been sometimes to have them change those patterns when they really have disordered breathing issues?

It's difficult to assess it really directly because I work with people remotely, but there are specific tools that we can utilize. One of my favorites is a test called the BOLT score, B-O-L-T, Body Oxygen Level Test. This test, I learned about it first in a book called The Oxygen Advantage by Patrick McKeon. I would highly recommend anybody who's interested in learning about breath and breathing practices to definitely, definitely read this book. The BOLT score is a great way to assess this, something I talk about in the second book quite a bit as well. And what this is, is how long can a patient hold their breath, hold an exhale without feeling like they absolutely need to breathe in? And how, how long can you maintain essentially resilience to high carbon dioxide. So anything below 10 seconds is a sign that this person has incredibly dysfunctional breathing and has essentially set themselves up to not be able to handle any carbon dioxide buildup in the body. So very low resilience from the breath. Between kind of 10 to 20 seconds means it's dysfunctional, it's not great, and this is an area that we can really improve. The breathing on. The average score is somewhere between 20 and 39 seconds, and this is good but not optimal. We want to be able to maintain a held breath for as long as possible, and anything over that 40-second mark is what we're looking at as being an optimal finding on the body oxygen level test. And this is something that is very dynamic. It can change day to day. It can even change hour to hour. But I have my patients do a BOLT score test every week. And when they do their BOLT score, the same time every week, so it can be Sunday morning at 8 o'clock in the morning when they wake up or earlier, whatever time, but then within kind of the first half hour of waking up, I'll have them do a body oxygen level test. And that will help me identify trends. Are they improving? Are they getting worse? What's happening there. And there are specific exercises and practices that are talked about in the Oxygen Advantage book to help improve that BOLT score. And what you're essentially trying to do is improve how efficient your body is with oxygen, and that will help change breathing patterns in one way or the other. The other thing we want to do is focus on the nose as the pathway by which air flows. We have our nose, which is our breathing tube, and we have our mouth, which is our eating tube. And both are kind of backups if the other one goes down. But really what we want to do is focus on that, on the use of nasal breathing as the main driver of the intake and output of air. So those are things that I am never quiet about with my patients. I make sure they all know about this.

There's been a lot of discussions lately when it comes to brain stimulation for people that are neurodivergent. So those that have ADHD or who might be on the neurodivergent spectrum in one way or another. There's been talk about brown music or brown noise, white noise, different frequencies and waves and types of music. I know you had mentioned the Mozart effect when it comes to vagus nerve stimulation.

Yes.

Are you finding that a lot of the research that's being done regarding music therapy and these different wavelengths or these different tempos or cadence of music Is that also involving the vagus nerve, which is why it has that effect on concentration?

Yeah, I definitely didn't have time to get into it, but I'm very happy to share this. Vagus nerve stimulation, or vagus nerve development when we're younger, is often— this may seem a little woo, but it absolutely is real, and it's what the entire polyvagal theory is kind of based on. The development of A good functional strong vagus nerve is reliant on mid-level frequencies, not high, not low, but mid-level frequencies. These are audio inputs that come into our ear. Think of it this way. A nurturing voice from a mother will help to create a feeling of safety within the body. The vagus nerve will be activated when there is a feeling of safety, and that nerve will get stronger because what it's signaling is safety to the body. That's really cool because as we get older, if we don't get those signals of safety in because our parents are screaming at each other one at a time, or mother is sadly dealing with postpartum depression and just is in a high-frequency state all the time, or a low-affect mood and not able to provide care that is optimal for their child, that child will take in these high and low frequencies, and that actually decreases the development of the vagus nerve and strengthening of that nerve bundle. This is research that's been done by Dr. Stephen Porges, who's a neuropsychologist and just brilliant, brilliant gentleman. He developed something called the polyvagal theory. For those who are interested in digging into that, please do. It's a whole rabbit hole of understanding why people experience challenges. And one of the tools that I've recently become aware of, and I'm starting to utilize with patients with phenomenal effect, is a protocol that was developed by Dr. Porges called the Safe and Sound Protocol. And what it is is music that's specially filtered to have mid-level frequencies only, and then slowly move out into the higher and mid-level or higher and lower frequencies over a progression of 5 hours. I recently became certified in the use of SSP, Safe and Sound Protocol, and I am just astounded by some of the changes that we can create when we help patients rebuild that mid-level frequency area through auditory inputs. So I'm a huge fan of helping to build brains back up using interesting changes that can come in through auditory signals.

That is very fascinating. And I know, again, that was really a great resource as well. There's another book that I recently read called Scattered, which has to do with ADHD. And he does talk a lot about this theory that sometimes the environment in which you develop in as a very, very infant, young child can really affect your brain's ability to function optimally later on in life.

Absolutely.

When it comes to how you treat patients, and I know we have only a little bit of time left, guys. So if you have any other questions, certainly chat those in. This has been a really great discussion. But when it comes to the team of providers that you work with, oftentimes when it comes to co-managing your patients, do you find that you often have strong relationships with mental health professionals, with medical doctors? Like who is kind of your, your A-team when it comes to co-managing care?

Often clients will come to me with their, their own primary care provider already in line. And so I make an effort to ensure that we are working together to create a positive shift in the health of our clients. I send letters or messages out to these, these doctors to ensure that we're all on the same page. I will find that most medical doctors are very happy to go along with what we're doing and And accepting of some of the things that seem outside of their normal scope. So very happy to, to have those great discussions. We obviously will have some that don't go positively or don't love what we're saying or doing, and so they tend not to work with. But I have a team of people that I refer to where necessary. And so yes, medical doctors, nutritionists are a great part of my tool— my team as well. And mental health professionals where possible, because often we just need to talk through things. And I'm not an expert in that, but I know there are a lot of people that are great at talk therapy. Wonderful.

Thank you so much. And again, we very much look forward to hearing more from you in the new year, certainly when your book is released in February. So, and then how can they get in touch with you? Do you have social media accounts that they can follow you on, or how do they learn more about what you do?

Absolutely. I've just shifted the slide here and there's some links there. So the website for the company is healthupgraded.com. You can email me directly. I'm happy to answer any questions for clinicians that are looking to make some changes in their practice or want to integrate something cool in there. And on social media, it's @DrNavazHabib. That's particularly on Instagram. I tend not to do the Twitter thing.

That's it for today's episode. Be sure to tune in for our next episode where we feature a new 2-part series titled Swing Sport Smash Factor Athlete Evaluation and Treatment with guest instructor Dr. Joey Guinto. We will take a deep dive into the dynamics of weight transfer, rotational strength, core stability, And movement patterns for swing sport athletes such as golfers, tennis players, baseball, and softball athletes. You won't wanna miss it. Episode 85 launches in 2 weeks. Be sure to visit our show notes to access the link to our website where you can use our AI chat feature to access the full episode transcript or ask questions to extrapolate key points, get insights into how to implement what you've learned into practice, and more. And finally, don't forget to join us for our next webinar on Wednesday. July 31st at 1:00 PM Eastern Standard Time, where our topic of focus is advances in electrophysiological neuromodulation technology and its incredible impact on autonomic nervous system dysfunction. Click the registration link in our show notes to get the link to the free webinar event. And if you can't join us live, don't worry. All registrants will receive a link to the recorded replay after the live broadcast. We'll see you next time.

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