Ancient Wisdom Meets Modern Neurology with Dr. Trupti Gokani

Dr. Shubhti Gokani, welcome back. I think it's been like a decade.

It has been, yeah. Has it?

Where have you been?

Where have we both been?

We've been busy. Clearly you've been busy, but now we've got another book coming out, so you're back on. And so we have to reintroduce you to everybody. Sure. And you've got an interesting background as a neurologist and an Ayurvedic practitioner. So how did those two come together? What happened?

Was not by choice. It was not by choice because these are two different worlds, completely different worlds. And you know what's fascinating in life, I think we all have been through this, is sometimes life directs you somewhere and you didn't plan on going, and you realize everything happens for a reason. So I was a first-year medical student doing my thing, working hard, studying hard, and suddenly I started struggling with sleep issues. And it was a few nights a week, and then it was every night, and then before you knew it, I wasn't sleeping at all. 3 months had gone by. My dad, physician at that time, did my labs, told me I was fine. You know, labs are fine. You're healthy. There's nothing wrong with you. I don't know what's going on. Just this will get better with time. And I thought, there's more to this story. I don't know what's going on. So kind of—

What kind of doctor was he?

Primary care internist. Fabulous internist. Really well-practiced, you know. And I think just following conventional medicine, right? Following the— Yeah.

And it's, well, it's funny too, like conventional medicine, Like what labs would you look at to see in conventional medicine that you—

So I remember he said, "Do you have," and kind of this makes sense, blood sugar issues, right? Hypoglycemia, interrupting sleep, thyroid issues, you know? Those, I remember, the two big categories. He's like, "You don't have diabetes or thyroid issues, so you're fine." You're fine. But then again, we weren't doing optimal lab testing like we do now with functional medicine, all these beautiful things. But at least, you know, in his frame of mind, he's like, "I ruled out those things. Your exam is fine. You're a healthy person." And so then where do you go next? You go to the therapist, right? And I go to the therapist and the therapist's favorite question, I remember this like it was yesterday. She said, "Do you feel stressed?" Now mind you, I'm a—

You're a first-year medical student.

Medical student. I mean, do you need to even ask the question? And my answer was no, because what did I know? And it was a fascinating thing. I look back at the me then, 30 years ago or so, and yeah, I actually did not think think I was stressed. 'Cause you know, 30 years ago, what did we, you know, we didn't really talk about stress the way we discuss it openly now. And coming of an immigrant generation where you work hard, be hard, everything is work, work, work. That's all I knew was that personality, that way of living. So, you know, to me I was like, my family is great. I have a wonderful boyfriend. I'm doing great in school. Check, check, check. I'm not stressed. I'm great. Oh, well, you know, I remember her teaching me a breathing technique and then saying, you're good, there's nothing wrong with you. So I got ruled out by the primary care doctor, my dad, ruled out by the therapist. Where next? So then I decided, 'cause this continued on and I was ready to quit medical school. You know, I can laugh about it now, but I was actually ready to quit. I was like, I can't function. It'd been 3 months of just not sleeping. So then my dad said, why don't I take you to my really dear friend, the psychiatrist. I'm like, all right, let's go. I'm ready. So, so excited. I actually was excited for this visit. I remember. And I went to this office, I got there a little early, you know, waiting out there, called me in, sat down, I was ready to go. 10 minutes and 8 questions. He did the SIGICAPS, the acronym that's used for diagnosing depression. Do you feel sad? Do you have insomnia? Do you have any guilt? Do you have low energy, low concentration? Goes on and on. I'm saying yes to a lot of these. Low concentration? Yeah, I haven't slept.

Well, if you haven't slept, of course you have low concentration.

Low energy? Like how the heck am I gonna have energy if I haven't slept in 3 months? So I, you know, I'm kind of like going through this wanting to say yes, but he just said yes or no. It's almost like being in a deposition. Yes or no. Don't give me an answer. I was like, so he's like taking notes and he's nodding his head, taking notes. And by the end of the, you know, 8 questions, I, I said yes to 6 and he said, oh, you have depression.

Oh, now you get Prozac.

Bingo. See, who needs to go to med school residency? You're just like, okay. So seriously, 10 minutes, 8 questions. I mean, I laugh about it now 'cause it's how many years later. And I remember just being stunned. I thought this was gonna be this like really deep introspective, like we're gonna, I watched Hitchcock back in the day. I got into like deep thinking and I was like, this is gonna be so interesting. He's gonna figure this out. He said, here, Prozac and 'You have depression.' And I walked out the door, I'm like 24 or so, prescription and diagnosis. And so then where did I go? The bookstores. And then I found Ayurvedic medicine.

So how long did I— But how, like, how did you— you went to the bookstore?

Yeah, yeah. So here I was in between histology and anatomy books and studying and then taking study breaks and going to the self-help section, and I would look at these different books. The first one actually I read was, um, not Ayurvedic. It was Bernie Siegel, "Love, Medicine and Miracles." Brilliant man, recently passed, right? And then I read Andrew Weil's "Spontaneous Healing." So just kind of getting into that space. And mind you—

Oh boy, you are going down that rabbit hole.

I'm going deep. I'm going deep. And mind you—

Don't tell dad.

Don't tell dad, right? I'm Western, Indian of origin. Here I am, born in Africa, kind of kicked outta the country. There's a whole story there. That's a different story for another podcast.

Okay.

I was smuggled out. We'll share that story another time. Yeah, there's a whole crazy story there. Point being, I wasn't trained with Eastern medicine. I was trained very Western, came to the US at a very young age. My mom spoke, you know, only spoke to me in English. She wanted me to speak well. So we were very Western. So when I went into that space, that world that I didn't even know existed, okay? And we had 5 channels on the TV station. Like there weren't a lot of, who's listening now that's young? We didn't have all this cool, interesting, we didn't have the internet, we didn't have all these things. So I walked in.

This is well beyond 40. Everyone knows what you speak of.

I'm in my 50s. Everyone remembers. Everyone remembers. Okay.

We don't have the, the, the, the channel going off the air.

You know, friends might be sharing it with their daughters and others that may not know that world that we lived in. So what is, you lived with 5 channels on your TV that went to like a fuzzy screen at the end of the night. So, so it was interesting because I, I actually didn't know anything about this world. And so I started reading these books and I found them fascinating. Started learning about mind, body, spiritual healing and thought, okay, what, what is this? And because I was so desperate and so open, because I wasn't brainwashed, I was only a first-year medical student, you know, and I'd never really seen a physician. My dad was my doc, you know? So it was actually a beautiful space to enter into that world. And I started with Deepak Chopra's book, Perfect Health, you know? And I did a little, call it a Dosha quiz, learning a mind-body type. Learned that I was extremely Vata imbalanced. That's wind imbalance. We can go through this in a moment. And, uh, my diagnosis was a Vata imbalance, imbalance of the wind energy. And it wasn't something that was going to be easily seen in labs or on an exam, though I had a lot of those features of wind imbalance. And so started to follow the protocols started sleeping really well again and no medications. Here I am, 53, sleeping well and do not have depression, you know. So I'm so grateful that I kind of took that path, you know.

Okay, so wait a minute, so this is your first year of medical school, you read, uh, you read this book, you start to look at these different Ayurvedic types. I actually took Ayurvedic medicine in grad school.

Cool.

I took a course in it. It was fascinating. I'm trying to remember which type I was, but I can have a guess. It's— are we— do we have a quiz that everyone can take?

There's actually a quiz on my website. It's this stress— yeah, it's a stress personality.

And I'll go through my strategy, put that on there so everyone can take their— take their test. But what it— so, yeah, but I have to ask, like, what did your dad— you read the book, you, you fixed yourself. Yeah. What'd Dad say?

You know, love, love, love my dad. He's a great guy. And I think he, I'll preface it by saying he trained in India, which you'd think, well, that's great. I mean, shouldn't he be open to Ayurveda? It's based in India. The British, when they colonized, they actually shut down that system. They didn't allow Ayurvedic practitioners to practice. And in fact, a lot of them practiced behind the scenes because the Western system was the more, you know, elegant, better system to practice. And so when my dad trained in India, and a lot of Indian doctors, it's just important to know this, there's a whole generation that trained in India that weren't exposed to Ayurveda, even though it's 5,000 years old. Wow. Because during that time it was not allowed to be kind of practiced. So in 1971, ha, the year that I was born, it actually became back, it was allowed back into the healthcare system in India. So there's an entire generation. So my dad was one of them, trained in India, didn't get exposed to it. And what was kind of like, just even today, today we can think about this, the Western way seemed to be the better way. So when I told him about this, he just thought, are you doing Ayurvedic medicine for yourself? Why would you do that? And there was a lot of skepticism, yet he was just, you know, happy that I was feeling better, and he was happy that I didn't take a prescription. He didn't get what I was really doing, and I'm happy to share that later, though he didn't want to argue if it was working. So he's like, "Okay, I'm not sure I get it, but that's all right." And I went on my path and yeah, and it has forever transformed me.

I mean, inspired me. So you went down your path, but you became a neurologist. How did you, like, were you studying, kind of studying Ayurvedic on the side? Like, how did you incorporate the two of them together?

Yeah, so it's almost, you know, once you see, you can't unsee. So suddenly as I saw that world, I almost couldn't not see that world. And so what I started doing, and of course I'm in medical school, I'm just trying to survive, you know, survival mode of just getting through medical school. I kind of kept it in my back pocket. I practiced. So one of the things, and I was listening to one of your earlier podcasts, and I appreciate that you said this, one of the things that I started doing back in my 20s was yoga. And I was not a yoga person at all. I was doing, remember Tae Bo, kickboxing? That was my thing. Like I put the DVD, the VHS in and every day come back from class and do kickboxing. And I was the last person, like honestly, yoga was not in the cards for me. And Deepak Chopra in his books would write the importance of meditation, yoga, changing your thought patterns. And I said, okay, let's start. Doing some yoga. I was up anyways. I wasn't really, I didn't have the energy honestly to do a lot of the more aggressive workouts. So I started with the simple kind of techniques of practicing very, very gentle poses. And what I realized was that I started practicing Ayurveda without really realizing I was practicing Ayurveda.

So it's like it was in your DNA.

Yeah. Yeah. I felt like I was just called to it. Yeah. It was almost like I had to have that, eye-opening, no pun intended, experience of being awake all night to get me to see that this is a path that not only it's important to start to discover for myself, but really share it with as many people as I could. So I went through med school, I kept on practicing some yoga, some of those techniques that were taught. One of the other things is an Abhyanga massage, and it's a warm oil massage. And when you do this massage, in fact, I just recently heard a podcast, you'd find this interesting, about using it for working out and before workouts, massaging your joints with warm oil, which sounds very interesting. Why would you do that? But the oils, especially ones that are like sesame-based, they're warming, coconut is cooling. So if you're the windy, we'll go through the types real quick, but when you're a certain type, the different oils can help your joints and your bones. And we can discuss that before working out to strengthen.

Oh, so let's go through these types.

Yeah, let's go through that. Yeah, so it's kind of cool. So here I am reading this book. Imagine just kind of this idea of Ayurveda, A-Y-U-R-R-A-Y-U-R means life, Veda is wisdom, the wisdom of life, the wisdom of longevity. And you and I both have heard the longevity is going down. And it's really sad to hear that we may live longer lives than our kids because of the incredible medicines.

I know, and here everyone in India wanted to be Western. And I'm like, worst health in the world.

Worst in the world.

You know?

Crisis, right? Our numbers are what? $4.5 trillion in healthcare spending going up to $6.28 trillion, you know, probably in 2028.

And we're the sickest, like, I think we're one of the sickest countries in the world. Sickest countries in the world. If not the sickest.

And the highest stressed and very, very, very sad situation. And I do a lot of migraine work and migraine is just, like I mentioned earlier, I wrote this book, "Mysterious Mind," and that was in 2015. And I thought, oh, that's gonna move on to the next book, you know, it's coming. And honestly, I'm spending more time talking about "Mysterious Mind" now and migraine because migraines have worsened and vertigo has worsened and all these neurological conditions are worsened.

Why is that?

Really, I do think it's down to the kind of picture of us being disconnected with ourselves, which Ayurveda helps us solve that answer. Gut and processed foods and imbalance of digestive function, putting that together. When you're disconnected, you're more stressed, you're more likely to feel stressed, carry stress, and then that impairs the gut microbiome, and then it's top-down, bottom-up. So if we can kind of get to the core of those areas, we can become healthier and live longer lives and not have to worry as much about being dependent on the physicians and the prescriptions. And so Ayurveda—

Clearly what we're doing is not working. Not working. Like all this advanced medical care.

It's absolutely a mess and we're getting more expensive and everything is getting— I'm just even watching it. I'll get into Ayurveda, but just for a second in the migraine space, when I practiced early in the years, you know, some simple little tools, you know, medications here and there, abortives here and there would work, and we'd kind of allow patients to get better. And now we've got these fancy injectables and all these fancy tools, and I'm thinking to myself, not that— I mean, I'm happy that we have them, I'm really grateful we have them. Why have we forgotten, you know, some of these simpler methods? And we're getting fancier and fancier, and I think it's important to keep in mind that just because something is older doesn't mean that new is better, right? Right. And I just wanna remind myself even of that sometimes. You get caught up with that like shiny object thing, right? So Ayurveda takes us back to the ancient roots. And so Ayurveda is based on the concept, again, ayur means life, veda is wisdom. The Vedic civilization was in Southeast Asia 5,000, 6,000 years ago. Ayurveda was based kind of that Vedic civilization moving on to India. Homeopathy and traditional Chinese medicine all come from that same civilization. So you'll hear some themes. It's all about going back into homeostasis, going back into balance, bringing yourself into alignment, clearing the blocks, be it the blocks in the meridians, blocks in the prana, the channels of energy to create optimal flow and of the mind and the body. So how do you like get there? In Ayurveda, the belief is the 5 elements. Are Air, Space, Fire, Earth, and Water. All living things have 5 elements. A plant, a pet, a human, all have 5 elements. The unique thing, we have different elemental makeup at birth. So to keep it simple, we might say someone is born with more of the Air and Space element as their dominant nature. We call that Air and Space element nature person is a vata, V-A-T-A, vata type. Fire and water individual is the pitta, P-I-T-T-A person.

I think that was what I was.

That's what you are. I was gonna tell you. I've known you for a while. And the pittas are fabulous. I'll go through all three. I mean, they're all fabulous.

Of course they are. They're fabulous. All are fabulous.

Yes. All are fabulous in different ways if we keep 'em in harmony. And the last one, earth and water is the kapha. So K-A-P-H-A. So vata, pitta, kapha. Vata types. Think about, if you're listening to this, who were you when you were younger and try to think of your nature, right? It's the best way to think about this, 'cause this is our birth nature. Then we get thrown off 'cause of life. Vatas are individuals that tend to have longer frames, tend to be longer bone, usually smaller, kind of, I think of Ally McBeal, you know, kind of moving, going, body is moving, mind is moving. Very enthusiastic, often the life of the party, loves to talk, very interested in doing new things, says yes to so many different things and likes to be involved, enjoys being around a lot of creative people and things and doesn't like to be in one spot. Often choose jobs of sales and creative pursuits. They are artists, they're musicians. That's the Vatas, right? Vata in balance is great, creative, spiritual, artistic, moving, going, doing. The Pittas, more muscular, more driven, fire and water element, can see how things need to get— be done and get done. And really, you want to put a Pitta in charge, like yourself, of tasks, because Pittas are like, I'll get this done, I know exactly how to see this. And you almost help another person find that solution. So Pittas are driven, they're competitive, they're often muscular. Pittas tend to be very clear with their words. They love to speak and explain and educate. Pittas are very direct. Vatas can kind of babble and go different directions. Lots of thoughts. Pittas are direct. Okay. And organized, right? In harmony. Fabulous. Right? Kapha, more earth elements. It's earth and water element. Bigger frame, bigger body type. A little softer, a little more introspective, connected, grounded, homemaker, loves to cook, be in the kitchen, one-on-one, not big groups, you know, give me that one-on-one interaction, give me the smaller groups. Kaphas are more grounded, more connected. So they're kind of the opposites of Vatas, who kind of like to move and go and be in all different situations. Kaphas are very happy in very, you know, kind of comfortable spaces. So out of alignment, this is where things get interesting. If the vata gets out of alignment or we pick up windy tendencies, and we could talk about how that happens. That was me back in med school. How do you pick up windy tendencies? You start to disrespect the circadian rhythm. Moving, going, doing all the time. Who needs lunch? Who needs dinner? I don't need to be on schedule, right? I can sleep at 3:00 AM and be fine. My schedule got so thrown off because of med school. I was drinking cold drinks. This is where food comes in. I was eating a lot of salads because I thought they were healthy. There's a lot of interest about kind of Ayurvedic twists on conventional wisdom of what's healthy. And suddenly I was getting more vata imbalanced because my mom even said to me, Tripti, you talk so fast. I don't know how your patients are ever going to understand you. I was talking to her. Vatas love to talk. So what happens is vatas need a lot of grounding. They need a lot of like balancing of the circadian rhythm. Their goal is to create kind of almost a pattern of certainty and comfort. So the mind comes down because if you get too vata, you go into freeze. And what is freeze state? Body gets tight, neck gets tight, colon gets tight, constipation, gas, bloating, wind. Mind starts to spin, anxious, problems focusing. That's a classic vata. And all of us can go into that state. I wasn't born as a vata, though I started doing those things, skipping kind of the routine, disregarded almost Mother Nature to some extent and just lived the life that was needed to survive medical school. And then doing a lot of cold things, lived in Chicago, which was cold, you know, during that time, right? It was February when I got the, most severity of my sleep issues. The Pitta is different. Pitta is more fire. So think of intensity, not necessarily moving in terms of a windy kind of energy, but moving intensely. So if you're too intense, too hard on yourself, too perfectionistic, the Pitta energy can come out and that shows up as a fire flight state. We think of freeze, this is fight, angry, irritable, sharp with the words, right? Reflux, nausea, diarrhea. So that's how Pitta can get out of alignment. Migraine is a classic presentation. And the neck symptoms tend to fall into Vata, the tight neck, where this one's more head and redness and reflux and rashes, autoimmune conditions. You're thinking Pitta. Kapha is a different personality. Kapha or energy. Kapha's in all of us can become this way. In fact, I've noticed a little bit 'cause we just moved houses and I've been kind of in moving mode. And I haven't been as hydrated as I should, and I'm noticing a little more congestion. Oh, it's kind of the fall, I mean the spring here, we're moving out of cold dry state into the summer months. This is when the body kind of starts to get a little bit more prone to kapha imbalances. Cough comes from kapha. If I'm too sedentary or if I'm too dry, I could start getting very kapha. And kapha energy is sluggish, depressed, heavy. So does that make sense? So in all three basically states, you get three different gut types and you get three different mind types. The last state is depression, the middle one, pitta, is anger, and the first is anxiety.

It is so right on for me, I can tell you.

You feel it, right?

Oh yeah, I totally get that one.

Did you see if you read all this? Well, can you imagine, like, here I was stuck and I didn't know why I couldn't sleep well, and I read this and I was checking off all the boxes in vata, and I was doing every single thing that I thought was healthy and right, I was actually wrong. I was, what I thought was being healthy wasn't really being healthy, right? The kickboxing wasn't good for me. Think about what my mind was doing when I was kickboxing. I was perceiving danger. You know, I was—

Whereas I need to kickbox.

Yes. Yeah, it depends. And Pittas kickbox if they're balanced Pittas. If you were to, or anyone that's in the state of excess Pitta energy, And let's say someone's getting irritable, starting to notice reflux, starting to have progesterone depletion issues. I would say kickboxing, you might wanna be a little careful about the intensity.

You might hurt somebody or yourself.

You might, exactly right. You don't wanna be too fired up 'cause it can get into trouble there. And they say violence increases in the summer months. And that's why, 'cause the heat, the heat, we get more pitta, we get more fired up, all of us. Wow. Yeah. Fascinating stuff. So it pulled me in and then I started using it for myself. Got to my practice, seeing migraine patients. Opiates were starting to be, you know, OxyContin at those days, this is the early 2000s, right? Were given out left and right. And I said, oh my gosh, wait a second. Uh-uh, I know this other science. And then I eventually got certified in auric acupuncture.

So would you not, like when you first went into practice, you were doing more conventional neurology.

I was.

How long did you do that before you started to go, wait a minute, Oh, not even.

I started saying, wait a minute, within the first, like, month or two, because I was in this practice where it was like at the tertiary headache clinic and a lot of medications were being given out. And I was thankfully injecting Botox injections, doing trigger point injections, other things to kind of not have to prescribe so much. Though this was in a time where you could refill meds over the phone, you could refill Vicodin over the phone or refill Xanax, you know. And so very quickly I started bringing in some lifestyle. I started bringing in integrative went to some integrative meetings and learned about food intolerances at that time. So I was doing some functional medicine too. And then eventually I said, you know, I love Ayurveda. That really spoke to me. And then after taking my board exams, I went back to training in Ayurveda. My husband's like, one of these days you'll be done studying. I said, one of these days.

I'm still waiting for that day. Not really, never.

Still waiting for that day. Yeah, not yet. Not yet. Right? Yeah, it's just too much. It's just too interesting to kind of, as you learn, you just wanna keep on evolving, right?

It's more exciting now. Like, I am more excited and kind of obsessed with everything than I've ever been. Like, there's so much great information out there, right? And what's so crazy, Tripti, is that here you are going back. Yeah, like, so many of the answers lie in what we did thousands of years ago. Like, it's amazing to me that homeopathic is basically like— it's almost illegal in the United States. It's bizarre. Like, I go, what?

You know, are you kidding? I know. Like in some of these simple techniques, my son had a femur fracture. He was skiing. This is before pandemic. And we were at this beautiful Children's Hospital of Milwaukee, Wisconsin. And in the evening they would give him an OxyContin prescription. They also offered on the floor, which is so novel, essential oils. And I still remember them coming in with the little cotton ball with one drop of the essential oil saying, now this is how you use this. Make sure when he inhales it and giving all these descriptions of how to use that. And here's the OxyContin. —And it's so fascinating how we've kind of forgotten, you know, not only the power of these ancient tools, yet how safe they can be if used wisely. We can really, you know, benefit from them, and they're very low in toxicity when you think about it. So many of these—

It was one of the first things I did with my son when he was in a coma in the hospital. And so we, you know, like, when your son's in a coma, you're like, people are like, I've got this, like, send it over, right? You're like, sure, bring it all in. Totally. But, you know, essential oils, that was the It was the first thing that I was able to do to get a response, to know he was in there. I mean, I knew he was in there, but you know what I mean.

But for him to actually respond to you.

And the doctor's like, well, we're just letting you do your little, like, your little cute things. I'm like, okay, all right.

Okay. And it's so sad, you know? It's really, we have evolved, and I was so grateful that they had a sign saying, if you want essential oils, just ask the nurse. I think she was shocked when I asked her for it. She said, which one? I said, give me all of them. You know, it was vetiver and peppermint and lavender. I'm like, give them all to me. And every hour when he'd wake up severe pain, 'cause he, you know, he had this massive compound fracture. He'd wake up and I would have him just practice the breathing with the different oils. I'd fall back asleep, give him the OxyContin, didn't even touch him, quite frankly, at this time where he was, he was in so much pain. And the power of the breath and the amygdala and quieting down the fear center, right? Yeah. And what that can do to wake up the brain and bring you back. And so that's kind of where I moved into, we can go into this three-brain model if you wanna hear about it. Like I kinda moved into this. Yeah, no, I wanna hear about it.

'Cause it's so amazing right now. Like I think we're is finally starting to— and I think a lot of it actually is happening because of the Oura Ring and people talking about HRV and then all of a sudden going, you know, oh, parasympathetic, sympathetic, vagal tone, blah, blah, blah, blah, blah, you know. So I think that we're kind of waking up to some of this stuff. Yeah. So yeah, go in. Let's hear.

I love this stuff. It's so fun. It's so great, isn't it? So because you see improvement and you see improvement in a way that is so much more profound. And at a deeper level than what we've ever seen before. Because if we get into the core of this, I looked, you know, back at my patients and clients over how many years, couple decades, and I had closed my clinic in 2021 and I decided to do coaching only, you know, and in the time I looked back at my patients and I said, you know, who really has succeeded? Who are these like incredible success stories? And they were doing things that were very, you know, interesting. And I kind of package into this 3-brain model just to make it easier to think about. So as a neurologist, we think of the one brain, that brain up here in the head, and that's what we're trained to focus on is fixing the circuitry of up here, fix that brain here. And a lot of conventional doctors, when you think of neurology, are thinking of the brain that's in the head, the central nervous system. And that's an important, of course, control center. And when you think of the central nervous system, instead of the structure and function, how about the processing in terms of executive function of how we think? So many people I was meeting in my practice and that we meet day in and day out have an interesting program of how they respond to stress and how they're naturally geared to view the world. Their model of the world is very much dictated by their early programs. You know, if I grew up with a parent, which I did, we were kicked out of Africa. I mentioned I was smuggled outta the country at a very young age. My mom's mantra was work hard, otherwise you won't survive. I mean, that was her mantra. So you wonder why I became a perfectionist, hardworking, and eventually had sleep issues in med school. I was just in this kind of mindset. This therapist said, are you stressed? And no, I mean, this is my— this is who I am. I was living in a state. So what I realized, a lot of my patients that were kind of able to break these chronic cycles of pain and sleep issues, a lot of them, what they were doing is realizing and waking up to their state. So the first brain to me is understanding what is your model of the world? Is it working for you or against you? And how can we change the pattern So you can start to see the reality of yourself and not live in that state. And the state is the windy, which is the vata state, the pitta, the fired up state, or the earthy kapha state. I'll even kind of tell you, yesterday I was playing pickleball, okay? And I'm playing pickleball and, you know, you get on the court and so fascinating to see the personalities that come out, right? And I'm like, this is my off time, let's have a good time. And I'm like hitting the ball and I'm pretty good. You know, I played tennis when I was in high school and on the varsity team and, you know, That was fascinating to see. You can be competitive, but you can also be intense. And I was playing against this woman who I played against before, and she was like, bam, bam, bam, and just angry.

Like, it's a game. It's a game.

It's a game. And honestly, it's fascinating to me because I almost see, I can't unsee what you see, right? There's certain states that people bring out to the world, even a pickleball game. And so The first brain is just acknowledging if you are stuck and having symptoms, it's probably because your state is out of alignment. And hey, thankfully Ayurvedic medicine gives you an idea of how to figure out what that state is and maybe give you some ideas of how to get outta that state. 'Cause I was in that state when I was younger and I didn't see it, right? 'Cause I was in the thick of it. You can't see the forest through the trees, right? You just like, you're there. So then that's the first brain, central nervous system. Second brain is the enteric nervous system, right? The brain within the gut. We spent zero time, I mean, barely touched on it in medical school. Enteric nervous system is this complex, right, array of neurons and neurotransmitters that are created in the gut. You make every single neurotransmitter in the gut that we make in the head, and 90% of the serotonin comes from the gut. And the enteric nervous system is communicating with the third brain, the microbiome, to send signals up. And there's more conversation from gut to brain than there is from brain to gut. So I realize—

How much is this in the medical school now? Like, is it in med school? In school now? Do you know?

I don't think that much because I just did some grand rounds at a couple places and I did bring up the ENS and I said, how much you guys know about what is ENS? What is the function of the ENS? And it's still kind of, yeah, there's like, you know, I don't think the understanding is this, that there's an emotional component. Enteric nervous is the sensing brain. It's the feeling brain. And the importance when it comes to clients and coaching and talking to people is, are you feeling? Are you, do you have an emotive side to you or are you tasking and disconnecting from your emotional body? Ayurveda and by nature of doing yoga and breathwork and slowing down, you start to connect to the emotions underneath the thinking brain, right? So a lot of the clients, when I started working with them and started giving them tools, be it breath, give it the oils, give it, you know, they started to kind of get connected with their emotional body. I've been holding anger towards my dad for a long time. I probably should clarify. That, right? And you know, they started to kind of open up to something that was underneath the migraine, right? And then the third brain with a lot of them working on the diet, which you, I know is you, this is your world, the Sugar Revolution, all the things that you've done, like really understanding the impact of food. And don't disregard the importance that food is medicine, medicine's like food. Like just really take time to think about what you're putting in your, on your plate and in your body. How are you chewing it? What are you bringing in? Is it nourishing? We call it dhatus, D-H-A-T-U-S, dhatus in Ayurveda, the layers of the body, your skin, your subcutaneous tissue, your muscle, your bones. These are all nourished by food. You know, you are what you eat.

So I remember though in Ayurvedic, and I'm like, this is like, I'm going back now. Yeah. Two decades, I think. That there were warming foods, cooling foods, like the right foods for different types. So someone would take this quiz and find out the right foods, 'cause that's the other piece is like something that would work well for me may not work well for you.

Right, and that's what makes it a little bit tricky. And that's where a lot of individuals get either overwhelmed or lost with Ayurveda. So we'll try to make it kind of a little simpler to understand and, and at least approachable to start, and then you can always go deeper. Starting with the concept, we'll go back to me and the windy energy and problems falling asleep. When you're windy and you're too excitable, imagine wind blowing on you. You get kind of cold, go back into that freeze state. What you want is like warm, warm cup of tea. You feel the warmth, you know, having a cold iced drink is going to put you more into freeze. So we look into state of food first. Whereas if I'm really fired up and heated and angry and I have a hot cup of coffee, may not be a good idea for me. Maybe coconut water, maybe aloe vera juice, cooling would be beneficial. You know, think of what's in a tropical climate when it's hot. Or you've gotta remember, was a science not based on evidence-based, you know, double-blind placebo-controlled studies. It was based on just look, When you're in a tropical climate, you have these cooling coconuts that come that cool your body down. So aloe vera plants are growing, you know, so it's the nature gives you the answer, the antidote to the energy body. Kapha, you know, if you're getting really congested, I remember my son, he was so— my kids, by nature of just me practicing this at home, they started to kind of follow the principles. And I remember my son came home one day and he's like, Mom, my throat hurts and I'm congested. Can you give me some kimchi? Why? Why would you say kimchi? Because kimchi is spicy and it breaks up the mucus and the congestion. And so they naturally, you know, would turn to those things. My kids did because I would kind of guide them. And so Ayurveda, a lot of the foods are based on your state. And so if you're really heated, avoid hot and spicy. No habanero, you know, no spicy margaritas for you. You know, if you're really cold and windy, don't drink iced beverages, you know. If you're really Kapha and earthy, it's also a state that's made up of water and earth energy. You don't want to do anything that's too heavy or thick, like, you know, having a really like creamy cappuccino or a heavy drink like a milkshake would not be good for Kapha, or milky drinks because they're really thick and heavy. And gluten would not be good for Kapha. Because they're in the congested state and sticky. So lighter grains are better. So it's kind of first step is just to say, which state am I out of alignment with? Do I need to move into something that's a different temperature? And then you can go further and say, okay, now that I'm kind of avoiding the salads because salads are not good in winter in Chicago or anywhere actually, 'cause it's a cold season, what can I do to warm the body up? How about I do a soup instead? Really simple. And then you can get into the fancy, okay, which spices? And there's 6 different tastes in Ayurveda, sweet, sour, salty, bitter, pungent, astringent. Do I need to add some bitters? Should I add some astringents in? If I'm congested, add some astringents like pomegranate to pull the mucus out. So you can start to get fancy with eating, but you can start really simple. Does that make sense? Which—

what does this like— where does this help the most? Like someone listening to this right now, what types of conditions should— would they— Is this most effective, or is it everything? I, I actually think everything.

I think that underneath everything, our body is stressed.

And I mean, it's kind of looking at this, like, why wouldn't you just start by looking at this and kind of giving it as, you know, we're all trying to find our N of 1 of what works the best. And when I write diet books, I'm always taking people through a process to kind of go, does this work for you, or does it not? And this feels like a really good foundational place to go, all right, here's where we're going start. Yeah. And does going through the quiz and assessing this help you kind of see if you're on track or, or creating more of a disconnect?

So the quiz is quick and fast to just get a flavor, and to get a flavor of, are you windy, earthy, or are you fired up? What are the specific symptoms and what does that look like? And there's little videos after that explain that. And to start the process of understanding that if you're out of alignment with your state then you can address the state first before you address how many proteins, carbs, and fats in your diet. Because what I found is happening over the years is that there's a lot of attention, you know, towards, you know, how much protein, which is great, it's important. And in fact, each of these states, there's a different expectation of how much protein, fat, and carb, which can get a little bit tricky to do right away. First is just start with, are you out of alignment with the state? What are some of the simple things you can change in terms of the types of foods, in terms of the temperature of the foods? And then the next thing to start asking is, am I getting enough nourishing things in the diet that satisfy me? And you can get fancy and use more very specific diets that will align to your eating style. So if you like to— you're more pescatarian, or you're more— you like to have more vegetarian, you know, foods. The key is this, to me, is the foundation, I believe, to using functional medicine, to use the other approaches, because you get a little bit more fine-tuned within it. Like, whatever you're using as your favorite diet, you could tweak it, right? You could just tweak it and say, I'm doing this kind of diet, but if I know that I'm a windy person, then maybe it's that salad, the same vegetables, but I'll cook them, you know, and sauté them or put them in a soup. So you're still getting the nutrition but doing it in a little bit of a different way. And so it, to me, the quiz gives you a window in, and what I think it helps one do is to see the connection between the emotional body and the physical body. Because the emotions and your mind triggers your gut to go out of alignment. If I'm always anxious all the time, I'm going to feel constipated more frequently because the mind, it's top-down, bottom-up. If I'm stressed here, it's going to create that constriction of the gut. If I'm always angry, I'm going to have looser stools. So instead of going on that, you know, probiotic right away, how about I work on that piece first? Because I'm noticing is that if you do that piece first, everything works much better. The diet that's recommended, the workout you're given, the probiotic, everything, the medications, the pharmaceuticals, the neuromodulation devices, everything is much more effective. And I tend to get people that have failed. I mean, they're not gonna come to me usually until they've failed multiple, usually.

And then you have these most basic foundational, isn't it? It's kind of crazy.

It's kind of cool. Really? And it's exciting to say, you know what, if you fix these 3 things, I bet you that's all gonna work better. And there's a lot of like, really? Come on. It's only, I've been doing it for 2 decades now. So I'm gonna tell you, it does. And this is 5,000 years old. I'd like to say I came up, it's not mine. I'm just sharing it in a way that can be hopefully tangible. So the quiz gets you kind of in and then with however dial you're working, whatever you're working with, you can blend it with this. That's the beauty. Yeah. Is it pairs along with, it just gives you a little bit deeper of a foundation. Does that make sense? Kind of a going into further space with it.

So now to take the quiz. Yep. It's on your website. Yep. We're gonna put everything at jjvirgin.com/troopdi and that's T-R-U-P-T-I. And then you have your new book out, "The Stress Rx: A Neurologist's Ayurvedic Prescription to Happiness and Health." Are you the only Ayurvedic neurologist out there in the United States?

There used to be one other. She moved to India. I have to check now. I honestly, I don't, I might be, I might be. That's practicing. You know, it's interesting because I think it's a hard thing to practice both. To do the Western and the Eastern and kind of, you know, and I think the reality is that these worlds are, they seem very different. And yet when you really look at it, they come together. They come together because now we have, for example, I mentioned neuromodulation devices. There's so many devices coming out. What are they doing, JJ Virgin? What are they doing? They're actually helping quiet that excitable nervous system down. Exactly what the ancients said 5,000 years ago. Do some yoga or do a, put on a neuromodulation device. You know, so it's kind of like the Western is kind of meeting up with the Eastern. That's 5,000 years old. It's kind of cool to watch that.

So all this biohacking stuff is sort of like, yeah, okay. You know, it's cool though.

It's cool. I like it. I'm happy to see it come together. I knew at some point we would not be speaking two different languages, which is why I'm sticking with both. 'Cause I feel like, just got my boards again, recertified last year, every 10 years for neurology. You know, I said, I'm gonna stay with it because I do think these worlds are coming together.

I sure hope so, because isn't neurology like one of the highest suicide rates because there's so little you can actually— like, it's so hard to get your patients better with what we have. Like, a lot of it's just managing symptoms, and now we have like a foundational thing. Like, yeah, why wouldn't we use all— like, that has never made sense to me. Use all the tools in the toolbox. Like, especially when my son was in the hospital and there's like this clear path one way, and I went, all right, You saved his life, but now he's— we're stuck. Yeah. Like we had to use all and like use all the tools in the toolbox.

Yeah, all the tools. I think the problem is that most people don't know what those tools are. Right. And if they're not aware of the tools, they don't know how to use the tools. And I think that's my biggest challenge is the resistance to being open. A lot of— God bless, I get it. Med school, residency, boards, you're just done. Like afterwards, like, I'm moving on. I got my— with the tools that I know. And that's why I said earlier on, I'm so glad I wasn't brainwashed early. I don't mean to say brainwashed, but, you know, I was open. I was more receptive my first year of medical school to all of us. The more you practice, the more you kind of see things in a very specific way. We get very polarized and very opinionated as physicians and very much believing that this is the way to do it. It's hard to see something outside of what you've learned and been tested on and your knowledge base. And this is a different world, though the beauty is now patients, I love it, are asking the internet. There's, you know, Instagram, there's all these different, you know, influencers that are out there that are speaking up and saying, wait, there's another way to look at this. And I think the beauty is that we're going to start to really change neurodegenerative diseases. We look at Parkinson's disease, constipation is the first symptom, starts 20 years before the first symptom of Parkinson's. Right? And it's that alpha-synuclein and leaky gut and the LPS activating the cytokines and allowing alpha-synuclein to move into the brain. But it starts in the gut.

And is there a certain Ayurvedic type that's more prone to that?

Think of the, okay, let's have fun with this. Think about back to the three, fight, flight, or freeze. So think of the vata windy freeze state. What are we doing? I'm kind of moving myself in. Think of the Parkinson's gait. It's a shuffled, gate, you're leaning forward, shaking movement, too much wind energy, excitable energy. So Parkinson's falls right into excess Vata wind energy. So you can actually start to see the diseases linked to the energetic state imbalance. So my friends out there that have tight necks and constipation, let's fast forward 20 years, that can lead to Parkinson's disease. So you want to do some things like, ah, drop the shoulders down away, do some yoga, open up, practice your breath, you know, clear all of that excitable energy out of the body by doing slow, gentle movements, by warming the body up. You know, these are things that can actually prevent diseases. Isn't that amazing? Autoimmune is like pitta fire out of control is autoimmune diseases. So, you know, for feeling angry.

Yeah, and that's, I get a flare if I'm like, you know, do I stop it?

Stop it. I've gotten like a severe throbbing right-sided headache, you know, right when I'm pushing too hard. And I'm like, Tripti, that's your pitta coming out, your fire coming out. Right side, by the way, is fire energy. Left side is wind energy. So if you're thinking about which state is out of alignment, if you're always getting left-sided things, wind energy is out of alignment. If you're getting right-sided symptoms, that's fire. And so, you know, Book 1 was really more about getting to know Ayurveda. Book 2 is what's even deeper than that, because once I saw that there's these 3 brains, like, that people were— and back to those successful clients, they they were improving every piece of those three brains. They're improving the way they managed and responded to stress. They worked on their emotional body using the breath and the Ayurvedic work, and they worked on their gut microbiome. Then suddenly these chronic things got so much better. Suddenly medications start working and I could even taper some of them, you know? And it was not so crazy. It's really not that hard. And it's fascinating that this 5,000-year-old science isn't in everyone's back pocket. And to me, Why isn't it? You know, we should all be just trying these things because a lot of them are free, you know?

Yeah. Most of the things you've talked about here are free. I just think it's so cool that this really is in your DNA. Yeah, right. I mean, it's just— it's so interesting. Now, what do your— what do your parents think about this now?

So now— and God bless, my mom passed a couple of years ago. She had severe migraines and she had severe digestive issues. And I'm sorry, but I think she was gaslit most of her life and Oh, I love her dearly. Love her soul. She's there still. And I think that she was my inspiration to like do this book number 2, you know? Mm-hmm. Um, my dad's a huge fan. He's 86 years old. He's traveling all over the world. He's actually in Chile, somewhere in South America right now. I can't even keep up with him. Go, Dad. And, um, Daddy's like a real kapha type, earthy type. He can kind of keep up with, with crazy. And what I love is that he's now kind of more open and seeing that this is something that can really help a lot of people. And the beauty is that the ancient medicine now, I believe, because we're seeing the Western system crashing, a lot of people are going towards what was done thousands of years ago. And why is that a longevity science? And how can we increase longevity in the US? And back to, oh, the massage, I won't forget this. Like something as simple as massaging, right? If you're joints. If you have really cracking dry joints, think of dry as Vata wind energy. Using warm sesame oil and just massaging your joints and you're in the wrist, you could circle and kind of, you just kind of go along the length of the bone towards lymphatics, you know, for moving the oil. It can actually help you before working out. If you're getting red and inflamed, using coconut because it's cooling, sesame is warming, can actually protect your joints and protect your muscles when you're working out. So again, these are thousands of year old exercises or techniques that were used to allow you to do yoga poses and do all these amazing things long into your life. Yeah.

And let's be clear, why is there no double-blind placebo-controlled study? Because there's no money to do this because it's not right. So this is the other side that, you know, these things were around for thousands of years because they worked. Yeah. They wouldn't have done them if they hadn't have worked. That's why you look at some of these things and go, you know, same with essential oils.

Gosh, how long have they been? And that's what I tend to say. I'm like, do you really need a study when it's been around 5,000 years? Right. Because I can tell you right now, if it wasn't going to work, it wouldn't be around 5,000 years.

Where's the double-blind placebo-controlled studies on aspirin? They're not there. They're not there, right? So I mean, you know, some of this stuff, it's just people get fed that as a thing.

And I worked in the pharma world for a long time. This is someone that's coming in a balanced way. I, I was like a faculty trainer. I trained doctors for pharmaceutical companies. I was pretty much the faculty trainer for 200 doctors at a time. So I'm Western. It's not there's a whole only Eastern side to me. I played in that world for a long time. And reality is that, you know, studies are developed a certain way. You know, they're created in a certain way, the certain population. They didn't study the chronic daily severe headache patient. They studied the ones that had 2 to 8 migraines per month that were women that had this, that, that. And the reality is, I get that. You have to study a certain population in this way, though there's a lot of outliers, a lot of people that don't fit into that. Specific. And so when we say that got FDA approved, it's based on the studies very specifically chosen with very specific patients. Doesn't apply to everybody. And I think, you know, Eastern medicine and all these different holistic techniques are looking at the whole spectrum of patients and people because we're not just going to fit in a box. It'd be nice if we did, but we don't, you know.

So you have two books because now, like, it sounds like you'd be great to have both of them. A Mysterious Mind, which was 10 years ago, now on its 10th anniversary nearly. You've got StressRx. And we're going to put those both at jjvirgin.com/troopti, along with your website where they can take the quiz. And the books are on Amazon. And it's like, I don't know why everyone wouldn't just do this as a foundational thing. And it's bringing me back— I haven't looked at this in a long time, but I remember when I did study, I had this Ayurvedic class in doctoral school, and I went, this is the coolest stuff ever. And then I'm like going, where did, why did it drop off my radar?

Right? I'll have you get back into it. I'll bring you back in.

I'm gonna go take the quiz, but I know, I remember back then that I was a pitta. I remember it.

And the reality is just—

I also can be a pitta at times as well, so.

We all can. And then the beauty is to know that we're human. We're getting pulled different directions. Just be connected with yourself and then bring yourself back in as fast as you can, right? And realizing, okay, I feel my energy being pulled this way. But at least we have tools now. Okay, we have tools. We can use diet, we can use breath, we can use exercise. We can exercise the right way. So for example, if I'm doing a cardio intense workout, if I'm feeling really pizza, I might lighten it up a little bit, do a little bit more stretching, a little bit more breath, a little bit less intensity. It doesn't mean that I don't work out. I just do it, modify it, right? Based on where I am. And it's just about getting to know yourself so you can kind of be your own healer, I think, at the end of the day.

Really, the N of one and you as your healthcare CEO is the important thing. Most important. This is just another tool. So you got it, a foundational tool. Thank you. Love it. I agree. Thank you, Trupti.

Thank you so much for having me. I love you. You're amazing. Please just keep doing your beautiful thing and helping the world. And you too. Thank you, my friend. Will do.