Why Burnout Keeps Coming Back Even When You Rest with Dr. Scott Sherr

What's the fastest way to shift your body out of fight or flight now?

Fastest way is gonna be so different for each person that's listening. I would love to say that it's an easy thing to do. It's not. I would love to say that breathwork is gonna work every single time. I would love to say that going outside in nature is gonna work every single time. I would love to say not checking your phone's going to work. This is very individual, but knowing that it's possible once you find the right tools.

Today is a really special day. I'm back with one of my favorite people, Dr. Scott Sher. Welcome back to Rooted in Wellness.

I'm so happy to be back with you, Mona. I know this time it's not in person, but all good. It's good to be with you either way.

Thank you. Yeah, I was saying before we started recording, uh, you're stuck with me, so this is the first of many in the future.

I dig it. I dig it. I love being with you, so thank you for having me back.

Thank you. And for our listeners, as a reminder, you know, the intention of this podcast, we've gone a little bit deeper and I'm really amazed and in awe how, you know, it's really transformed, but the essence is still the same, merging ancient wisdom with modern-day medicine and really how all of our listeners, this amazing community, can feel more rooted. And you know that I've got a philosophy where I truly believe that we all have the capacity to heal ourselves. And that starts with feeling rooted every day.

Mm-hmm.

Rooted in ourself and our happiness and our rituals and really who we are. And I know you've got a couple of incredible rituals. You were just saying going outside to take a break from screens. But can you just, for our audience, what are 2 or 3 things that help you feel more rooted in who you are every day?

Well, I love that as a start of a conversation because all of us should be rooted as we're having the conversation and listening, right? Because I think that's hard because many of us listen to podcasts on the go, listening in between birthday parties and soccer games and all the other things that we are doing along with our work and everything else in between. But it's It's really important because when we feel rooted, what you're really talking about is being back in your body, right? Which is, and you talk about this a lot already, Mona, but the idea is that when we're just head-driven, in our head all the time, it's not a great place to be for most of us. Our minds are not evolved to keep us happy. They're evolved to keep us alive and to procreate. That's pretty much it. And then maybe keep people around us alive if we have little ones. in the home. I remember the first time that I was at a playground. You'll appreciate this, Mona. I was at a playground with all 4 of my kids and I could just sit down on a bench and watch them or not even watch them. It was like, wait, I'm not on suicide watch anymore. It's a big deal.

Yeah.

When your kids are young, you're at a playground, no matter where you are, they're like, oh, look at that little beautiful tree that's across a bridge or something. You have to be so careful with your kids. And so, our minds are really set up in that way. And, when you're having about 60,000 or 70,000 thoughts on average every single day, it's a lot to be up there. So, to your question, to be rooted. So, for me, it starts actually with my bedtime routine actually. Now, most people would think, well, you would start off with your morning routine as the time to root yourself or have a grounded type of thing. But, I find that for me and a lot of the people that I work with, my patients, is that really need to focus on sleep for them. Right. Almost everybody needs to focus on sleep. I don't know who doesn't need to focus on it. Maybe there's somebody out there. I don't know. But most of us.

Mm-hmm.

So, my routine starts with rooting myself with a great evening routine in a way to try to get myself my good restorative sleep every single night. And, that usually doesn't just start when you hit the pillow. It usually starts 15 or 20 minutes ahead of time at least, if not a couple hours, if not 3 hours ahead of time. And so, I have a colleague whose name is Dr. Ted, and he started the companies that I'm a part of, and he's a mentor of mine. And, one thing he said to me very early on was like, Scott, what if we told our patients that your day starts when you go to bed, not when you wake up?

Hmm.

And, I may have mentioned this on the last podcast we had, I don't remember, but it's something that's been very helpful for me because I didn't think that I needed as much sleep as I did for a long time. And, many of you that are listening were in your 20s, you could go on less sleep and be fine, and then maybe even in your 30s, but when you get to to your 40s and to your 50s, you don't have the same capacity. So I think the thing that I've been the most consistent with, I think, over the last several years is being rooted in my sleep routine. And then feeling grounded and feeling safe and feeling protected and all the things before going to bed is huge because then you're going to get the good rest that you need. So I think that would be my number one thing, although that's kind of many things within that as far as what that routine looks like and things. I'm happy to stop there or keep going, whatever you choose.

Do you practice with your Do you have a nighttime ritual with your kids?

So when they were young, I did. My 8-year-old—

They're getting a little older.

Yeah. And so it was really interesting. They've done a lot of studies. I think this is funny, but there's a lot of studies on kids looking at how their personality develops. And by the time they're about 7 or 8, most of it, it's already there. So I knew that research. And so I spent a ton of time with my kids when they were younger. We did bedtime routines. We did affirmations. We did breathing. exercises. We still read. I still read with my 8-year-olds. Right now, we're reading a book about presidents when they were kids, for example, which is fun. And so I do have— I don't do as much as I used to with them because what I've realized is that they evolve, right? They're not— my older daughters are not in the place where like we're going to talk about affirmations before bed or anything like that.

Yeah.

My older daughter, she's like, good night, Dad. And I'm like, love you. Bye. So that's pretty much it. But, I think we really did emphasize that a lot when they were younger. And, I think it's really transformed their bedtimes now. They're all very good about— they're not on screens, they're reading or they're hanging out with each other or something. And, what I really try to model for them and have them model is having some sort of wind-down. There's always exceptions to this, but for example, my daughter decided that it would be great to make a cake yesterday and then all my kids had a sugar bomb an hour before they go to bed. Kids can tolerate that more than adults can. Let's be clear. Okay, everybody's listening. But, I really do try. I really tried for a while. And, it's something that I think that it's hard as parents. We're all very busy. But, if you can just spend even 5 minutes with your child, it can go a long way. So, I don't usually include them in my entire bedtime routine, but part of that Part of their bedtime is at least seeing me and me and saying goodnight. It used to be a lot more significant when they were younger.

So that's exactly it. And thank you for hovering on that. Something that I often work with my, my clients on is a philosophy that I grew up with. You know, if you remember my story about growing up on an ashram, I do.

Yeah.

I didn't realize, like, my dad, the practices, those rituals were— it was imprinting on me. So now as an adult, or in my greatest times of need, I go back to those rituals. So you nailed it. I think a lot of parents who might be listening, You know, we don't recognize the power of our kids watching us and watching our rituals every single night.

Yeah.

But it's really, it's, it's really a priority. And I love the reframe. As a nutritionist, even sleep has moved to the number one category before food. And it's just so, it's so powerful. It impacts how we show up every day as a human being. So thank you for that.

Yeah.

And on the opposite side, you know, a lot of people who are listening to this podcast, I think they have an expectation or understanding that as practitioners, we show up, we've figured it out, we have a master plan, we have a roadmap, I know you've arrived at optimal health and wellness for life, but tell us a little bit about 2 or 3 things that— do you notice when you're drifting from feeling rooted? What causes you to feel uprooted in your life and how do you course correct?

Oh, another great question. It's one of those things where it's going to be a little bit different for everybody, right? Because a lot of this will depend on what you're doing on a day-to-day basis and how you are flowing through that or not, right? And so for me, a lot of it is How easy are things, right? Are things pretty easy throughout the day, or does it feel like you keep running into things, or things keep falling over, or you actually are spilling things on the ground, right? It's like if you're looking at like, wow, why am I knocking into things, or things like I'm spilling things, or that's like— there's all different ways. But for me, it's usually when I get very excited about things, actually.

Mm-hmm.

Like when I get super excited about what I'm doing, or I have a lot going on and I'm excited about, I sometimes Forget to breathe because I get very passionate about the things that I do. I very much enjoy what I do. And so, sometimes when that's the case, I have to be careful because I can get very much sort of like just get— what is it called? My head is much further than my body. My head's out here somewhere and then my body's back here somewhere. And, you start— for me, what ends up feeling for is I get mildly lightheaded and I also get less— my mind goes a lot faster as well. And so then I feel that, again, it's sort of like the cart before the horse. I'm like, okay, I got to get back here, right? Because then over the years I've realized that even though if I get super excited and then I'm getting very, very passionate about things, if I get too overstimulated, too much sort of unrooted, I'm not showing up as well for the people that I'm talking to actually or my family because I'm not is grounded in the work that I'm doing, right? So, it's an interesting dichotomy because a lot of us think, as you know, we just need to push, push, push, push, more and more and more hustle, hustle, hustle. And, that's my nature to some degree.

Mm-hmm.

But, a lot of us think that's the case, but it's often because it's programming, it's cultural programming where we are programmed to hustle, we are programmed to not sleep, we are programmed to make as much money as absolutely possible because that's what society rewards. And, when all of us, me included here, we can get kind of caught up by that sometimes. And then, my catching up with that is typically when I get very excited about things, I'm like, okay, I want to do this. I want to do that. Now, I'm going to go do this. And then, I'm going to do these 15 things. And then, I'm like, wait a second. Wait, wait. What am I doing?

Yeah, yeah. I'm the same.

And so, for me, I have to build in breaks during the day typically to just take a couple minutes or longer, take a walk if I can. I mean, that's my favorite thing, especially when it's nice outside. I don't live in Tabanga, but I live in Colorado and I have mountains. outside too. So, I have nice places to do it. So, I think for me and a lot of my patients, I find is that it's overscheduled and it's not taking enough breaks. And then, hopefully, it's— and I have a lot of people that don't have this, which I feel very, very grateful that I'm doing the work that I really love to do. And, that would, you would think, be great and fulfilling in its own right, and it is. But, I can get overwhelmed by it and I I can— it can unroot me as a result sometimes too.

Yeah. The reason why I asked this question on repeat is I know everyone listening has an understanding. We know when we become uprooted, but the practice is the mindfulness around it where we can actually stop and say, oh, I'm doing it again. Oh, I'm doing it again. The more that we're aware of it, we'll create different practices to align. And as you were speaking, you were making me think of something that I coach my kids on, but I really just need a mirror back to myself. Unlike you, when we see things that are happening in life that bring a lot of excitement and What we'll talk about quite a bit today is this, like, hypervigilance really feels comforting for me. And I know that that's the result of how my nervous system was trained as a child. But I try to coach my kids on, are you feeling scared, anxiety, or is it excitement? Right? Because often they can feel like the same thing within the body.

That's right.

And for you, I know you and I can kind of, I can sense your excitement, but I can also see, my gosh, you must be able to multitask at like a whole new level than a lot of other people. So it's It's a good reflection piece to really look back at ourselves and understand, is it excitement? Do I need to take a break? Or is it true anxiety?

Yeah. And that's the thing about emotions is that the body can feel very similar with very different feeling or sounding emotions. And it can be very difficult to kind of piece that out. I mean, just like if you're a good example of this, it's always talked in meditation, I think, not always, but it's common, is that you run up a mountain and you're breathing really heavy. It's the same feeling as if you were having anxiety, but instead of the anxiety of sitting in front of a computer and having somebody send you a bad message, you just ran up a hill, right? So the physiology is the same, which means if you can take the story out of it, that's interesting, right? Because if you could take the story out of, oh, this is just what my body does when this kind of thing happens, right? It's kind of an interesting mechanism for being more mindful of your day. And I do that a lot these days because I, you know, We all get bludgeoned by stuff, and especially with the news and things are— it's a really tough time. People can get really sad and down and out, but you have to realize that the emotions are just sensations, right? They don't have a meaning unless you make them have one. And, that's what meditation is so great for, but that takes practice.

Yeah.

And, it's not an easy thing to do. But, I always tell parents all the time, and I'm sure you're part of this too, is like, and it sounds It might sound a little caustic when I say it, but follow me for a second, which is if your kid is yelling at you, you don't have to yell back. That's on you, right? So unless they are in a place where they're in danger or you need to, you know, something to save them or something like that, that's different. Like if somebody's about to pick up a knife, scream, sure.

Yeah.

But if they just dropped something on the ground and yelled and you yell back, That's on you. And, that's hard. That's hard for parents because I get we're all tired and we all have a lot going on. But, that's a nervous system thing that we as parents can work on. And, you mentioned that word hypervigilance. I think that's a big piece of it, especially when you have kids because you just want to protect them. And, I see this with my wife who's just like she gets into these modes where she just becomes hypervigilant about stuff. And she just wants to protect them. And a good example of this, and I'll let you speak after this, but a good example is my daughter, who's 15, just started driving, right? So, she just got her learner's permit.

Oh, wow.

And my wife was in the car with her the first time. And after about 2 hours in the car, she came home. My daughter did great, but my wife came home. She immediately said, I need to go to bed. Right now, because she was so stressed and tired of like, of being so vigilant, because she couldn't control the car, you know. And so it's a good example of what we're all doing on some level is, is trying to protect, but then also realizing that it's our nervous system that we need to regulate.

It's such a beautiful reflection and reframe to really connect with what happens in our bodies. I think a lot of us are disconnected from that completely. So We'll dive into all of that. We're going to kick things off a little bit differently than we did last time, and we're going to start with some rapid-fire questions.

Oh, nice.

Okay. Good ones that we're going to dive deeper into. So, to do this, whatever comes to mind. All right?

Okay. How long would you like the answers to be? Like, we're talking about 30 seconds, 5 seconds, 2 minutes?

30 seconds. Can you do it?

I can do it.

You can do it. Yeah. Or less, even one word. Let's see. Well, I guess the first one, let's see if Finish this sentence. That's an easy one. Your nervous system is not broken, it's—

Overwhelmed.

What's one thing that people do every morning that's immediately spiking their sympathetic nervous system?

Checking their phone, obviously.

So obviously, yeah, we all do it. Let's not normalize it anymore. All right, next. What's the fastest way to shift your body out of fight or flight now?

Fastest way is going to be so different for each person that's listening. I would love to say that it's, it's an easy thing to do. It's not. Um, I would love to say that breathwork is going going to work every single time. I would love to say that going outside in nature is going to work every single time. I would love to say not checking your phone is going to work. This is very individual. But knowing that it's possible once you find the right tools.

Beautiful. Let's do this one. Hot take: Is burnout a mindset problem or a metabolic one?

It's mostly a metabolic one, actually.

What's the worst thing that you can do after a bad night's sleep?

Exercise and stress your nervous system more. That's a big one because people are like, I want to feel better in the morning. I didn't sleep well. I need to exercise. It's the prime time you're going to injure yourself, actually, if you got a bad night of sleep.

And yet we force ourselves to go to the gym and we muscle through it every single day. We don't take the time.

I probably should have said cold plunge. Cold plunge would have been worse.

Yeah.

After a bad night of sleep, you don't want to cold plunge because your nervous system is already dysregulated. And when you cold plunge, you're going to basically put yourself into fight or flight.

Yeah.

And then ideally afterwards, your system would go back down from that. But if you're already dysregulated from a bad night of sleep, it's very difficult for that to happen. So—

Gosh, if your nervous system had a voice, hey? If we were taught how to listen to our nervous system. If it only came with a training manual.

Yeah. No, it doesn't. And again, it wasn't set up to keep us happy, right? It wasn't set up to keep us relaxed. It was set up to keep us alive and find mates. So we have to reprogram this over time and know that it's not just outside things that are causing stress, like sympathetic things that, like, we're activating things that are causing from the outside, like your stress of your job, your relationship, your kids. That's all happening. But the other piece of it is that it's also the world that we live in causing toxicity to our body, right? And to our cells in a part of our cell called the mitochondria specifically that makes energy. And so if you have something that's hitting your mitochondria and causing energy deficits, you're also not going to be able to show up the way you want to show up. And it's also going to affect your nervous system in significant ways that'll be detrimental too. So it's not just the outside stuff that matters. And that's why with one of your answers, one of your questions about is this a— is there a metabolic component to nervous system dysregulation is absolutely the case.

Yeah. Yeah. So let's really break this down because this is exactly how we got here. Right now we're living in a world where there's constant stimulation, whether that's blue light exposure, notifications on our phone, chronic low-grade stress, a list of things to do, you know, world events, politics, ultra-processed food. Like, it's a really, really long list of things that our bodies need to digest.

Mm-hmm.

People aren't just dealing with one stressor. You know, if I ask people what's stressing them out, they can give me a laundry list.

Mm-hmm.

So let's break this down for listeners. For somebody who's like, who's listening to this, they know that there's a lot of stress. What's actually happening to them physiologically? That they can tune into how they're— I think a lot of people don't understand how to listen to their body. What does it mean?

And then the other aspect of this is that if you've been on constant stress or under constant stress for a long period of time, is that you start to compensate for it. You don't even realize that you're in that stress mode. But you may look at your HRV if you have a ring or something like that and see that it's always low. You may see that you never get good deep sleep. You may see that your stress levels are always high throughout the day even though you don't feel that you're stressed. It's just how you operate, right? And, that's quite common. What happens, the body always is trying to compensate itself, right? It's always trying to find ways to compensate. It's not doing anything wrong, it's just doing what it's trying to do to create as much balance as possible. We have to remember that. And so, when you're under constant stress, constant fight-or-flight for long periods of time, You're releasing a number of different hormones and neurotransmitters that are trying to maintain your capacity to be under that stress. That includes cortisol, for example. Cortisol is your stress, your steroid hormone. Cortisol has been vilified over the last couple of years, but it's an extremely essential hormone. Cortisol rises when you wake up to help you wake up from sleep. And then, it's supposed to be up when you're exercising and under stress, but it's supposed to come down As well. And, the lowest it's supposed to be is right before you go to bed. And, the problem is if you're always under stress, that cortisol level is elevated all the time, it doesn't have a beneficial effect anymore. It starts breaking down your body, breaking down your immune system, breaking down your hormones, also breaking down the mitochondria, the part of your cells that make energy. Because what happens is that when that cortisol is elevated for long periods of time, you are stimulating the parts of your cell, the mitochondria, to make energy all the time. So, what's going to happen? Your cells aren't going to be able to keep up. And so, this is the wired but tired kind of thing that people talk about all the time. It's like, I'm awake. I feel wired, but I'm really tired at the same time. And, that's because that stress response is elevated, but your energy capacity, your energetic capacity can't keep up. And, as a result of that, you feel more stressed because like, I need to feel more awake and I need more energy, but the body can't.

Yeah.

can't compensate for that. The body can't do it. And because what happens is when the mitochondria are under a lot of stress, the part of your cell that makes energy, instead of making more energy over time, they're actually going to make less. And, that's because they're trying to protect themselves. They're trying to protect themselves because when they're being stimulated to make a lot of energy, our cells are like gasoline-powered cars. They don't just make energy, the ATP, that's our energy currency, but they also make what are called free radicals, reactive oxygen species. And, that's okay in small amounts. They need to be there to help with signaling and sensing and things like that. And, we have anti- antioxidants in the body that help neutralize that stress. But, if you're under a lot of energetic need from a sympathetic way because you've been in this fight-or-flight for a while, then what happens is that the cells can't keep up, the mitochondria can't keep up, and then they make all these reactive oxygen species and there's not enough antioxidants around. And so, what happens is that they flip into a process called the cell danger response, the CDR. And, the cell danger response is your cell, specifically your mitochondria, trying to protect itself and to go into a hibernation kind of state. And, they kind of hibernate in a way so that they don't make as much energy trying to protect themselves. And, this is very common as well when you have people that have a lot of weight to lose but they can't lose it. It's because the body's holding on to things on some level to try to protect itself. It's a similar kind of process where— and then, as a result of this, you're getting a breakdown of the system. And cortisol as well, when it's elevated for a while, it starts depositing fat around your organs as well. And so, short-term cortisol is actually important because it actually breaks down fat, it breaks down carbohydrates, so you have energy to fuel yourselves. But long-term cortisol is actually going to deposit fat in areas around your organs because what your body thinks and your mind is part of your body, everybody, right? Is that you are under significant amounts of stress. For example, it would have been like you didn't get food for 3 or 4 days when we didn't have a good consistent food source. And so, what the body would do if the elevated cortisol was level was, well, we actually put fat around the organs to save it there so that it would have it for the next time there wasn't any food around, right?

Mm-hmm.

And so, it's your body trying to protect itself. It's your body trying to balance itself as best it can. But the problem is that we have these things called brains that, especially, you know, our more evolved parts of them that are not getting with the picture. They don't understand what's happening in the body. We don't— like, our brain doesn't know that. They— I don't know who they is, but you know what I mean? Like, the brain doesn't under— like, it's not— it doesn't have the same programs because we're programmed to do the things that we're doing from a sociocultural perspective, right? So it's— there becomes a disconnect there. And that's really why it's so important to get back rooted down, as you say, because then— Once you get rooted back down, then you can start understanding maybe how to, you know, break this, break this pattern.

Gosh, you're just one of my favorite teachers. What I'm hearing from you is you're really identifying the incredible wisdom and beauty of the body. We demonize our symptoms all the time. We've demonized cortisol, we've demonized belly fat and all of these things. And instantly, you know, media society tells us to look for a fix.

Mm-hmm.

Something to fix about ourselves instead of understanding, no, no, no, your body's doing exactly what it needs to be doing to try to save you, to try to protect you, try to rebuild balance within your body to regulate again. And I think that we're still disconnected from what that means. Like, what is this terrain of the body that we're constantly chasing? Because we live in a society where technology is just going to get faster. We're going to continue to be busier. We're going to continue to normalize our symptoms unless we really address this. And in my world, although So, you know, people come to me, the entry point is always nutrition, supplementation, food, diet, those things. But 80% of the time I'm coaching on these issues of the mind that are sabotaging the body. And more often than not, I use this analogy of decapitation. Our heads become decapitated from the wisdom of our bodies. Our bodies are holding all these symptoms that communicate with us, but our minds, you know, partially out of seeking security or protection or whatever it is, We don't recognize that those stressors are often mental. For a lot of the people that I work with, whether they're, you know, mothers who are also high performers, but, you know, CEOs and, you know, those types of people, every single day with their brains functioning the way that they do, they're thinking about perfectionism, constantly optimizing, multiple tabs running, maybe self-criticism that's been onset since they were children.

Mm-hmm.

They honestly don't even recognize that there's another way that they could be because this has been instilled within them for so many times. And can you share with us, maybe, you know, you do so much in this space. Are there a lot of your patients who have become so customized to living with stress or hypervigilance that it's become them? Can they imagine another way of being? You know, you introduced the science, but are they understanding that there's another way to be and how to get there?

So it usually doesn't doesn't start becoming overly available to them to have this conversation until things start breaking down, right? Because we're not the type of— again, as humans, we didn't evolve to think about living a long time. We lived for the next day, for the next week, for the next month, right? So to shift that perspective typically takes symptoms. And as you said, Mona, so well, is that our body is always telling us what's going on, right? It is an amazing machine that has lots of different sensors, lots of different capacity if we just tune into it. And oftentimes, it becomes to the point where it becomes you can't deny that things are happening and changing. And so, you find that you're not recovering as well in general. Maybe you're exercising but you're getting these small injuries that are not going away. You find that your mood is becoming more unstable. It used to be relatively stable and now it's kind of up and down. You're more reactive than you used to be. You'll find that your mood is up and down as well. It used to be more stable. It could be that you just feel wired but tired. Maybe your sleep is now starting to be affected. Maybe your relationships are starting to be affected. And then typically when somebody looks to find some help, right, something is changing and this is not good on some levels. And it's usually more of a slow burn rather than falling off a cliff, although that can happen during perimenopause when women's hormones start going all over the place. Estrogen fluctuations are a big one because estrogen is an amazing mitochondrial enhancer. This is why during the menstrual phases when your estrogen level is highest, that's when you feel the best by far. And, that's during ovulation. And so, that's why during ovulation you feel the best is this has all evolved to make you feel the best so you're ready to procreate at that time, basically.

Yeah.

But again, you can also utilize that for lots of great things outside of procreating, of course. But the idea here is that women will sometimes have a bigger cliff than men because of hormones and hormone changes. And then the conversation becomes, which is— this is an interesting one. This is kind of, I think, the crux of your question is like, how do you describe what that there can be an alternative to what they're in now and that they can still function at a high level without being at this sort of massively stressed place. And so that takes practice and it takes time for people to realize that one, you can bring down your nervous system and regulate just a little bit less than you were. It doesn't have to be like parasympathetic, like sitting on a couch relaxing with your family on a Sunday evening. Like, that's nice too, but like you can't And, if you can't be there potentially if you're at work and you have your kids and you have to go places, I totally understand that. But, one of the examples I give is a little bit sideways, but follow me. So, if you're a Navy SEAL and you are supposed to be performing at your max, do you think that you're going to do that when you're super, super stressed? Or, do you think you're going to be a little bit better if you're down a little bit lower but just flowing in there?

Mm-hmm.

Another good example I like to— Jeremy likes when I give this story. His name is Jeremy Bloom. He's a friend of mine. He's the only professional wide receiver in the NFL and an Olympic skier. And, Jeremy lives close to me in Colorado. And, I was talking to Jeremy. I interviewed him once. He's a super cool guy. He's actually the CEO of the X Games right now.

Oh, cool.

And so, when he was skiing, when he was first skiing as a kid, he would listen to Metallica and hard rock to get down the mountain. But, by the time he became an Olympic skier, he's listening to Mozart and Beethoven.

Why?

Because he didn't need his nervous system to be more stimulated. He needed to drop down. And so, if you can teach people that, if you can drop down just a little bit, you're going to perform so much better. And, it's not about being at that hyperstimulatory place all the time, that hypervigilance, because you don't perform as well up there. The front of your brain, the frontal lobe doesn't get as much blood flow if you're hypervigilant all the time. And, it's much more difficult to think about to keep them in your mind, to take things out of long-term memory bank storage and bring it to the front of your brain. And so when you start having that conversation and go, what if you could perform better than you are now? Like, what if we could drop down your nervous system? Not so that you're laying on the couch so you can't move, but just that you're down a little bit more. Because I think what people don't realize, Mona, is that sympathetic and parasympathetic, so the branches of our nervous system, it's a spectrum. It's not like you're just on one. It's not like A, B.

Yeah.

It's like, no, you have like a gradation of grayscale between the two. And so as a result of that, you just want to be further down on the spectrum more of the time.

Right.

And then when you do that, you're going to have more reserve if there's anything that does happen to you and that you need to show up for. And that's what I call sympathetic reserve, or I call the parasympathetic edge if you want to get fancy with it. But bringing it down and teaching people how to be there, that's the gold. It takes time. And there's lots of different And there's some ways to do this which we can talk about, but that's really the conversation that I'm having. And then as we're learning, as people are learning to bring down their nervous system, they have to do it in a really supported way, a very well, a very supported way, because it can be scary in some cases to bring down the nervous system if you've been up so long.

Social media has really missed the mark on that as well, right? I think we don't talk about adaptability. living in a sympathetic state, that you should always be in parasympathetic. But no, it's the balance of both and understanding how they can serve you and really the brilliance of the body to be able to take you from one to the other.

Yeah. A good example, another one would be exercise. So people need to exercise. Exercise is kind of an important thing. But if you're super stressed before you go into your exercise, how efficient do you think your exercise is going to be versus your nervous system is more regulated, And, you have less tension overall, you're going to be able to put more tension on your muscles when you're exercising. And, it's that delta, it's that change that causes you to be able to build muscle, to build strength. If you're already hypertense going into a workout, you don't have a lot more reserve, you don't have a lot more capacity. And then, you're going to ask me, well, why am I not making any gains at the gym? Why do I feel like I'm working so hard but I can't lose weight? Why am I working so hard but I can't build any muscle? I'm like, well, it's because you're in stress mode all the time, man, because it's The other aspect of it is when you're in that stress mode, you don't heal, you don't detoxify because it's the parasympathetic side of things where you rest, digest, detoxify, and heal. And so, you don't make your gains in the gym, you make your gains after when you recover.

And yet, how many practitioners or doctors are really talking about the power of resting when optimization is always about doing more, adding more, accomplishing more, becoming better, being somebody else, fixing something when really there's so There's such a superpower there. I think that's where most of my clients have done their greatest healing is when they know how to restore and figuring out kind of what their protocol is to help them get into that state. Let's break down, perhaps you have some male patients. When we think about the word safety, which we're using a lot.

Yeah.

A lot of people will say, well, what do you mean? I have a good life. My kids are happy. Business is great. But they don't understand a nervous system that feels unsafe. And maybe you can tie this into the mitochondria in that wartime zone that you speak to. What's happening at a cellular level or to our nervous system when it does feel unsafe? Like, it is a privilege to live in the world that we live in, especially with what we see and what we have access to through our phones and what's happening globally. But the way that the nervous system experiences fear or trauma is the same. Can you break that down?

Yeah, that's a great, that's a great question. We talk, I've been talking a lot more about physiologic safety.

Mm-hmm.

Recently. And I've noticed that it's becoming more of a bit of a hot topic as well. And I think it's, it's different from psychological safety, right? And I think that's what people have to remember. But they're very much not mutually exclusive. Because to feel physiologically safe, you also have to be psychologically safe too, right? And if you want to, if you're feeling psychologically safe, you also have to be physiologically safe. So they go together, but they're a little bit different, right? Because Yeah. There are different mechanisms. There's different processes ongoing that are so interrelated. And there's hormones, there's neurotransmitters, there's— but the big part of this, as you were just alluding to, is the part of the cell called the mitochondria and how that really will manifest both of these aspects simultaneously, both your physiologic and your psychological safety. So, if you have mitochondrial dysfunction, it's very difficult to feel physiologically safe and psychologically safe at all times because your cells are always in— they're under threat. They feel like they're under threat. And so, if they feel like they're under threat, they're going to be putting out other hormones, other neurotransmitters to manifest your capacity to help mount a response if there was something that you needed to respond to. So, that's the hypervigilance thing there too. So, the key with physiologic safety is you have to look at this on both ends. You have to look at what's actually happening in the body from metabolic side and you have to look at what's going out outside the body that's causing any psychological stress that's not being well managed. And as you mentioned, though, as well, Mona, it's not just one thing, right? There's multiple things. Oftentimes, there's just one thing that might just be that final thing that causes the domino effect, right?

Mm-hmm.

You're doing well. And I've had this in my own life, and I can think of a number of examples where I feel like I'm doing okay, and then all of a sudden, I have to do something else, whatever it might be. I'm like, how the hell am I going to figure out how to do this right now? And, all of you can probably resonate with that. I have so much going on. I cannot imagine doing something else. And, that's for me whenever that happens to me, which it happens, it does. I'm like, okay, this is what's going on. Inside physiologically, metabolically, something is not optimized. Something is not there to really keep me safe from a physiologic perspective.

Yeah.

But, you mentioned the thing also just kind of as an additional point here that's important. It's not like I'm asking people to do more typically here, right?

Yeah.

It's not like we need to optimize by doing more. It's often by doing less. And, I think that's the hard part is that I'm going to tell you that you're going to have to do less to feel safe physiologically and psychologically. And, that's hard because that's not what we're used to. I mean, I've had this conversation with a lot of my patients. I just need more energy. I just need more stimulants. What can you give me to give me more stimulation, more energy throughout the day? I'm like, how about we calm you down? You know, and I say that in the nicest way possible. I don't tell people that are anxious to calm down. That doesn't work. I had a conversation with my— you like this— I had a conversation with my 8-year-old, my 8-year-old boy. So I have 3 girls. My youngest is a boy, so he's 8. And he's like, Dad, what are some things you don't tell girls? And so all my daughters and my wife were in the room. I'm like, okay, there's many things, right? But one of the things you do not say is calm down if they're angry or upset or anxious, because that's not going to work, right?

Ever.

Never. There's other things you say, and we don't have to go through the whole list, but there's many. And my daughters were very vocal as well as my wife. But I said, there's certain things that you can say to your sisters that you can't say to other girls too. It's okay too. But that's the story for another day. But in the end, telling people to calm down doesn't work.

Doesn't work.

And so you have to give them the feeling of calming down. That's what it comes down to. And then calming down the nervous system and also supporting energy at the same time. That's kind of been one— what I've realized recently has been the most effective is that you're doing things simultaneously for people because the problem is Because if you just tell somebody to relax or give them ways to relax but their energy capacity is so low, what happens is that they can crash. And, I've seen this where somebody that was going at a high level knew that their stress is a big deal, decreased their stress, maybe they took something, maybe they did some breathwork, maybe they went on a retreat or something like that, a meditation retreat, and things just went haywire.

Yeah.

Their nervous system was trying to calm down, but they didn't have enough capacity physiologically, metabolically to be able to tolerate coming down and being at a lower level. Not enough energy being made, too much toxicity. There are so many things going on. And so, what I found to be so helpful, especially if people are more dysregulated, on the higher dysregulated side, is working on energy first.

Mm-hmm.

Not trying to give people more stimulation, Just working on your capacity to make energy and capacity to neutralize the stress of making energy. And, that's really in your mitochondria. So, metabolic health is what I'm talking about here. People have heard that term, but what that term really means is, can you make energy from your food effectively?

Right.

And, can you address the stress of having a gasoline-powered engine in your cells that makes waste products that need to be addressed as well? So, it's really, really important, I found, to address their energy capacity. But, it's so important also to address the stress because if you just address the energy capacity but you don't deal with the stress, it's the one time that I agree with some of my conventional colleagues, like giving supplements to somebody and giving them expensive urine because the stress is still there. Nothing's going to change because they're so clamped down.

Mm-hmm.

It's so important to remember that too. And, on the other end of it, if you just deal with somebody's stress like we're talking about but don't address that energy side of things, Then they very well might crash. I had another colleague of mine that just reached out about one of his patients that had chronic Lyme, chronic mold, multiple different things, super stressed as well. And they went and got what's called a sympathetic ganglion block. I don't know if you've heard of these.

Right. Yeah.

It's sometimes called the God shot, I think, now. I mean, basically what it's supposed to do is shut off your sympathetic nervous system. Okay, that can work in some people. But in many people, like this particular lady that he was describing to me, she completely crashed, right?

Couldn't get out of bed for 2 weeks afterwards because of it.

And now slowly building her back up. So that just gives you a description, I think, of how I describe and think about physiologic safety. It's not just metabolic, it's psychological, but it has to be addressed on both ends.

Do you think— you mentioned the Conventional docs that you're working with, are they having the conversation around mitochondria yet? Is mitochondrial function happening?

No, no, not in conventional medicine. No. I mean, conventional medicine doesn't have the time for it, right? Because if you're a conventional doc, you have 15 minutes with your patient and most of that is typing on a computer about their issues for that particular day. And, I was in that bubble for a little while. I know how hard it is. I worked in a clinic when I finished my residency in internal medicine in Baltimore at the University of Maryland, for my first year in clinical practice, I worked in a family medicine doctor's office and I was the other doctor in the office and 15 minutes with patients, right? And, I was walking around with a computer and trying to do it and seeing patients. It was terrifyingly terrible. I did not like it at all. And, I saw what he was doing. If people came in with anxiety, fatigue, Depression, SSRIs. That's it, right? And that was it. And they don't have time. And so I— but they mean— most of them mean very well. Like, let me make sure I understand. Like, most of the doctors that I know that are in the conventional system, they really do care. They're trying their best, but they just don't have the time. And they're also hamstrung by the idea that everything has to have a randomized placebo-controlled trial. And that's just unfortunate. Because by the time that stuff hits the main— by the time things that we're doing in the integrative space hits some of the conventional docs, it's already been 20 or 30 years. I'm like, I don't want to wait for that kind of thing. If it's going to be a reasonable intervention that has physiologic basis that's not going to harm somebody, somebody like myself who's an integrative doctor is happy to do it. But a conventional doctor will say, no, there's no studies. No, there's no evidence.

Yeah. Exactly.

That's unfortunate, but they're stuck by time and they're also stuck by having to be in that conventional bubble of what's research-backed, what's evidence-based, and that could be very hard.

This is where I think you're also so forward-thinking because most practitioners today were either talking about nervous system health or we're talking about mitochondrial health, 2 separate conversations. And for listeners, I really just want you to kind of tune in even if there's no stress around you, the distinction between psychological stress and physiological stress and how that might correspond to how your body metabolizes toxins or gut issues or the inflammation that you have or whatever symptom that you have, just to start to really tune into what your body's trying to communicate with you. And instead of looking for something to fix or the protocol or the expensive urine that you're trying to look at.

Yeah.

An analogy that I heard from a doctor recently, and I actually thought about you.

Mm-hmm.

You know, we tend to demonize nervous system dysregulation, but he's like, stop. What if you came into this world being able to have the capacity to hold a lot, to do a lot, to think about a lot, and you're able to operate at that level? You've got a Ferrari, right? But sometimes the Ferrari, if it doesn't have the fuel, means that you're running on fumes. A Ferrari cannot run on fumes. And so you need to take a step back and refuel properly. And finding a practitioner to kind of help you with that root cause might feel a little bit overwhelming or a bit of a lost cause. But if you do need the science, you started off this podcast saying like the source of chronic inflammation, right? And how that's related to metabolic dysfunction in our society is very prevalent and how that's linked to all diseases.

Yeah.

The other thing that you made me think of is when you do a yoga teacher training, often people who end up in this dysregulated They'll go and do yoga teacher training. It's typically around week 3 of a yoga teacher training where the practitioners will get up and, you know, leave their yoga mat because they have some sort of a release. What they've practiced up until that time is they've shifted their environment, right? There's no threat. They've shifted their diet. They've lowered their inflammation. They've learned how to move their body. They're optimizing their mitochondrial function by being outside, lowering blue light exposure, increasing their fiber intake, checking all the boxes. The stage has been set for them to have that release and recalibration. And I think the invitation here is to really just take a step back and look at your life. Where can you recalibrate to the areas in your life and in your home, at your office, in your relationships for you to experience a little bit more of a release or relief?

There's a couple of simple things that I found to be very helpful for people. It sounds simple, but I know it's not easy, right? One of them is Maybe put your phone away for a couple hours on the weekend, right? Have a little bit of a phone holiday. It sounds simple, but being away from your phone for 3 or 4 hours is glorious after the first 10 to 15 minutes, OK?

Yeah.

Because that's when you're going to have a little bit of anxiety about your phone, about what calls you're missing, who's, you know, et cetera, et cetera, right? Do it at a time when you know it's going to be a safer time to turn off your phone, OK? You know, maybe your kids are with somebody else or you have a little bit of extra time and nobody's going to be needing you, right? But, I found that really what all of us need to do to start help regulating, Mona, is get more time off our screens. And, I think that that's one of the first things that I usually recommend with my patients and something that I do my very best to do as well, although I'm not as successful with it every time as I want to be, as all of us. But, the best word that you can use here is— it's a very simple word, subtract. Take things out.

Yeah.

And really, and I have my colleague, Dr. Ted, who runs our companies. He's the founder. He likes to say, kill your constants. And he's a mathematics guy, so I don't really understand the math about it. But what he really is talking about is that there are certain things that you think you need to do that you probably don't need to do, right? Even the things that you think you need to do, like you probably don't need to do all those things, right? Do you need to go on a vacation every weekend? Do you need to find a new thing to do all the time? Could you just spend some time at home and relax, right? Could you find something that's simple and easy? Maybe not make— maybe you're working all day and you want to make this beautiful dinner for your kids. Maybe you just make chicken and rice, make something easy, and they're going to be okay, right? And so, for me, it's having this conversation with my patients and internally too, like, what are the things that you do really need to do today? What are the things that are really, really helpful for you? for your capacity and the things that you're trying to show up for in this world. Is it your kids? Is it your job? Is it your spouse? That's great, but that's still all external stuff. In the end, it's all about your own internal biology, right? Because when you show up for yourself, for this avatar that you wear, everything else gets easier. And that's the real secret. It's not really a secret, right? But it's like the Michael Jackson songs and changing the world. You got to change yourself and all that kind of thing. But it all sounds cheesy, but it's true. And it's hard because I know a lot of women especially, it makes them feel selfish on some level because they're like, well, I can't take care of myself. I got to take care of everybody else. But you have to realize that you are a much better human for everybody else in your life if you're also taking some time for yourself. And so subtracting is part of that. Like, what are the things that you don't need? What are the things that you really don't need but you're just doing because you're trying to keep up with the Joneses or whatever it might be, right? Especially if you live in a place where there's a lot of affluent people like And my kids get this like, oh, Dad, my kids, my friend just went to Hawaii. Why can't we go? Or like, you know, all these kinds of things. I'm like, wherever you go, there you are.

Yeah, wherever you go, there you are. Always. Yeah. And this is where, like, I really pray that we've talked about integrative healthcare for so long, but I really don't see a lot of practitioners practicing it. One is time and availability and really the ability to make changes. And I have a rooted community. And just earlier this week, I would say the hardest thing for most people in that community and the clients that I work with, when I say that if you want to optimize your health, all you have to do is move yourself into the number one list of things to do on your priority list. And it doesn't mean do more, but just prioritize what you think that you need, right? This idea of personalized healthcare doesn't mean doing more. It's just being attuned to what your physical body actually needs. And maybe this is a good I think that's a good segue into understanding for a lot of the people that I work with also, they need some sort of metric, they need some sort of lab or test in order for them to really understand that they need to make a change. So I guess first, is there really an effective way yet or more effective way to assess the health of our mitochondrial health? You also talk a lot about the top-down versus bottom-up entry. So let's talk about testing first.

Sure.

Yeah, maybe understanding how somebody can approach their symptoms if they don't want to look at testing.

Sure. So I think my favorite metric right now to look at nervous system regulation is called heart rate variability or HRV. And many of you listening have probably heard about this before, but for those who haven't, just a brief primer on it. Heart rate variability, so your heart beats regularly for most of us unless you have any arrhythmia, but even if your heart's beating regularly, there are these small beat-to-beat variations of every single one of your heartbeats. And, these small beat-to-beat variations are called your heart rate variability. And, actually, what's most healthy when you have a balanced nervous system, more balanced nervous system, that you have more variability actually between these heartbeats. Again, you wouldn't hear it if you had a stethoscope on your chest, but if you're looking at these various ways of looking at the data from an EKG, electroencephalogram— I see an electrocardiogram. So, electroencephalogram is the brain.

Electrocardiogram.

Cardiogram, you would see this B2B variability. And if you have more B2B variability, that is healthier because it's a better balance between your nervous system, your sympathetic and parasympathetic. If you have a lower heart rate variability, you have more dysfunction of that balance, typically more sympathetic than parasympathetic. I don't know very many people out there that are more parasympathetic than sympathetic out there. If you are, congratulations, you're definitely an anomaly. For the most part, most people are on that sympathetic dominant side of things. And so, what I really love to be able to show my patients is how this shifts when they start bringing in more sleep, bringing in more breaks during the day, bringing in more acknowledgement that this avatar that you wear requires being in that parasympathetic mode. And so, when you can show heart rate variability improving. And, there's different ways to do this. There's typically wearables are the other best way. So, you have an Oura Ring or you have a Whoop or you have an Apple. I think even Apple has an HRV on it now too, the Apple Watch. I'm not positive about that. But, that's the one measurement outside of laboratory testing that I've found to be very, very helpful because very, very common for high performers to tell me, I feel great but my HRV sucks. And, I go—

Yeah, exactly.

I know what's going on. And, it's the same deal over and over again. It's because you're in sympathetic the time and then you try to go to bed, you sleep, but your HRV is tanked because you don't have enough gas in the engine anymore, right? Because people also don't realize that you need energy to sleep well. And, that typically means that you have to have better energy throughout the day. If you're already on fumes by the end of the evening, you're not going to have enough energy to sleep either. And so, then it's kind of a strange one like you need more energy to sleep. I'm like, yeah, you need more cellular energy, right? You need more metabolic energy.

Yeah.

And so, I would say HRV is probably my favorite. I don't know if you have any favorites too that you use in practice, Mona, but that's the one that I use.

Yeah, HRV is a big one. I look at a lot of high performers and when I see them performing nonstop, traveling nonstop, they wear it as an accolade. Oh, I can get by on 4 or 5 hours of sleep. And, I'm looking at their HRV in their 20s and 30s and I'm like, are you though? Really?

Yeah, yeah. You don't have that gene. There's only maybe 1 or 2% of the population. population that can get less than 6 hours of sleep and still be able to function. My father is one of those people, but very, very rare. You are not one of those people most likely. If you're starting to get symptomatology, like you're getting issues with brain fog, recovery, cardiovascular issues, high blood pressure, these are things that are all giving you the indications that you cannot tolerate that kind of sleep. Average human needs between about 6.5 to 8 hours of sleep, and 7 to 7.5 is usually good. And, women need a little bit more. Women, depending on the time of their cycle, may need about 20 to 30 minutes more sleep every night than men as well just because of hormonal shifts and things like that. So, yeah, you can do it for a while. I mean, I'm not sure if I mentioned this last time we spoke, but when I was in medical school, my friends and I had shirts that said sleep is for quitters. You can tolerate less sleep for a little while if you're relatively healthy otherwise, right? If you're metabolically healthy, you can do it. I don't recommend it, but you can do it. But, it's not something that we should be trying to do. And, that's unfortunately what society has built into our proverbial, our DNA as it is, which is that we need to be hustling, we need to be doing less sleep, we need to work, work, work, hustle, hustle, hustle. But, that then tanks your HRV and it's down now in the 20s and something's going on even if you don't feel like anything's Right? I feel okay, but my HRV is 20.

I'm like, well, we gotta talk.

Yeah, we gotta talk.

Yeah. One of my least favorite words is the word fine. How are you? Fine. Fine. Are you just fine? Like, we've really forgotten the beauty and the joy that there is around living. And I really try to coach my clients on seeking more awe and more wonder every single day because it impacts your physiology, right? So don't answer fine. If you ask somebody how they are, really try to tune in, try to connect.

That's what my kids say. I mean, they say, how are you doing? I'm fine.

How's school? Fine.

Yeah, it's the 4-letter word. As a practitioner, I'm always very gentle around that word because it's something that can mean so many different things. A lot of it is intonation. A lot of it is eye movements and eye gazing. Are they giving you— are they actually looking you in the eyes? They're not. This is all the microexpressions that people use. And as practitioners, you get very attuned And I get to tune these to my kids too. So I can tell when the fine is like, everything's great, or fine's like, no, things aren't that good at all. And so you have to kind of like really piece it out. But I'm a big fan of not using that word. Just like the word interesting, it doesn't mean a lot anyway.

Yes, exactly. Over the years in your practice, have you noticed an increase in the feelings of burnout? And how do you guide somebody who feels like, going back to people who felt this since they were little kids. You know, everyone wants to know, well, how long does it take to break the cycle? How long does it take to learn how to become a new way? And I know for everybody it does look different, but what would be your entry point to somebody who's listening and be like, that's just who I am, it's how I've always been, I don't know any other way?

Yeah, well, I think burnout's much more common now. There's no doubt about it. And it's because we just have so much input, so much stuff coming into our field world at any moment, at any day compared to what your grandparents would have 50 years ago, even your parents 20 years ago. Even looking at my kids and just seeing how much is going on in their worlds, right? It accelerates with every generation. And, you add on that the toxicity of the world as well with the types of food that people are eating, the types of water they're drinking, the pesticides in the foods and the processing and the blah, blah, everything else. What it is is just it's like this huge pancake stack that just gets longer and longer and longer. And so, people younger and younger are reaching their capacity. And, I have a colleague of mine that her name is Dr. Jill Carnahan. She's a really great lady and she talks about your bucket size, your toxic bucket. She says everybody has a different size bucket when they're born. People have a smaller Yeah. They get sick earlier with toxicity. Other people have larger buckets. They could be like— I don't remember who— I don't know if you remember who George Burns was, but he was this comedian that lived to like 100 years old smoking cigars and drinking whiskey every day, right? So many people, most people do not have that sized bucket. Like, that's like the size of Olympic swimming pool or something like that, right? Where other people have a very small one and they get— and so the issue is that we're getting more toxic exposures and people are overfilling their buckets earlier and they don't have enough capacity to to have a drain at the end of that bucket to get the stuff out. And so, as practitioners, we have to learn and teach people that modern society is not built to keep you healthy. It's actually built to make you sick. It's just plain and simple. Physically, emotionally, psychologically, it's built to make you sick because what it does is that we are in a commodity world, right? Everything gets commoditized to steal your attention, to steal your hunger, give you the perfect Dorito that has 45 different ingredients with the right You know, the right spice and the right taste and the right crunch and just to really try to exploit your biology. So, not every company is doing this. Of course, we have— there's amazing people doing amazing things out there. But, in general, convenience, humans want that, right?

Mm-hmm.

And then, what companies do is create things to create and leverage your biology so that you You get taken away by those conveniences. And then, we sit around, we don't walk anymore because we don't have to. We can just call Instacart, right? We don't have to get outside anymore because, well, there's lights inside, aren't there? So, I don't have to go outside. So, in my practice, that's what I've seen is there's a lot more burnout earlier. And so, to the second part of your question, which was, well, how do you start here?

Mm-hmm.

I think it's a great question, right? And, I think a lot of this depends on the individual. It's very difficult to give overt advice. And what I like to describe here, what we have been describing, is a pattern that I lovingly call the sympathetic spiral of doom, which is this pattern we've been talking about with sympathetic activation, mitochondrial dysfunction, and it can happen in a lot of different ways. And once you recognize that you're somewhere on the spectrum, then it becomes, okay, what are some of the major levers that I can start pulling to make a big difference?

Right.

And maybe it doesn't have to be a major one. Maybe it's really low-hanging fruit. Maybe it's— maybe I just won't check my phone for a week in the morning and see how the rest of my day goes. Maybe it just— instead of checking my phone first thing, I just won't do that just for a week to see what happens, right? Um, you like this? I, I never realized how many stories I have until I start talking about it.

I love it. I love them.

But, you know, my kids, they don't eat the healthiest. They do— we do great at the house, but they've eaten, you know, they have They were just in testing, they're getting candy. And, my daughter made a cake last night, whatever. But, for a week, every quarter or so, maybe we try to do 2 weeks, I make them do a detox, which is like, okay, no sugar, no gluten, no dairy just for 2 weeks. They hem and they haw the whole thing. But, by the end of the 2 weeks, they're like, wow, I feel pretty good.

Interesting.

My daughter who's 15, she's like, my Skin looks great, but then she goes back to sugar. It's like I don't care, Dad.

I'm still eating sugar.

You know, fine, right? But something like that, right? Do take one thing out of your diet that might not be the thing that you know is not that great for you. Like maybe it's your ice cream at night. Maybe it's your glass of wine after dinner. Like something small that can make a big difference. And that's what I typically do for people is like it's not one of those things that's going to happen with. without you wanting to have a little bit of motivation. What I'm trying to say is there needs to be a little bit of motivation. Something has to be going wrong typically or not as optimal as it was before for you to be able to make these decisions, I think. But if you're listening and you resonate with any of this, try to find something that's a low-hanging fruit for you that you know can make a big difference. And if you're looking for those things, you can find them online too. You're like, what are low-hanging fruits that are going to decrease my stress that I'm doing on a daily Just put that question in there, and I bet you there'll be 5 things on that list that you're doing.

Yeah, yeah.

You could stop doing one of them for a week or 2 and just see. You know, you and I are big on nutrition, and so that's often a very easy way in. And sometimes it's like, I'm not gonna stop my phone, but maybe I'll stop dairy for 2 weeks, you know, just to try it, you know. Or maybe I'll stop eating gluten for a month, you know. I can do that with some of my patients. Or even if they don't want to stop eating something, maybe I just don't have them eat for 17 hours. Maybe just have them eat for 8 hours and see how that goes, like a little bit of intermittent fasting. So I guess I'm not giving an answer, but I'm answering you, which is that—

You are.

Which is there's lots of different ways in. Low-hanging fruit is really important. But I guess the other piece of this too, Mona, which we haven't spoken a lot about, but if I can, I will present the idea that sometimes Sometimes supplementation short-term can be helpful here, which is giving things that can help with a little bit of energy or giving things that can help downregulate your nervous system can be helpful because we are programmed to like to do more, as you said. So, let's try something more, right? But, in the context of giving you something more to give you the experience of what it feels like, so hopefully over the long term, you can do less. That's the idea.

Yeah.

So, I like to use something called Tro Calm from my company, Transcriptions, which I like a lot because it is a way for people to downregulate their nervous system without feeling tired. And then, that is a way to get a sense of what it feels like to not be as stressed. Now, I don't do that directly if somebody's super stressed and super chronically wired and tired. That's when I usually start off with a little bit of mitochondrial support first. And, that could be with a little bit of methylene blue, which I know you like.

Yeah.

like, or it can be with even just getting a couple different shifts in their diet, which can be helpful there too. But sometimes supplementation can be helpful as a window, as a bridge, as to what the road looks like once you start feeling a little bit better.

Yeah, we weren't ever meant to be taking upwards of 30, 40, 50, 60 supplements a day. And more often than not in the past year, as you were With burnout increasing, I'm noticing people just, you know, trust that they need to be taking all of these things. And as a practitioner, and I know that you offer this in your practice, there's such a deep level of investigation to see what my entry point is to make the most impact for each person on an individual basis. And I often make the joke that it's often through their gut, right?

Always.

People will open up and talk to me about their poop and their digestion and digestive systems, and that opens the doorway to talk about their stress stress, their overwhelm, their anxiety and stuff like that, which, which I really love. But everyone listening, like, your protocol should really be different. But this is a great opportunity when we think about mitochondrial health. I keep going back to this essence, like the terrain of the body that actually knows how to work. And it's something that most of us are disconnected with. We can't see it. Most doctors aren't talking about it, let alone testing it. But if you were to just imagine what if your body, you could just optimize its function. And that would turn the lights on on every other pathway to optimize a little bit more. So let's hover a little bit on methylene blue first.

All right. Sure.

On its benefits. Talk to us about transcriptions. And it's been about a year since you and I met, and I was new to methylene blue and I was really curious about it and I was doing my research on it. And it, it's pretty profound. It's, it's something that's been around for a really long time. The studies are there to really back its relevance when we think about it in terms of oxidative stress or optimizing energy or ATP production and stuff like that. How does someone kind of enter into using it for its benefits? Is it something that we should take consistently? Is there a proper protocol that we could go on to really see if we could feel the difference? I noticed for me, I have beta thalassemia. I don't know if I shared that with you on the first podcast. You did.

podcast.

So, you know, oxygenation of my red blood cells was, was an issue. And I'm also somebody who on the outside looks calm, cool, and collected, but on the inside I tend to be screaming. And so you were my 911 and you prescribed, you know, using Tro Calm along with the methylene blue together. And it was a game changer for me. I felt like my brain turned on, but it didn't put me into override. I had that calmness so I could show up and feel like I had a little bit more flow. So all that to unpack. Let's dive into the benefits of methylene blue.

I love that. I appreciate that it was so helpful for you, Mona. And it's very common because most of us, as we've talked about this whole podcast, are— maybe some of us are calm and cool and collected, maybe some of us aren't out the outside, but certainly many of us, most of us are having some element of what's called mitochondrial dysfunction. About 94% of US adults have some element of this. It's a huge number. Only, only 6% None of us are metabolically healthy all the time. And so, it's a spectrum though. It's not like everybody has severe mitochondrial dysfunction. At the worst of it, you have an inherited mitochondrial disorder where you don't have mitochondria that work well because of a congenital reason. But then, from there, you have a big spectrum of what this can look like. And, what that means if you're not making energy effectively, you're also— so, when it comes down to Mitochondrial dysfunction, I should sort of define that. So, mitochondrial dysfunction is either defined as that you can't make energy effectively or you cannot neutralize the stress of making energy. As we talked about earlier, we make reactive oxygen species. Those need to be neutralized by antioxidants, but the body sometimes doesn't have that capacity. And so, as I mentioned earlier, our cells are like gasoline-powered cars. We make energy, we make waste. And so, the very cool thing about lower doses of methylene blue from a good clean source is really, really important here because it sometimes can be contaminated with things like heavy metals like lead, mercury, cadmium, and arsenic, and you don't want those, of course. But very low doses of methylene blue are fantastic at being a very different type of car, an electric-powered car, because it comes in, it helps you make more energy, but it also can be its own detoxifier. So, it can work directly as an antioxidant and it actually indirectly can Stimulate the production of more antioxidants in your body too. There's very few compounds out there though that are like this. It's called a redox cycler, R-E-D-O-X cycler, meaning that it helps with energy and detoxification at the same time. And, that's why I can use it so prevalently in my practice because it's doing the work at supporting mitochondrial function right now. It's not one of those things that builds up in your body over 30 days or a year or something like that. And, there are certain things that I use and bring practice, like vitamins and minerals, that can take 3, 6 months to really build up in the system. But, what's nice about methylene blue is it comes into the system and then within about 3 days, you should feel the difference. If you don't, you increase the dose. And, if you don't feel it, then you increase the dose even further. And so, you start off at a low dose and you titrate to what works for you. And, what I found over the years, the best way to have the experience of using it is to start off that low dose and then just find that dose over about 3 days. If it doesn't work for you that one dose, increase it the next for the 3 days and then increase it again. And then, when you start feeling the right dose, you will know it. It shouldn't be mild. It should be like, okay, this is something different here. The thing about methylene blue on its own is it's not a stimulant. It's not like caffeine.

Right.

It's not going to give you this stimulation that you feel like you're super high and then you crash down. It doesn't do that. It gives you more energy and then it keeps you there for about 4 to 6 hours. And you'll feel like you're just more elevated. In some people, especially people not as rooted in general, is that they'll look at the rest of the day like, oh, at the end of the day, I didn't get as tired in the middle of the day. I didn't get that afternoon slump. I didn't yell at my kids when they yelled at me kind of deal. And that's sometimes kind of like a rearview mirror effect. But in general, the way I would describe it is this. If you have more to go, if you have more support that you need, you're going to feel it more significantly compared to somebody that's more on the optimized side. They're not going to feel it as much because they're relatively well optimized. It's like if you have 300 pounds to lose or 20, right? It's easier to start seeing the weight come off when it's 300 pounds than when it's 20. It's the same thing with methylene blue. And, I've gotten a really so just amazing— it's been so amazing and just hard to describe just how much I've seen over the last 6 years with this particular compound because I was very skeptical about it initially when we first decided to come out with a product using methylene blue. methylene blue because it's not something that comes from nature. It's actually something that was made in a lab back in the 1800s. In the 1890s, it was the first drug registered with the FDA. So, my first sort of hump was, well, it's synthetic. People shouldn't be taking something synthetic. But, when I realized, okay, let's have that argument, right? So, not everything natural is good for you, everybody, right?

Exactly.

You can have natural things like arsenic that aren't very good for you that might kill you, right? Cyanide is also natural, right? So, again, not everything natural is good for you and not everything synthetic is bad for you. Okay. And, methylene blue falls into this category. If you're taking insulin right now as a type 1 diabetic, that's synthetic. My son who's now 8, but when he was 5, he had a tracking skin infection cellulitis up his leg. I watched it go up his leg. I was watching the redness go up. And, I'm an internal medicine doctor. I know what that means. That's not good.

Yeah.

And so, back in the 1800s, there was nothing that you could have treated it for. It was just good luck. Maybe it gets better. Maybe you're going to die. But, I took him to the hospital. I gave him antibiotics, which are synthetic. He was better in a couple days, right?

Exactly.

And so, there's a reason for synthetic things sometimes. And, I think methylene blue falls into this category where it becomes this bridge for so many of us because it can give you energy now. It can give you detoxification now. It can decrease inflammation. So, I've seen people with brain fog get better, concentration improve, inflammation in the body, pain, many, many things over the years. And, it's been transformative to so many of my patients, I use it as a bridge, Mona, in the sense that sometimes in the beginning, we need to be using it maybe daily in some people as they're really trying to build up their system because it can take them down their health optimization path and take them multiple levels further on their path. So now, they have more motivation, they have a little more energy, they can do some of the harder things that they couldn't do before, which weren't possible where they were at that point. But, the goal always for me is that once some of those other things are starting to come online, dietary changes, lifestyle, stress response, then we can peel it off and not use it as often and only use it as needed when you have more stress, when you're traveling or when somebody's sick or when you had a bad night of sleep. Then, you use it as more of a support during those times as opposed to all the time. So, it's a fantastic compound and one that I use a lot to support the mitochondrial aspect of the sympathetic spiral that we've been talking about. But, in general, most of us need And maybe not all the time, but some of the time, at least for many of us.

So initially, then, there are benefits to the cumulative aspect to it. I'm hearing more so, so that you can actually feel the difference. And that in and of itself is the magic, right? Because then you are inspired to make more positive changes. You can show up every single day and notice a noticeable difference in how you perform and how you function and then how you sleep. And I think for all of us listening, We're all hard workers. We all have a lot to do. We never want to have our leftovers that we give to our kids and our families at the end of the day. Having that hour with my kids at night is life. Like, that is everything for me.

Totally.

And I would say that that was probably one of the greatest noticeable differences that I, that I had. And I think that I'm at a point where now I can use it in times of need. But I think I could probably go back and understand. So, as an entryway, what would be the proper protocol. I can just— I can hold this up for people who are watching, but these little packs that come just like this. Yeah, so Just Blue.

Yeah, Just Blue was really transformative to my clinical practice when we started using it. And then of course, our company Troscriptions was the first company to come out with a methylene blue-containing product for commercial use back in 2020. So way before it was cool, way before you probably heard about it, most of the people that are listening today. Way before RFK was caught on a plane in his water. I think the framing here is important, which is that what we decided to do— so Troscriptions is the company that makes the Just Blue that's in front of you there, Mona. And Troscriptions actually was birthed, it emerged out of a nonprofit organization called Health Optimization Medicine and Practice, or HOMO for short. And Health Optimization Medicine and Practice was founded and pioneered by this brilliant guy named Dr. Jed Atrokoso. And, the idea with the nonprofit was to bring people on a journey to optimize their health rather than focusing on disease or even the root causes of disease, just focusing on what health really is. And, we have a definition for that and we have a whole nonprofit with trained practitioners, 7 modules, a certification for practitioners as well. So, that whole ecosystem was already getting started when we were like, well, we want to also create a company that can help people right now while they're on that longer path because that path, as we've been describing, can take a while. It's not like if it took you 40 or 50 years to get to where you are that tomorrow you're going to feel better.

Exactly.

So, if I tell my patients, oh, don't worry, just wait 3 or 6 months and you're going to feel better, they're not going to come back and see you. And, I understand that. What people want, ways to address bottlenecks along that way. And so, Just Blue, our pure methylene blue product there, was one of our major ways of creating a way for people to have more energy. Energy, detox, resilience right away within the first couple of days of taking it. So, all of a sudden, as you were describing, now you have more capacity and now you can do some of the harder things that were difficult before, deal with some of your stress, deal with some of the other reasons why your mitochondria may not be working well. Maybe you have a chronic infection, you need to work with somebody and get on the right medications or the right supplements and things like that, but you've been hesitating because you don't have enough energy. You can't get You can't get out of bed, some people, or the brain fog is so bad. So, methylene blue, the way I dose it typically, so Just Blue, which you have in front of you, is 16 milligrams, 1-6. So, 16 milligrams. And, it's developed in what's called a buccal troche. It's a dissolvable lozenge that goes between your upper cheek and gum and dissolves usually. What's nice about a buccal troche is that because it's buccal in the cheek, it's very fast The ingredients stay highly potent. So, you lose a lot of potency when it goes through digestion for the most part except for methylene blue actually, which I'll talk about in a minute. And then, also, they're titratable. So, you can take a quarter of it and start there and then take a half and take 3 quarters and full and find the dose that's right for you. You typically want to take it in the mornings, see how you feel. Sometimes, you can take it early in the afternoons as well. It's not like a stimulant. So, most people can take it early morning and early afternoon and be totally fine with that. The thing about methylene The problem with methylene blue as a buccal troche, though, is if you dissolve in the mouth, your mouth is going to be very, very blue. And, if you don't mind, that's great, but most people don't seem to like that. And so, you can also swallow it on an empty stomach because methylene blue is so highly bioavailable. It's very potent even if it's swallowed. So, it's very rare as well that you swallow it and most of that is actually getting into the body, whereas most supplements that you would take orally lose a lot of their bioavailability. Now, we have some of our other products like our Tro Calm and others that are better in the mouth because the ingredients are going to be more bioavailable up there. Interesting.

Okay.

But, methylene blue on its own is very highly bioavailable. So, the dosing for me is almost with everybody, it's going to be about the same. Start with 4 milligrams, which is just a quarter of a troche. Try that for a couple days. Swallow it on an empty stomach. That's typically best. And, for an additional hack or additional cool way of doing it, eat about 20 to 30 minutes later because it's going to work faster that way. And, if you've ever had THC gummies, you know what I'm talking about and then had some food 30 minutes later. But, that's a different story when I was much younger.

I don't like THC now for the most part.

But you can take the 4 milligrams on an empty stomach for about 3 days. If you don't feel much, increase it to 8 milligrams, which is half the troche. Take it on an empty stomach. If you don't feel much at the 8 milligrams, then take it and increase it to 12 and then increase it to 16 from there. But usually around 8 to 12 milligrams, somewhere around there, for most people, they start feeling a shift. They start like, oh, I have more energy. My brain is actually functioning better. I don't have as much brain fog. My anxiety, my stress feels a little bit Which is unusual, right? You're like, why would my stress or anxiety feel better if I'm giving myself more energy? It's because what we've been talking about. Now, your mitochondria, your cells are like, oh, now I have enough energy. I don't have to be putting out stress signals anymore. I don't have to put out those smoke flags anymore. I'm now able to calm down and make energy more effectively. And so, it's cumulative in the sense that methylene blue is going to work as you're using it, right? And, it's also going to help support mitochondrial function and help rebuild some of the mitochondria as it But if you're not doing some of the other work over time to optimize your diet, your lifestyle, et cetera, if you stop your methylene blue, very likely you're going to go back very similar to the way you were before starting it if you didn't do some of those other things that are so important over the long term.

Yeah, we don't like Band-Aids. Don't look at things as Band-Aids, especially if you're going back into the environment that caused everything else to happen. So where in the past, I would say the past 6 months or so, I've been recommending these the most is actually my perimenopause community. Can we put this through the lens of perimenopause and the shifts that are happening there and how it could benefit there?

Absolutely, yeah. So, when you're having lots of shifts, estrogen is a big one. We talked about that earlier. Estrogen, when it is going up and down, is putting a lot of stress on your mitochondria. And so, having the methylene blue on board is huge during perimenopause even if you're on HRT, even if you're doing HRT. Many women will find that they still don't feel as well even on HRT. And then, you start giving them the mitochondrial support that they need and they And they start feeling much, much better. And then, we also get them to sleep better. Sometimes, being on progesterone is not enough. And again, because there's always fluctuations, we have something called Tro Zzz, which works on the GABA system. And, GABA is our primary way that we calm down the nervous system. It's the brakes of our brain. And so, using the GABA system, you can work and really optimize your capacity to both fall asleep, stay asleep, and then wake up feeling rested. But, Tro Zzz has 8 different ingredients in it, not just on the GABA side. It's the most comprehensive sleep formula that I've seen working on the GABA system, melatonin, serotonin, adenosine, and the endocannabinoid system. So, a lot of different signals there to really get you to go to bed. So, in the perimenopausal community as well, we have one other product that's been really transformative called Blue Canotine.

Hmm.

Blue Canotine is a combination of methylene blue with nicotine, caffeine, and CBD. So, this is a stimulant, okay? So, I don't recommend this if you're really on the hyper-stressed side of things. But, it does work and it does decrease brain fog. It does work like Adderall kind of but without the jitters and come down and crash. And so, that's why people like it. But, if you're already sort of hypervigilant all the time, I usually don't recommend starting there. I usually recommend starting with the Just Blue as a way to more support your nervous system without the stimulation. But, in a pinch, if you really need to get things done, the blue caffeine is the way to do it because it's going to take away brain fog very, very quickly. And even though it's a stimulant, nicotine itself, people get worried about. But nicotine is a great way to also decrease inflammation in the brain and also to calm down your nervous system. Interestingly enough, as long as you keep the dose low, you don't smoke it, you don't vape.

Okay.

Dose is low. So it's only 1 milligram in a full troche. But usually people— the average dose for blue nicotine is about half. Typically.

The feedback that I've gotten from a few women is just The things that all of a sudden were triggering for them or caused them to just be reactive, it took that edge away, which I think is a win for so many people. And let's just talk about that quickly, the neuroprotective benefits on this. So with that said, are you cycling people on and off? Are you looking in practice if they should stay on it for a month?

Is it, is it ongoing until they get, you know, they can slow their or decrease their What's interesting about methylene blue over the years is that what often happens is as the system gets more optimized, they need it less often and they need less of a dose to get the same benefits, plain and simple.

Interesting.

And so, it's like reverse tolerance where most tolerance is like you need more to get the same effect over time, where with methylene blue, you need less to get the same effect, less milligram dosage and less often. So, oftentimes what happens is I find that somebody that needed it 5 or 7 days a week and they're Initially, I can ramp them down to 3 times a week, maybe even just as needed depending on how they're doing. That's because the system is going to be more optimized and have more capacity overall. And then, the methylene blue comes in in a pinch when you have more stress, when you have a bad night of sleep, when you're going on an airplane, for example. Travel is very stressful. Also, you're at low oxygen levels when you travel, and methylene blue can compensate for that by acting just like oxygen in the cells. And so, you can use methylene blue for We have a whole travel protocol on our website if people are interested for that. But, on the other side of the spectrum, which is the really healthy people, people doing endurance racing, I have a lot of those guys using methylene blue as well and gals because methylene blue can work just like oxygen as I just mentioned. And, as a result of that, can help with aerobic capacity. So, I have guys and gals doing jiu-jitsu and endurance races and having a lot of great success using methylene blue in those cases as well.

Yeah. I'm working with a client who's a dancer. And, for her, just constantly being on, constantly moving her body, constantly Constantly working on her soft tissue and recovery and things like that on top for myself. That's why I've asked so many questions about this today. So thank you. Can you take a second to debunk— did you see the stuff floating around social media with the blue brain? I did.

Yeah, yeah, yeah. There was a blog article that was demonstrating very fantastically, of course, these blue brains. And what had happened in this particular blog and the study that they were referring to was that there were certain patients that were hospitalized with severe presentations, things like cardiopulmonary arrest, septic shock, things like that. And, as a last-ditch effort, they gave them huge amounts of IV, intravenous methylene blue to try to save their life because what methylene blue can do in some very, very rare— in some instances, although it's used as sort of a last-ditch effort, is to try to save somebody's life, especially by getting their blood vessels to constrict at very, very high levels of methylene blue.

Wow.

And so, they gave them them around 3 milligrams per kilogram IV of methylene blue, which is the equivalent of 300 milligrams of methylene blue in an IV. And, that was given over a couple hours and all these patients died. And so, they died and they had an autopsy within about 4 hours of them dying. And so, when they did the autopsies, their brains were blue, which is not surprising because they got a huge amount of methylene blue and the system had no time to metabolize it.

No.

There's no time actually to get it to go away because what happens is that methylene blue sticks around for about— the half-life is around 4 to 6 hours and then it cycles in the body, then it comes out. And so, in this particular study, they used— well, in this particular article, they showed these brains that had been the autopsies 4 hours after they had died with a huge amount of blue in their brains. Now, my postulation is 2 things here. Number one, we're not using that kind of dosing at all in clinical practice. We're using or with our products. have 16 milligrams, 1-6. That's much less than a milligram per kilogram by a long shot. So, 16 versus 300, okay?

Yeah.

We're also using oral in our products, not IV. That's a very big difference, okay? That's the first thing. So, much lower doses. That's the first major thing. The second is that my best guess here is that all of those patients, if they had lived, their brains would not have been blue because the body would have metabolized And it would have come out in the urine. So, by the way, if you take methylene blue, your urine's going to turn blue, so be aware of that. Okay? But my guess, strong feeling here, is that their brains wouldn't have been blue if they had survived because it would have gone out of the system over the timeframe that I was just describing. So, there's no need to worry about that. No need to worry about a blue brain. That's not going to happen. Your tissue's not going to turn blue and none of that stuff. Okay? In your body, it goes back and forth between being blue and colorless, blue, colorless, blue, colorless, and that eventually comes out in your urine blue. And so if you're urinating blue, don't be surprised. You've taken methylene blue. If you've had your B vitamins in the morning on top of your methylene blue, it might be like a nice meal.

A little green.

A big thing, though, when you're looking at methylene blue quality, liquids are the worst, by the way. If you're finding liquids out there, liquids are typically low potency and higher in heavy metals, even if they have a certificate of analysis that says otherwise. We've tested all these products and we know.

Wow.

And then liquids are a huge mess. You get it on a countertop, it's over.

Yeah, exactly.

Our troches are much easier because they're very easy to cut. You just want to cut them on a dark surface. You don't want to cut them on a light surface usually. You can cut them on like a paper towel, that works too. Because they're scored, you can easily cut them into quarters, halves, or fulls depending on what you need. And so quality is so paramount with methylene blue, and because of the contamination contamination with those heavy metals like lead, mercury, cadmium, and arsenic. You don't want those. And so, at Transcriptions, we do multiple different rounds of testing to make sure that it's as what we say on the label it is and that there's lowest amounts of heavy metals possible. And so, no methylene blue is going to be completely free, but we're talking about super, super, super low amounts that are not physiologically relevant. And, we've done our testing compared to all the other companies out there and ours is always the best. And, this is kind of important because you can find cheaper stuff. You can go on Amazon and find very cheap methylene blue, but I don't recommend getting it because— yeah, yeah.

Leave it to social media to induce fear tactics, right? Or want to scare people to drive them to make decisions, right? And I knew that you would clear that up. We're going to link out everything below. And, you know, something that I do in my household, when you find something that works for you, make it part of your rituals. Like when I cut my transcriptions in the morning, I've given it to my husband as well. So do it for your loved one also, because if you both get the benefits, you feel better in your household together. If you're not following Dr. Scott Sher already, please go and find him. You are such a phenomenal educator, and you can speak to a variety of, you know, dysfunction and optimization. And I know that it comes from your practice and the variety of people that you work with, men and women. And I'm so grateful for that as a practitioner as well. I would love for practitioners also to link out the program that you talked about as well. Is that something that you run an annual cohort on, or is it on So both.

So it's ongoing education that anybody can take at any time. We have a 7-module certification. People can take a look at homehope.org.

Mm-hmm.

And in addition to the ongoing education, about 2 or 3 times a year, up to actually more than that now, we do cohort-style learning. So if you're a practitioner and like a cohort style, which means for the entirety of that module, usually it's either our gut module, which is I think 8 weeks long versus our metabolomics module, which is our foundational one that's 12 weeks. You meet weekly with one of the faculty to go over the lesson of the week, and you meet with a small group of students, typically between 10 and 20 students at a time there. And it's great. It's a nice way for like a small group learning. And also we do case group presentations, we do journal clubs and things like that. So you can check that out if you're interested at homehope.org. And if you're a practitioner as Well, at Transcriptions, our for-profit company that has the products, we have our own practitioner ecosystem as well with our own practitioner products that are higher potency. And, you have the capacity to get them at discounts at lesser amounts of money because you're a practitioner. So, we have wholesale discounts. We have a huge portal with lots of information, physician desk references, research protocols, and a lot of other fun things for people to check out. So, that's also available if you're a practitioner.

So good to know. I don't know why I haven't registered for that yet.

We'll get you on there. Yeah, for sure.

Yeah, on it. I'm on it today. All right. I could talk to you for hours, but to be continued until the next time. To wrap things up, tell me about something that you are excited about around the world of health optimization in the future. Hmm.

Well, I don't mean this to be a plug, but it's going to be a plug. We have our annual nonprofit conference This year, it's going to be in Chicago, October 2nd and 3rd at the Drake Hotel. We do an annual conference, the Health Optimization Medicine and Practice Conference. It is a 2-day event. There are speakers for 2 days. We have a great time bringing in some of the most cutting-edge, the best people out there doing some amazing things in this world and speaking about various topics, anything from peptides, hormones, longevity, healthspan, span, metabolomics. I'm not sure what I'm speaking about this year, probably the parasympathetic edge, probably this year as we've been talking about here. I'll be doing a lecture on that because that's the opposite of the sympathetic spiral of doom, by the way, which is living on that parasympathetic side. We'll have some great speakers from all over the world coming in. Epigenetics, that's 2 days. There'll be continuing medical education credits for those that need them, and the hotel is great. We're gonna have some fun in Chicago. That's October 2nd and 3rd. So I'm super excited about that because we put a lot of effort into that every year. This will be our 4th one. Last year was in Boulder where I am. It was fun to be local that time. The year before was in Vegas, which I'll never do again. And then the first year I think was in Florida. So this year in Chicago, I'm really excited. So I'd love some of you to join us. You can check it out at homehope.org and we have— you can just check our events page and you'll find out all about our conference. You don't have to be a practitioner to come.

Yeah.

You can be, of course, be a practitioner, but if you're health curious and you really want to see what's on the cutting edge and learn about it from a different perspective. Our perspective is different, Mona, as you know. It's like, let's focus on optimizing health. Let's focus on what we can truly bring in or subtract a lot of times to create that. And so, I'm super excited to have our conference and I hope some of you can join us.

You are one of my greatest mentors in this space. So, yes, I know exactly what to expect and we'll be sure to share all of that. Thank you so much much for your time, for being back. Next time we'll do it in person, right?

I hope so. I hope so. Thank you for having me. And I really always appreciate being with you, Mona.

You too.