Podcasts about Autonomic

The practice of immersing your body in ice water is growing in popularity based on claims of improved mood and well-being, muscle recovery after exercise, even longevity. But this ignores the well-established fact that sudden cardiac death is a real risk due to coronary spasm, causing heart attack, and unstable heart rhythms due to a situation called autonomic conflict. There are a growing number of lawsuits that have been filed for the many sudden cardiac deaths that have occurred. So let's discuss what we know about this concept of cold water immersion and why it is such a dangerous practice. • Immersion in water around 15°C/60°F triggers dangerous physiological responses• Cold exposure causes coronary arteries to spasm, potentially leading to heart attack• Most adults have some degree of endothelial dysfunction, making them vulnerable• "Autonomic conflict" occurs when both nervous system branches activate simultaneously• Multiple lawsuits have been filed over deaths from ice baths and polar plunges• Safer alternatives exist for achieving the claimed benefits of cold exposure• Cold showering (starting warm and gradually cooling) may offer similar benefits with less risk________________________________________________________________________________For BiotiQuest probiotics including Sugar Shift, go here.A 15% discount is available for Defiant Health podcast listeners by entering discount code UNDOC15 (case-sensitive) at checkout.*_________________________________________________________________________________Get your 15% Paleovalley discount on fermented grass-fed beef sticks, Bone Broth Collagen, low-carb snack bars and other high-quality organic foods here.* For 12% off every order of grass-fed and pasture-raised meats from Wild Pastures, go here._____________________________________________________________________________MyReuteri and Gut to Glow can be found here: oxiceutics.comSupport the showBooks: Super Gut: The 4-Week Plan to Reprogram Your Microbiome, Restore Health, and Lose Weight Wheat Belly: Lose the Wheat, Lose the Weight and Find Your Path Back to Health; revised & expanded ed

The pelvic floor isn't just another muscle—so why do we treat it like one?The pelvic floor is different from every other muscle or area in the body, and if we don't acknowledge that, we won't get the best results for our patients.This is a replay of one of our most thought-provoking episodes! While I'm out on maternity leave, we're bringing back some of the best conversations we've had over 500+ episodes.In this episode, we break down five key ways the pelvic floor is unique:✅ Autonomic innervation – The pelvic floor has both voluntary and involuntary control, making treatment more complex.✅ Unique anatomy & function – It doesn't have a typical origin/insertion like other muscles.✅ Interconnected with organs – Unlike most muscles, the pelvic floor is woven into multiple organ systems.✅ Emotional & psychosocial components – Trauma, stigma, and cultural attitudes impact pelvic health treatment.✅ You can't rest it – The pelvic floor is always in use, which makes healing more challenging.When we understand these differences, we can treat the pelvic floor more effectively—instead of relying on outdated approaches that don't take its complexity into account.Tune in to hear why there's no such thing as a simple pelvic floor patient!About UsNicole and Jesse Cozean founded Pelvic PT Rising to provide clinical and business resources to physical therapists to change the way we treat pelvic health.   PelvicSanity Physical Therapy (www.pelvicsanity.com) together in 2016.  It grew quickly into one of the largest cash-based physical therapy practices in the country.Through Pelvic PT Rising, Nicole has created clinical courses (www.pelvicptrising.com/clinical) to help pelvic health providers gain confidence in their skills and provide frameworks to get better patient outcomes.  Together, Jesse and Nicole have helped 600+ pelvic practices start and grow through the Pelvic PT Rising Business Programs (www.pelvicptrising.com/business) to build a practice that works for them! Get in Touch!Learn more at www.pelvicptrising.com, follow Nicole @nicolecozeandpt (www.instagram.com/nicolecozeandpt) or reach out via email (nicole@pelvicsanity.com).Check out our Clinical Courses, Business Resources and learn more about us at Pelvic PT Rising...Let's Continue to Rise!

Understand and identify your polyvagal primary and mixed states. This episode covers connection, escape, aggression, collapse, play, motivation, stillness, intimacy, freeze, and appeasement and fawn states. Start identifying your states today.00:00 Intro: Apply your Polyvagal Knowledge02:27 Do you feel like connecting?04:30 Do you feel like escaping or aggressing?05:56 Do you feel like collapsing?07:35 Do you feel ready to have with someone else?08:41 Do you feel motivated?10:24 Do you feel reflective and mindful?11:51 Do you want to connect with someone else?13:51 Do you feel out of control or overwhelmed?15:28 Do you placate or appease others?17:05 stuck not broken outroResources:

Did you know that nearly twenty-five percent of adolescents suffer from chronic pain, and for some, it's severe enough to impact daily life? In this episode of Pediatric Meltdown, Dr. Lia Gaggino and guest Dr. Lonnie Zeltzer talk about the complexity of chronic pain in children and adolescents—a subject often misunderstood and inadequately addressed in pediatric medicine. Through personal anecdotes and expert insights, Dr. Zeltzer shares her journey from a curiosity about adolescent medicine to specializing in pediatric chronic pain using modern pain science. This conversation not only unravels the preconceived beliefs surrounding chronic pain but also offers potential pathways and methods to manage and reframe the experience of pain in young individuals. The episode is an eye-opener for anyone seeking to understand and support children grappling with chronic pain.[00:00 - 17:02] Prevalence and Challenges of Pediatric Chronic PainChronic pain affects 15–30% of adolescents globally, with 15% experiencing severe impairment. 70% of adolescents with untreated chronic pain develop adult chronic pain. Pediatricians often lack training in modern chronic pain management concepts. Subspecialists frequently struggle to address chronic pain after ruling out organic causes. [17:02 - 27:55] Neurobiological and Psychosocial Factors Chronic pain correlates with limbic system hyperactivity and prefrontal cortex underdevelopment in adolescents. Neurodiverse individuals may experience heightened sensory sensitivity, amplifying pain perception. Hypnotherapy and cognitive behavioral therapy (CBT) retrain pain-related neural pathways. POTS (postural orthostatic tachycardia syndrome) reflects autonomic nervous system dysregulation linked to chronic pain. [27:56 - 21:06] Gastrointestinal and Autonomic Dysregulation Irritable bowel syndrome (IBS) stems from brain-gut axis dysfunction, not structural gastrointestinal issues. Autonomic dysregulation in POTS requires salt intake, hydration, and compression garments for management. Acupuncture and acupressure offer nonpharmacologic relief, particularly for needle-tolerant patients. Abdominal pain often involves muscular tension, addressed through targeted physical therapy. [21:07 - 48:48 ] Practical Clinical Interventions Brief in-office mindfulness exercises (e.g., guided breathing) provide immediate stress relief. Motivational interviewing helps adolescents identify achievable goals, like gradual physical activity. Parent-child dyads benefit from joint mindfulness apps (e.g., Insight Timer) to reduce household stress. The "five golden minutes" of non-directed play or connection improve emotional regulation.[48:49 - 54:23] Dr. Lia's Takeaways Connect with Lonnie Zeltzerhttps://linktr.ee/mychyphttps://www.instagram.com/my_chyp/https://www.linkedin.com/company/creative-healing-for-youth-in-pain/https://www.facebook.com/creativehealingforyouthinpainResources mentioned in the...

Listener discretion is advised (language). References: Abdo WF, Heunks LM. Oxygen-induced hypercapnia in COPD: myths and facts. Crit Care. 2012 Oct 29;16(5):323. Bonilla Arcos D, Krishnan JA, et al. High-Dose Versus Low-Dose Systemic Steroids in the Treatment of Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Systematic Review. Chronic Obstr Pulm Dis. 2016 Feb 17;3(2):580-588. Fawzy A, Wise RA. Pulse Oximetry Misclassifies Need for Long-Term Oxygen Therapy in Chronic Obstructive Pulmonary Disease. Ann Am Thorac Soc. 2023 Nov;20(11):1556-1557. Goldberg P, Reissmann H, Maltais F, Ranieri M, Gottfried SB. Efficacy of noninvasive CPAP in COPD with acute respiratory failure. Eur Respir J. 1995 Nov;8(11):1894-900. Jennifer T. Thibodeau, Mark H. Drazner. The Role of the Clinical Examination in Patients With Heart Failure,JACC: Heart Failure, Volume 6, Issue 7, 2018, Pages 543-551. Kartal M, Goksu E, Eray O, et al. The value of ETCO2 measurement for COPD patients in the emergency department. Eur J Emerg Med. 2011 Feb;18(1):9-12. Ni, H., Aye, S., Naing, C. Magnesium sulfate for acute exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2022 May 26; 2022(5):CD013506. Pertzov, B., Ronen, M., Rosengarten, D. et al. Use of capnography for prediction of obstruction severity in non-intubated COPD and asthma patients. Respir Res 22, 154 (2021). Pu X, Liu L, Feng B, Wang M, Dong L, Zhang Z, Fan Q, Li Y, Wang G. Efficacy and Safety of Different Doses of Systemic Corticosteroids in COPD Exacerbation. Respir Care. 2021 Feb;66(2):316-326. Tyagi D, Govindagoudar MB, et al. Correlation of PaCO2 and ETCO2 in COPD Patients with Exacerbation on Mechanical Ventilation. Indian J Crit Care Med. 2021 Mar;25(3):305-309. van Gestel AJ, Steier J. Autonomic dysfunction in patients with chronic obstructive pulmonary disease (COPD). J Thorac Dis. 2010 Dec;2(4):215-22. doi: 10.3978/j.issn.2072-1439.2010.02.04.5.

The Missing Piece Everyone Overlooks: Why holistic, functional, and conventional medicine often miss the mark when addressing chronic health issues. Learn about the transformative E.A.S.E. Method, which focuses on balancing the Enteric, Autonomic, Somatic, and Empowered Psychology systems for lifelong health. This in-depth guide explores the limitations of relying solely on testing, supplements, and restrictive diets and emphasizes the critical role of mindset, stress management, nutrition, and movement in achieving sustainable healing. Find practical, actionable steps to reclaim your health and thrive.

Contributor: Jorge Chalit-Hernandez, OMS3 Educational Pearls: Serotonin syndrome occurs most commonly due to the combination of monoamine oxidase inhibition with concomitant serotonergic medications like SSRIs Examples of unexpected monoamine oxidase inhibitors Linezolid - a last-line antibiotic reserved for patients with true anaphylaxis to penicillins and cephalosporins Methylene blue - not mentioned in the podcast due to its uncommon usage for methemoglobinemia Other medications that can interact with SSRIs to cause serotonin syndrome Dextromethorphan - primarily an anti-tussive at sigma opioid receptors that also has serotonin reuptake inhibition Clinical presentation of serotonin syndrome Altered mental status Autonomic dysregulation leading to hypertension (most common), hypotension, and tachycardia Hyperthermia Neuromuscular hyperactivity - tremors, myoclonus, and hyperreflexia Hunter Criteria (high sensitivity and specificity for serotonin syndrome): Spontaneous clonus Inducible clonus + agitation or diaphoresis Ocular clonus + agitation or diaphoresis Tremor + hyperreflexia Hypertonia, temperature > 38º C, and ocular or inducible clonus Management of serotonin syndrome Primarily supportive - benzodiazepines can help treat hypertension, agitation, and hyperthermia. Patients often require repeated and higher dosing of benzodiazepines Avoid antipyretics to treat hyperthermia since the elevated temperature is due to sustained muscle contraction and not central temperature dysregulation In refractory patients, cyproheptadine (a 5HT2 antagonist) may be used as a second-line treatment Patients with temperatures > 41.1º C or 106º F require medically induced paralysis and intubation to control their temperature References Boyer EW, Shannon M. The serotonin syndrome [published correction appears in N Engl J Med. 2007 Jun 7;356(23):2437] [published correction appears in N Engl J Med. 2009 Oct 22;361(17):1714]. N Engl J Med. 2005;352(11):1112-1120. doi:10.1056/NEJMra041867 Dunkley EJ, Isbister GK, Sibbritt D, Dawson AH, Whyte IM. The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity. QJM. 2003;96(9):635-642. doi:10.1093/qjmed/hcg109 Ramsay RR, Dunford C, Gillman PK. Methylene blue and serotonin toxicity: inhibition of monoamine oxidase A (MAO A) confirms a theoretical prediction. Br J Pharmacol. 2007;152(6):946-951. doi:10.1038/sj.bjp.0707430 Schwartz AR, Pizon AF, Brooks DE. Dextromethorphan-induced serotonin syndrome. Clin Toxicol (Phila). 2008;46(8):771-773. doi:10.1080/15563650701668625 Thomas CR, Rosenberg M, Blythe V, Meyer WJ 3rd. Serotonin syndrome and linezolid. J Am Acad Child Adolesc Psychiatry. 2004;43(7):790. doi:10.1097/01.chi.0000128830.13997.aa Summarized & Edited by Jorge Chalit, OMS3 Donate: https://emergencymedicalminute.org/donate/

Welcome to AI with Honor! Today, we're exploring a transformative concept in artificial intelligence: Autonomic Agentic Workflows (AAW). Think of these systems as the AI equivalent of your body's autonomic nervous system, handling tasks independently and efficiently. But, like your body, the performance of AAW depends entirely on the quality of what you feed into it.Using a powerful analogy, we compare feeding bad data into AAW systems to living on junk food—eventually, the system breaks down. To prevent this, these workflows need their own "janitorial staff," a mechanism to constantly clean, filter, and improve the incoming data.We also discuss:The Importance of Data Maintenance: Drawing parallels to biological autophagy, we emphasize the need for systems to “cleanse” themselves regularly to prevent the buildup of inefficiency.The Role of Quantum Computing: Quantum technology may seem almost supernatural in its capabilities, but it represents a seismic shift in how AI systems will operate in the future.Practical Applications: From creating videos and podcasts to automating SEO and social media posts, AAW systems are already changing how we approach workflow automation.Control Mechanisms: Ensuring oversight in these systems is vital to maintain their effectiveness and prevent eventual degradation.We reflect on the rapid pace of technological change, from the early days of computing with the Sinclair TI99 to today's terabyte-powered machines. It's a reminder of how far we've come and the incredible potential we're on the cusp of realizing.As these technologies evolve, so must our understanding of how to use them responsibly. Whether you're a developer, content creator, or simply interested in the future of AI, this episode highlights the importance of maintaining data integrity and prioritizing ethical development in these powerful systems.Listen now to learn how we can navigate this exciting future together—with honor, purpose, and accountability.Youtube Channels:Conner with Honor - real estateHome Muscle - fat torchingFrom first responder to real estate expert, Connor with Honor brings honesty and integrity to your Santa Clarita home buying or selling journey. Subscribe to my YouTube channel for valuable tips, local market trends, and a glimpse into the Santa Clarita lifestyle.Dive into Real Estate with Connor with Honor:Santa Clarita's Trusted Realtor & Fitness EnthusiastReal Estate:Buying or selling in Santa Clarita? Connor with Honor, your local expert with over 2 decades of experience, guides you seamlessly through the process. Subscribe to his YouTube channel for insider market updates, expert advice, and a peek into the vibrant Santa Clarita lifestyle.Fitness:Ready to unlock your fitness potential? Join Connor's YouTube journey for inspiring workouts, healthy recipes, and motivational tips. Remember, a strong body fuels a strong mind and a successful life!Podcast:Dig deeper with Connor's podcast! Hear insightful interviews with industry experts, inspiring success stories, and targeted real estate advice specific to Santa Clarita.

What if you could become your own best doctor? Discover groundbreaking insights from Dr. Christine Schaffner, a leader in holistic health who transformed her career from conventional medicine to naturopathic healing. In this captivating episode, Dr. Schaffner shares her profound journey and highlights the often-overlooked oral systemic connection, emphasizing the importance of dental histories in understanding the root causes of diseases. Together, we explore how the body's autonomic nervous system and fascia play crucial roles in self-regulation and healing.We dive into the fascinating world of neurotherapy, focusing on the impact of scar tissue and segmental patterns on systemic health. Dr. Schaffner unravels the concept of "islands of turbulence," where scars create disruptions that affect the autonomic nervous system and fascia. Learn how targeted injections rejuvenate cellular communication and release trauma, offering patients rapid relief in a manner akin to "acupuncture on steroids." We also delve into the mysterious interstitium and its role in fluid movement, shedding light on how neurotherapy can revitalize this newly discovered organ.The conversation takes an intriguing turn as we examine the energetic aspects of health, particularly the potential toxicity of root canals and the power of energy-based modalities like light and sound therapies.Dr. Schaffner explains how maintaining high energy levels is vital for overcoming chronic illness, drawing inspiration from Dr. Tennant's "Healing is Voltage." As we conclude, we reflect on the transformative potential of sound and light therapies and the importance of collaboration in holistic healthcare. Don't miss out on exploring more of Dr. Christine's groundbreaking work through her podcast and website.Ready to connect with Dr. Schaffner? Check out her website https://www.drchristineschaffner.com/Connect with Dr. DiNola and his team https://mddentalwellnesscenter.com/To learn more about holistic dentistry, check out Dr. Carver's website:http://carverfamilydentistry.comTo contact Dr. Carver directly, email her at drcarver@carverfamilydentistry.comWant to talk with someone at Dr. Carver's office?  Call her practice: 413-663-7372Reverse Gum Disease In 6 Weeks! With Dr. Rachaele Carver Online Course!Learn more about here: https://reversegumdiseaseinsixweeks.info/optinpageDisclaimer: This podcast is for educational purposes only. Information discussed is not intended for diagnosis, curing, or prevention of any disease and is not intended to replace advice given by a licensed healthcare practitioner. Before using any products mentioned or attempting methods discussed, please speak with a licensed healthcare provider. This podcast disclaims responsibility from any possible adverse reactions associated with products or methods discussed. Opinions from guests are their own, and this podcast does not condone or endorse opinions made by guests. We do not provide guarantees about the guests' qualifications or credibility. This podcast and its guests may have direct or indirect financial interests associated with products mentioned.

Catch Headache Video Here : Have you ever experienced a headache that's far more intense than usual and localized to one side of your face, accompanied by perhaps some tearing or nasal congestion? These could be signs of Trigeminal Autonomic Cephalgia (TAC), a condition that's significantly more debilitating than your typical headache. Distinguishing between these and more common types of headaches is not just about managing pain but understanding a possibly serious underlying condition. Understanding trigeminal autonomic cephalalgias (TACs) begins with recognizing their unique and debilitating symptoms. As an experienced chiropractor for headaches, Dr. Brian McKay of Core Health in Darien offers cutting-edge therapy to eliminate TAC's. TAC's often present with unilateral pain that can be excruciatingly severe. This pain is frequently accompanied by autonomic symptoms such as eye watering, nasal congestion, or eyelid drooping, primarily affecting one side of your face. Dr. Brian McKay and his team specialize in non-medication headache relief techniques, which can be particularly beneficial if you're dealing with the intense pain of TACs.This podcast welcomes your feedback here are several ways to reach out to me. If you have a topic you would like to hear about send me a message. I appreciate your listening. Dr. Brian Mc Kayhttps://twitter.com/DarienChiro/https://www.facebook.com/ChiropractorBrianMckayhttps://chiropractor-darien-dr-brian-mckay.business.sitehttps://podcasts.apple.com/us/podcast/not-just-chiropractor-for-stamford-darien-norwalk-new/id1503674397?uo=4Core Health Darien-Dr.Brian Mc Kay 551 Post RoadDarien CT 06820203-656-363641.0833695 -73.46652073GMP+87 Darien, Connecticuthttps://youtu.be/WpA__dDF0O041.0834196 -73.46423349999999https://darienchiropractor.comhttps://darienchiropractor.com/darien/darien-ct-understanding-pain/Find us on Social Mediahttps://chiropractor-darien-dr-brian-mckay.business.site https://www.youtube.com/channel/UCNHc0Hn85Iiet56oGUpX8rwhttps://docs.google.com/spreadsheets/d/1nJ9wlvg2Tne8257paDkkIBEyIz-oZZYy/edit#gid=517721981https://goo.gl/maps/js6hGWvcwHKBGCZ88https://www.youtube.com/my_videos?o=Uhttps://www.linkedin.com/in/darienchiropractorhttps://www.facebook.com/ChiropractorBrianMckayhttps://sites.google.com/view/corehealthdarien/https://sites.google.com/view/corehealthdarien/home

In this episode, we review the high-yield topic of⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Autonomic Pathways⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠from the Pharmacology section. Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets

Looking at a new concept in medicine - that of decentralisation - taking back control and making surprising but simple changes to your lifestyle to enhance health.Find Dr Boon Lim's talk for the Awakening Heart Collective herehttps://www.youtube.com/watch?v=rksXwEf6ZWU&feature=youtu.be00:00 Intro to decentralised medicine - taking back control of your health. Especially important in chronic conditions like CFS/ME which are not dealt with well by conventional medicine.03:07 Integrative medicine - Dr Boon Lim as an example - a cardiologist who uses HRV as well as more conventional methods, to measure your autonomic (nervous system) health- the importance of breath to regulate.06:40 Sunlight as a nutrient - not just foods supply this. Better than supplementation as it helps boost mitochondrial function without the limitation of poor digestion. Autonomic regulation (vagal toning, etc) is much more likely to benefit those with low energy/immunity.08:36 We need daylight every day through the skin and eyes. Huge difference in irradiance between indoors and outdoors so exercise outdoors. Important for eye health and inflammatory brain disease like Parkinson's and Alzheimer's.11:15 Sound like binaural beats - helps brain coherence (resonance) and change your brain state away from beta (fight and flight) to alpha (rest and digest/flow state). Input vs. output. Dysautonomia common in long covid.13:31 EMDR - Eye movement densitisation and reprocessing helps us reprocess childhood trauma as over that then stops triggering your autonomic nervous system unconsciously.14:43 Taking back control - some innovative clinicians are working within the centralised system enables you to work as a team.16:50 My history from centralised to decentralised. (Imperial College to solo practitioner). Promotes personalised medicine. Future talks for the Awakening Heart Collection. *If you're suffering from Chronic pain, fatigue or anxiety, I CAN HELP*CONTACT ME: https://www.alchemytherapies.co.uk/Alchemy Therapies & Emotional MasterclassOTHER USEFUL RESOURCESGroup Healing Program: http://myemotionalaudit.comAuthor/Book site: https//patriciaworby.comPodcast: https://www.alchemytherapies.co.uk/po...121 and group therapy and training for stress related conditions like anxiety, fatigue and pain: https://alchemytherapies.co.ukSee in particular: Thrive! - an introductory mindbody connection program and The Emotional Audit for more intensive training.COMING SOON:Intensive Training Program: https://emotionalmasterclass.com

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**Spinal Cord Injuries & Sexuality: Tips from an OT & Sexologist** On today's show we have Norwegian Occupational Therapist and Sexologist,  Vanja Rizvic. We discuss the unique role of occupational therapy in pelvic and sexual health, the impacts of spinal cord injuries on sexuality, and share several practical strategies to navigate sexual dysfunction or dissatisfaction. From sensory play to reframing sexuality perspectives and fostering communication, Vanja guides us on an empowering journey of embracing our sexuality through curiosity and courage to enhance our sexual pleasure and well-being. Guest Bio: Vanja holds a bachelor's degree in Occupational Therapy, and has since 2017 worked in both outpatient and inpatient settings. He started his career at a hand therapy department, working with rheumatological illnesses and orthopedic injuries. Vanja has also worked in physical medication and rehabilitation, and currently works at one of Norway's biggest hospitals for rehabilitation medicine. He works specifically with spinal cord injuries, and has a special interest in sexual health and pelvic floor therapy. Vanja is a proud alumn of Lindsey vestals OT pioneers and is a sexual health advocate in the Norwegian OT community. Connect with Vanja on IG: @vvnnjjaa https://www.instagram.com/vvnnjjaa/ Video Chapters: - 00:00 Meet our video sponsor, Mainspring Medical featuring Vacurect - 00:40 Podcast Guest Introduction, Occupational Therapist and Sexologist Vanja Rizvic - 02:15 The role of occupational therapists in sexuality and sexual health - 02:30 Domains of occupational therapy for sex: context, potential, and narratives - 07:03 Sexual dysfunction as a trojan horse, the whole-person approach to improving sexual issues - 09:09 Supporting sexual function through relationship - 13:20 What is a spinal cord injury - 14:32 How a spinal cord injury impacts sex - 15:50 Autonomic dysreflexia considerations during sex - 17:40 Primary, secondary, and tertiary impacts to bladder, bowel, and sexual function with as spinal cord injury - 21:25 Orgasm and ejaculation with a spinal cord injury - 23:45 Sexual function versus sexual satisfaction - 29:00 Sex and sexual identity as an occupational narrative - 33:05 3 tips to explore with for sexual dysfunction

On today's episode of That Neuroscience Guy, we welcome guest Jaime ____ to discuss Autonomic, a biotech company aiming to help you improve your brain health. 

SP:MC is an MC (ofc), DJ, and producer from the UK, mostly inhabiting the DnB space but who also regularly ventures into other areas of bass music and beyond.We discuss the DnB scene in the US (where he was on tour when we recorded this conversation) as well as in the UK, his formative years MCing with DJ Friction, his journey as a producer, and also a few of the topical scene issues we've been discussing in recent weeks too.I'm still on holiday but will be back next week!If you're into what we're doing here on the pod then you can support the show on Patreon! There are two tiers - "Solidarity" for $4 a month, which features the show without ads, regular bonus podcasts, and extra content. And "Musicality" which for a mere $10 a month gets you all the music we release on Hotflush and affiliate labels AND other music too, some of which never comes out anywhere else.You can also make a one-off donation to the podcast using a card, with Paypal, or your Ethereum wallet! Head over to scubaofficial.io/support.Plus there's also a private area for Patreon supporters in the Hotflush Discord Server... but anyone can join the conversation in the public channels.Listen to the music discussed on the show via the Not A Diving Podcast Spotify playlistFollow Scuba: twitter instagram bandcamp spotify apple music beatport Hosted on Acast. See acast.com/privacy for more information.

Send us a textCurious about how the nervous system shapes our overall health, especially in children? This episode uncovers the groundbreaking work of Dr. Rhiannon, a specialist in neuro-focused chiropractic, who promises to redefine your understanding of chiropractic care. Dr. Rhiannon sheds light on how her practice diverges from traditional approaches by emphasizing the nervous system over musculoskeletal adjustments and explains why the notorious "cracking" sound isn't the core of effective therapy. TakeawaysChiropractic is not just about cracking bones, but about restoring optimal nervous system function.A neurotonal approach focuses on neurological indicators for adjustments and individualized care plans.Insight scans assess heart rate variability, thermal activity, and neural motor system function.Dr. Clauss primarily focuses on children to optimize their nervous system development.She teaches workshops and events to educate the public about the importance of a healthy nervous system.CONNECT WITH DR. RHIANNONWEBSITEINSTAGRAMFACEBOOKYOUTUBESupport the showIf you like this episode, please be sure to subscribe everywhere you listen to podcasts! FOLLOW ME on INSTAGRAM Check out the WEBSITE Help support this podcast by buying me a cup of coffee. I need it to stay awake editing! BUY ME COFFEE

Is astral projection all in your imagination? Yes. Yes it is. However Albert Einstein did say, "Imagination is the highest form of research. Knowledge is a map that guides us while imagination is the territory where we can roam freely and search for answers and opportunities."The Sunday join Liv as shares her earnest research into understanding what astral projection really is. Bringing insightful clarity to the sublime spiritual concept of astral travel. Touching on topics such as: What is astral projection?Does A.P. pose any physical or spiritual safety concerns?Different kinds of astral projectionCan anyone astral project?Limitations of astral travelTune in to listen along as Liv attempts to add to your map of knowledge when it comes to the metaphysical concept of astral projection. Your job? To let your imagination guide you. Who knows where it will take you.FOR MORE CHECK OUT THE YOUTUBE CHANNEL: https://www.youtube.com/@MetaPsycKicksOR READ THE BLOG: https://www.metapsyckicks.com/journalOR JOIN OUR PATREON: https://www.patreon.com/metapsyckicks——-BOOK A PSYCHIC MEDIUM READING:Olivia the Medium: https://www.metapsyckicks.com/liv-readings-----CHAPTERS:0:00 - Intro3:00 - Movement of the Consciousness5:21 - Autonomic vs. Somatic Soul Consciousness8:28 -The Umbrella Term of Astral Projection10:25 - The Nitty Gritty of Astral Travel34:21 - Anyone Can Astral Project47:51 - Liv Tries Astral Projecting52:12 - Thanks for Listening!-----RECOMMENDED PRODUCTS:Our YouTube Setup ►► https://kit.co/metapsyckicks/meta-psyckicks-youtube-setupOur Podcast Setup ►► https://kit.co/metapsyckicks/meta-psyckicks-podcasting-setupEm's Tarot Collection ►► https://kit.co/metapsyckicks/em-s-tarot-card-collectionOther Divination Tools: ►► https://kit.co/metapsyckicks/other-divination-toolsDISCLAIMER: This description might contain affiliate links that allow you to find the items mentioned in this video and support the channel at no cost to you. While this channel may earn minimal sums when the viewer uses the links, the viewer is in NO WAY obligated to use these links. Thank you for your support!-----ARE YOU A PSYCHIC QUIZ: https://www.metapsyckicks.com/extrasTELL US YOUR PARANORMAL STORIES HERE: https://www.metapsyckicks.com/extrasCHECK OUT OUR WEBSITE AND BLOG:www.metapsyckicks.comEMAIL US: metapsyckicks@gmail.com——-SAY HI ON SOCIAL:YouTube: https://www.youtube.com/channel/UC-Np1K0QH8e-EDHhIxX-FaAInstagram: https://www.instagram.com/metapsyckicksTikTok: https://www.tiktok.com/@metapsyckicks?lang=enFacebook: https://www.facebook.com/Meta-PsycKicks-107812201171308Olivia The Medium:Instagram -  https://www.instagram.com/oliviathemedium/Threads -https://www.threads.net/@oliviathemedium?invite=4Email - oliviathemedium@gmail.comSupport this podcast at — https://redcircle.com/meta-psyckicks/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

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Autonomic dysreflexia is listed in JRCALC as a condition with specific prehospital treatments, meaning it is something that emergency clinicians and ambulance crews need to be aware of. This month we take a look at what is happening with this unposed sympathetic activity, how spinal injury patients develop autonomic dysreflexia and what we can do to lower bloodpressure. Find the references and our other podcasts at www.generalbroadcast.org.uk This Podcast is supported by GEEKY MEDICS. Check out their range of online revision material at www.geekymedics.com. Use code: ---> PARAMEDUCATE24 Use code: FIT24GB

Autonomic dysfunction and tachycardia are strongly linked to poor outcomes in septic shock, contributing to high mortality rates. In the upcoming podcast, we explore whether β-blockade with landiolol for up to 14 days can reduce organ failure, as measured by the Sequential Organ Failure Assessment (SOFA) score, in critically ill patients with tachycardia and septic shock who have been on high-dose norepinephrine for over 24 hours. Dr. Tony Whitehouse, interviewed by two NEXT representatives, discusses the key findings of the STRESS-L Randomized Clinical Trial.

In this episode, Efstratios Koutroumpakis discusses a critical study on autonomic dysfunction among adult survivors of childhood cancer, highlighting its prevalence and functional significance compared to community controls. The research underscores the complex etiologies of autonomic dysfunction linked to cancer treatments and stresses the importance of early detection and standardized testing to improve cardiovascular health and quality of life in this growing survivor population.

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In this episode Dr Danilo Buonsenso explains the underlying mechanisms of Long COVID in children.Dr Danilo Buonsenso MD Phd is a Paediatric Infectious Disease Specialist and Physician Scientist who currently works at the Department of Woman, Child and Public Health at the Gemelli University Hospital in Rome. He has a PhD in Public Health and Biomolecular Sciences and is currently doing his MSc in Infectious Disease at Oxford University. References1. The WHO definition of Post-COVID condition in children.2. Bygdell M, Kindblom JM, Martikainen J, Li H, Nyberg F. Incidence and characteristics in children with post–COVID-19 condition in Sweden. JAMA Network Open. 2023 Jul 3;6(7):e2324246-. 3. Thors V, Bjornsdottir KL, Love TJ, Haraldsson A. Long COVID in Icelandic Children: A Matched Cohort Study of Nonspecific Symptoms Following SARS-CoV-2 Infection. The Pediatric InfectiousDisease Journal. 2024 Mar 1;43(3):226-33. (behind a paywall)4. Delogu AB, Aliberti C, Birritella L, De Rosa G, De Rose C, Morello R, Cambise N, Marino AG, Belmusto A, Tinti L, Di Renzo A. Autonomic cardiac function in children and adolescents with long COVID: a case-controlled study. European Journal of Pediatrics. 25. BaldiF, De Rose C, Mariani F, Morello R, Raffaelli F, Valentini P, Buonsenso D.Cardiopulmonary Exercise Testing in Children With Long COVID: A Case-controlledStudy. The Pediatric Infectious Disease Journal. 2024 May 7:10-97.6. Cocciolillo F, Chieffo DP, Giordano A, Arcangeli V, Lazzareschi I, Morello R, Zampino G,Valentini P, Buonsenso D. Case report: Post-COVID new-onset neurocognitive decline with bilateral mesial-temporal hypometabolism in two previously healthy sisters. Fr7. Cocciolillo F, Di Giuda D, Morello R, De Rose C, Valentini P, Buonsenso D. Orbito-frontal cortexhypometabolism in children with post-COVID condition (long COVID): a preliminary experience. The Pediatric Infectious Disease Journal. 2022 Aug 1;41(8):663-5.

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After finishing her training in neurology at Mayo Clinic, Dr. Svetlana Blitshteyn started a Dysautonomia Clinic in 2009. Little did she know what was in store many years later when Covid hit!Ground Truths podcasts are on Apple and Spotify. The video interviews are on YouTubeTranscript with audio and external linksEric Topol (00:07):Well, hello, it's Eric Topol from Ground Truths, and I have with me a really great authority on dysautonomia and POTS. We will get into what that is for those who aren't following this closely. And it's Svetlana Blitshteyn who is a faculty member at University of Buffalo and a neurologist who long before there was such a thing as Covid was already onto one of the most important pathways of the body, the autonomic nervous system and how it can go off track. So welcome, Svetlana.Svetlana Blitshteyn (00:40):Thank you so much, Eric for having me. And I want to say it's a great honor for me to be here and just to be on the list with your other guests. It's remarkable and I'm very grateful and congratulations on being on the TIME100 Health list for influential people in 2024. And I am grateful for everything that you've done. As I mentioned earlier, I'm a big fan of your work before the pandemic and of course with Covid I followed your podcast and posts because you became the best science communicator and I'm very happy to see you being a strong advocate and thank you for everything you've done.Eric Topol (01:27):Well, that's so kind to you. And I think talking about getting things going before the pandemic, back in 2011, you published a book with Jodi Epstein Rhum called POTS - Together We Stand: Riding the Waves of Dysautonomia. And you probably didn't have an idea that there would be an epidemic of that more than a decade later, I guess, right?Svetlana Blitshteyn (01:54):Yeah, absolutely. Of course, SARS-CoV-2 is a new virus and we can technically say that Long Covid and post Covid complications could be viewed as a new entity. But practically speaking, we know that post-infectious syndromes have been happening for many decades. And so, the most common trigger for POTS happened to be infection, whether it was influenza or mononucleosis or Lyme or enterovirus. We knew this was happening. So I think it didn't take long for me and my colleagues to realize that we're going to be seeing a lot of patients with autonomic dysfunction after Covid.On the Front LineEric Topol (02:40):Well, one of the things that's important for having you on is you're in the front lines taking care of lots of patients with Long Covid and this postural orthostatic tachycardia syndrome (POTS). And I wonder if you could tell us what it's care for these patients because so many of them are incapacitated. As a cardiologist, I see of course some because of the cardiovascular aspects, but you are dealing with this on a day-to-day basis.Svetlana Blitshteyn (03:14):Yeah, absolutely. As early as April 2020 when everything was closed, I got a call from a young doctor in New York City saying that he had Covid and he couldn't recover, he couldn't return to the hospital. And his colleagues and cardiology attendants also had the same symptoms and the symptoms were palpitations, orthostatic intolerance, tachycardia, fatigue. Now, how he knew to contact me is that his sister was my patient with POTS before Covid pandemic. So he kind of figured this looked like my sister, let me check this out. And it didn't take long for me to have a lot of patience from the early wave. And then fairly soon, I think within months I was thinking, we have to write this up because this is important. And to some of us it was not news, but I was sure that to many physicians and public health officials, this would be something new.Svetlana Blitshteyn (04:18):So because I'm a busy clinician and don't have a lot of time for publications, I had to recruit a graduate student from McMasters and together we had this paper out, which was the first and largest case series on post Covid POTS and other autonomic disorders. And interestingly, even though it came out I think in 2021, by the time it was published, it became the most citable paper for me. And so I think from then on organizations and societies became interested in the work that I do because prior to that, I must say in the kind of a niche specialty was I don't think it was very popular or of interest to me.How Did You Get Interested in Dysautonomia?Eric Topol (05:06):Yeah, so that's why I wanted to just take a step back with you Svetlana, because you had the foresight to be the founder and director of the Dysautonomia Clinic when a lot of people weren't in touch with this as an important entity. What prompted you as a neurologist to really zoom in on dysautonomia when you started this clinic?Svetlana Blitshteyn (05:28):Sure. So the reasons are how I ended up in this field is kind of a convoluted road and the reasons are many, but one, I will say that I trained at Mayo Clinic where we received very good training on autonomic disorders and EMG and coming back to returning back to Buffalo, I began working at the large multiple sclerosis clinic because Western New York has a high incidence MS. And so, what they quickly realized in that clinic is that there was a subset of women who did not qualify for the diagnostic criteria of multiple sclerosis, yet they had a lot of the same symptoms and they were certainly very disabled. Now I recognize that these women had autonomic disorders of all sorts and small fiber neuropathy, and I think this population sort of grew and eventually I realized there is no one not only in Buffalo but the entire Western New York who is doing this work.Svetlana Blitshteyn (06:34):So I kind of fell into that. But another reason is actually more personal that I haven't talked about. So years ago I was traveling to Toronto, Canada for a neurology meeting to present my big study on meningioma and hormone replacement therapy using Mayo Clinic database. And so, in that year, the study received top 10 noteworthy studies of the year award from the Society of Neuro-Oncology, and it was profiled in Reuters Health. Now, on the way back from the conference, I had the flu, and when they returned I could no longer walk the same hallways of the hospital where I walked previously. And no matter how hard I try to push my body, we all do this in medicine, we push through, I just couldn't do it. No amount of wishing or positive thinking. And so, I think that's how I came to know personally the post-infectious syndromes. And I think it almost became a duality of experiencing this and also practicing it.Eric Topol (07:52):No, that's really striking and it wasn't so common to hear about this post flu, but certainly it changed in 2020. So how does a person with POTS typically present to you?Clinical PresentationSvetlana Blitshteyn (08:08):So these are very important questions because what I want to stress is though POTS is one of the most common autonomic disorders. Even if you don't have POTS by the diagnostic criteria, you may still have autonomic dysfunction and significant autonomic symptoms. How do they present? Well, they present like most Long Covid patients, the most common symptoms are orthostatic intolerance, fatigue, exercise intolerance, post exertional malaise, dizziness, tachycardia, brain fog. And these are common themes across the board in Long Covid patients, but also in pre-Covid post-acute infection syndrome patients. And you have to recognize because I think what I tell my colleagues is that oftentimes patients are not going to present to you saying, I have orthostatic intolerance. Many times they will say, I'm very tired. I can no longer go to the gym or when I go to the store, I have to be out of there in 15 minutes because the orthostatic intolerance symptoms come up.Svetlana Blitshteyn (09:22):So sometimes the patients themselves don't recognize that and it's up to us physicians to ask the right questions to get the information down. History is very important, knowing the pattern. And then of course, as I always say in all of my papers and lectures, you have to do a 10-minute stand test by measuring supine and standing blood pressure and heart rate on every Long Covid patients. And that's how you spot those that have excessive postural tachycardia or their blood pressure dropping or so forth. So we have the tools. We don't need fancy autonomic labs. We don't even need a tilt table test. The diagnostic criteria for POTS is that you need to have either a 10-minute stand test or a tilt table test to get the diagnosis for POTS, orthostatic hypotension or even neurocardiogenic syncope. Now I think it's important to stress that even if a patient doesn't qualify, and let's say many patients with Long Covid will not elevate their heart rate by at least 30 beats per minute, it could be 20, it could be 25. These criteria are of course essential when we do research studies. But I think practically speaking, in patient care where everything is gray and nothing is black or white, especially in autonomic disorders, you really have to make a diagnosis saying, this sounds like autonomic dysfunction. Let me treat the patient for this problem.Eric Topol (11:07):Well, you brought up something that's really important because doctors don't have much time and they're inpatient. They don't wait 10 minutes to do a test to check your blood pressure. They send the patients for a tilt table, which nobody likes to have that test done, and it's unnecessary added appointment and expense and whatnot. So that's a good tip right there that you can get the same information just by checking the blood pressure and heart rate on standing for an extended period of time, which 10 minutes is a long time in the clinic of course. Now, what is the mechanism, what do you think is going on with the SARS-CoV-2 virus and its predilection to affect the autonomic nervous system? As you know, so many studies have questioned whether you even actually infect neurons or alternatively, which is more likely this an inflammation of the neural tissue. But what do you think is going on here?UnderpinningsSvetlana Blitshteyn (12:10):Right, so I think it's important to say we don't have exact pathophysiology of what exactly is going on. I think we can only extrapolate that what's going on in Long Covid is possibly what's going on in any post infectious onset dysautonomia. And so there are many hypothesis and there are many suggestions, and we share this disorder with cardiologist and immunologist and rheumatologist. The way I view this is what I described in my paper from a few years ago is that this is likely a central nervous system disorder with multisystemic involvement and it involves the cardiovascular system, immunologic, metabolic, possibly prothrombotic. The pathophysiology of all POTS closely parallels to pathophysiology of Long Covid. Now we don't know if it's the same thing and certainly I see that there may be more complications in Long Covid patients in the realm of cardiovascular manifestations in the realm of blood clots and things like that.Svetlana Blitshteyn (13:21):So we can't say it's the same, but it very closely resembles and I think at the core is going to be inflammation, autoimmunity and immunologic dysfunction. Now there are also other things that are very important and that would be mitochondrial dysfunction, that would be hypercoagulable state, it would be endothelial dysfunction. And I think the silver lining of Long Covid and having so many people invested in research and so many funds is that by uncovering what Long Covid is, we're now going to be uncovering what POTS and other autonomic disorders are. And I think we also need to mention a couple of other things. One is small fiber neuropathy, small fiber neuropathy and POTS are very much comorbid conditions. And similarly, small fiber neuropathy frequently occurs in patients with Long Covid, so that's a substrate with the damaged small nerve fibers that they're everywhere in our bodies and also innervate the organs as well.Svetlana Blitshteyn (14:34):The second big thing is that needs to be mentioned is hyperactive mast cells. So mast cells, small nerve fibers and capillaries are very much located in proximity. And what I have usually is a slide from an old paper in oral biology that gives you a specimen where you see a capillary vessel, a stain small nerve fiber, and in between them there is a mass cell with tryptase in it stained in black. And so there is a close communication between small nerve fibers between endothelial wall and between mast cells, and that's what we commonly see as a triad. We see this as a triad in Long Covid patients. We see that as a triad in patients with joint hypermobility syndrome and hypermobile EDS, and you also see this in many of the autoimmune disorders where people develop new allergies and new sensitivities concurrent or preceding the onset of autoimmune disease.Small Fiber NeuropathyEric Topol (15:49):Yeah, no, it's fascinating. And I know you've worked with this in Ehlers-Danlos syndrome (EDS) as you mentioned, the hypermobility, but just to go back on this, when you want to entertain the involvement of small fiber neuropathy, is that diagnosable? I mean it's obvious that you can get the tachycardia, the change in position blood pressure, but do you have to do other tests to say there is indeed a small fiber neuropathy or is that a clinical diagnosis?Svetlana Blitshteyn (16:20):Absolutely. We have the testing and the testing is skin biopsy. That is simply a punch biopsy that you can do in your clinic and it takes about 15 minutes. You have the free kit that the company of, there are many companies, I don't want to name specific ones, but there are several companies that do this kind of work. You send the biopsy back to them, they look under the microscope, they stain it. You can also stain it with amyloid stain to rule out amyloidosis, which we do in neurology, and I think that's quite accessible to many clinicians everywhere. Now we also have another test called QSART (quantitative sudomotor axon reflex test), and that's a test part of autonomic lab. Mayo Clinic has it, Cleveland Clinic has it, other big labs have it, and it's hard to get there because the wait time is big.Svetlana Blitshteyn (17:15):Patients need to travel. Insurance doesn't always authorize, so access is a big problem, but more accessible is the skin biopsy. And so, by doing skin biopsy and then correlating with neurologic exam findings, which oftentimes involved reduce pain and temperature sensation in the feet, sometimes in the hands you can conclude that the patient has small fiber neuropathy and that's a very tangible and objective diagnosis. There again, with everything related to diagnostics, some neuropathy is very patchy and the patchy neuropathy is the one that may not be in your feet where you do the skin biopsy. It may be in the torso, it may be in the face, and we don't have biopsy there. So you can totally miss it. The results can come back as normal, but you can have patchy type of small fiber neuropathy and there are also diagnostic tests that might be not sensitive to pick up issues. So I think in everything Long Covid, it highlights the fact that many tests that we use in medicine are outdated perhaps and not targeted towards these patients with Long Covid. Therefore we say, well, we did the workup, everything looks good. MRI looks good, cardiac echo looks great, and yet the patient is very sick with all kinds of Long Covid complications.Pure Post-Viral POTS?Eric Topol (18:55):Right. Now, before we get into the treatments, I want to just segment this a bit. Can you get pure POTS that is no Long Covid just POTS, or as you implied that usually there's some coalescence of symptoms with the usual Long Covid symptoms and POTS added to that?Svetlana Blitshteyn (19:21):So the studies have shown for us that about 40% of patients with POTS have post-infectious onset, which means more than a half doesn't. And so of course you can have POTS from other causes and the most common is puberty, hormonal change, the most common age of onset is about 13, 14 years old and 80% of women of childbearing age and other triggers or pregnancy, hormonal change again, surgery, trauma like concussion, post-concussion, autonomic dysfunction is quite common.Eric Topol (20:05):So these are pure POTS without the other symptoms. Is that what you're saying in these examples?Svetlana Blitshteyn (20:12):Well, it's a very good question. It depends what you mean by pure POTS, and I have seen especially cardiologists cling to this notion that there is pure POTS and then there is POTS plus. Now I think majority of people don't have pure POTS and by pure POTS I think you mean those who have postural tachycardia and nothing else. And so most patients, I think 80% have a number of symptoms. So in my clinic I almost never see someone who is otherwise well and all they have is postural tachycardia and then they're having a great time. Some patients do exist like that, they tend to be athletic, they can still function in their life, but majority of patients come to us with symptoms like dizziness, like fatigue, like exercise intolerance, decline in functioning. So I think there is this notion that while there is pure POTS, let me just fix the postural tachycardia and the patient will be great and we all want that. Certainly sometimes I get lucky and when I give the patient a beta blocker or ivabradine or a calcium channel blocker, sometimes we use it, certainly they get better, but most patients don't have that because the disability that drives POTS isn't actually postural tachycardia, it's all that other stuff and a lot of it's neurologic, which is why I put this as a central nervous system disorder.TreatmentsEric Topol (21:58):Yeah, that's so important. Now you mentioned the treatments. These are drug treatments, largely beta blockers, and can you tell us what's the success rate with the various treatments that you use in your clinic?Svetlana Blitshteyn (22:13):So the first thing we'll have to mention is that there are no FDA approved therapies for POTS, just like there are no FDA approved therapies for Long Covid. And so, everything we use is off label. Now, oftentimes people think that because it wasn't evidence-based and there are no big trials. We do have trials, we do have trials for beta blockers and we know they work. We have trials for Midodrine and we know that's working. We also have fludrocortisone, which is a medication that improves sodium and water resorption. So we know that there are certain things we've used for decades that have been working, and I think that's what I was trying to convey in this paper of post Covid autonomic dysfunction assessment and treatment is that when you see these patients, and you can be of any specialty, you can be in primary care, you can be a physiatrist, a cardiologist, there are things to do, there are medications to use.Svetlana Blitshteyn (23:20):Oftentimes colleagues would say, well, you diagnose them and then what do you treat them with? And then I can refer them to table six in that paper and say, look at this list. You have a lot of options to try. We have the first line treatment options, which are your beta blockers and Midodrine and Florinef and Mestinon. And then we have the second line therapies you can choose from the stimulants are there Provigil, Nuvigil, Wellbutrin, Droxidopa is FDA approved for neurogenic orthostatic hypotension. Now we don't use it commonly, but it can still be tried in people whose blood pressures are falling on your exam. So we have a number of medications to choose from in addition to non-pharmacologic therapies.Eric Topol (24:14):Right now, I'm going to get to the non-pharmacologic in a moment, but the beta blocker, which is kind of the first one to give, it's a little bit paradoxical. It makes people tired, and these people already are, don't have much energy. Is the success rate of beta blocker good enough that that should be the first thing to try?Svetlana Blitshteyn (24:35):Absolutely. The first line medication treatment options are beta blockers. Why? Okay, why are they working? They're not only working to reduce heart rate, but they may also decrease sympathetic overactivity, which is the driving mechanism of autonomic dysfunction. And when you reduce that overactivity, even your energy level can improve. Now, the key here is to use a low dose. A lot of the time I see this mistake being done where the doctor is just prescribing 25 milligrams of metoprolol twice a day. Well, this is too high. And so, the key is to use very low doses and to use them and then increase them as needed. We have a bunch of beta blockers to choose from. We have the non-selective propranolol that you can use when someone maybe has a migraine headache or significant anxiety, they penetrate the brain, and we have non-selected beta blockers like atenolol, metoprolol and others that you can use at half a tablet. Sometimes I start my patients at quarter of tablet and then go from there. So low doses will block tachycardia, decrease sympathetic overactivity, and in many cases will allow the patient to remain upright for longer periods of time.Eric Topol (26:09):That's really helpful. Now, one of the other things, I believe it's approved in Canada, not in the US, is a vagal neuromodulation device. And I wonder, it seems like it would be nice to avoid drugs if there was a device that worked really well. Is there anything that is in the hopper for that?Svetlana Blitshteyn (26:32):Yeah, absolutely. Non-invasive vagus nerve stimulator is in clinical trials for POTS and other autonomic disorders, but we have it FDA for treatment of migraine and cluster headaches, so it's already approved here and it can also be helpful for chronic pain and gastroparesis. So there are studies on mice that show that with the application of noninvasive vagus nerve stimulator, there is reduction of pro-inflammatory cytokines. So here is this very important connection that comes from Kevin Tracey's work that showed inflammatory reflex, and that's a reflex between the vagus nerve and the immune system. So when we talk about sympathetic overactivity, we need to also think about that. That's a mechanism for pro-inflammatory state and possibly prothrombotic state. So anything that decreases sympathetic overactivity and enhancing parasympathetic tone is going to be good for you.Eric Topol (27:51):Now, let's go over to, I mean, I'm going to get into this body brain axis in a moment because there's another part of the story here that's becoming more interesting, fascinating, in fact every day. But before I do that, you mentioned the small fiber neuropathy. Is there a specific treatment for that or is that just something that is just an added dimension of the problem without a specific treatment available?Svetlana Blitshteyn (28:21):Yeah, we certainly have treatment for small fiber neuropathy. We have symptomatic treatment for neuropathic pain, and these medications are gabapentin, pregabalin, amitriptyline and low dose naltrexone that have been gaining popularity. We used that before the pandemic. We used low dose naltrexone for people with chronic pain related to joint hypermobility. And so, we have symptomatic, we also have patches and creams and all kinds of topical applications for people with neuropathic pain. Then we also have, we try to go for the root cause, right? So the number one cause of small fiber neuropathy in the United States is diabetes. And certainly, you need to control hyperglycemia and in some patients you only need a pre-diabetic state, not even full diabetes to already have peripheral neuropathy. So you want to control blood glucose level first and foremost. Now then we have a big category of autoimmune and immune mediated causes, and that's where it gets very interesting because practical experience from many institutions and many neurologists worldwide have shown that when you give a subset of patients with autoimmune small fiber neuropathy, immunotherapy like IVIG, a lot of patients feel significantly better. And so, I think paralleling our field in dysautonomia and POTS, we are looking forward to immunotherapy being more mainstream rather than exception from the rule because access and insurance coverage is a huge barrier for clinicians and patients, but that may be a very effective treatment options for treatment refractory patients whose symptoms do not improve with symptomatic treatment.Eric Topol (30:38):Now, with all these treatments that are on the potential menu to try, and of course sometimes it really is a trial and error to get one that hopefully works for Covid, Long Covid, what is the natural history? Does this persist over years, or can it be completely resolved?Svetlana Blitshteyn (31:00):That's a great question. Everyday Long Covid patients ask me, and I think what we are seeing is that there is a good subset of patients for whom Long Covid is going to be temporary and they will improve and even recover close to normal. Now remember that original case series of patients that I reported in early 2021 based on my 2020 experience in that 20 patient case series, very few recovered, three patients recovered back to normal. Most patients had lingering ongoing chronic symptoms. So of course mine is a kind of a referral bias where I get to see the sickest patients and it looks to be like it's a problem of chronic illness variety. But I also think there is going to be a subset of patients and then we have to study them. We need to study who got better and who didn't. And people improve significantly and some even recover close to normal. But I think certain symptoms like maybe fatigue and heat intolerance could persist because those are very heavily rooted in autonomic dysfunction.Vaccination and POTSEric Topol (32:26):Yeah, well, that's something that's sobering and why we need trials and to go after this in much more intensity and priority. Now the other issue here is while with Covid, this is almost always the virus infection, there have been reports of the vaccine inducing POTS and Long Covid, and so what does that tell us?Svetlana Blitshteyn (32:54):Well, that's a big, big topic. Years ago, I was the first one to report a patient with POTS that was developed after HPV vaccine Gardasil. Now, at that time I was a young neurologist. Then the patient came to me saying she was an athlete saying two weeks after Gardasil vaccine, she developed these very disabling symptoms. And I thought it was very interesting and unique and I thought, well, I'll just publish it. I never knew that this would be the start of a whole different discussion and debate on HPV vaccines. There were multiple reports from numerous countries, Denmark, Mexico, Japan. Japan actually suspended their mass HPV vaccination program. So somehow it became a big deal. Now many people, including my colleagues didn't agree that POTS can begin POTS, small fiber neuropathy, other adverse neurologic events can begin after vaccination in general. And so, this was a topic that was widely debated and the European medical agencies came back saying, we don't have enough evidence.Svetlana Blitshteyn (34:20):Of course, we all want to have a good cancer vaccine. And it was amazing to watch this Covid vaccine issue unfolding where more than one study now have shown that indeed you can develop POTS after Covid vaccines and that the rate of POTS after Covid vaccines is actually slightly higher than before vaccination. So I think it was kind of interesting to see this unfold where I was now invited by Nature Journal to write an editorial on this very topic. So I think it's important to mention that sometimes POTS can begin after vaccination and however, I've always advised my patients to be vaccinated even now. Even now, I have patients who are unvaccinated and I say, I'm worried about you getting a second Covid or third without these vaccines, so please get vaccinated. Vaccines are very important public health measure, but we also have to acknowledge that sometimes people develop POTS, small fiber neuropathy and other complications after Covid vaccines.Prominence of the Vagus Nerve Eric Topol (35:44):Yeah, I think this is important to emphasize here because of all vaccinations can lead to neurologic sequelae. I mean look at Guillain-Barre, which is even more worrisome and that brings in the autoimmune component I think. And of course, the Covid vaccines and boosters have a liability in a small, very small percentage of people to do this. And that can't be discounted because it's a small risk and it's always this kind of risk benefit story when you're getting vaccinated that you are again spotlighting. Now gets us to the biggest thing of all besides the practical pearls you've been coming up with to help everyone in patients and clinicians. In recent weeks, there's been explosion of these intra body circuits. There was a paper from Columbia last week that taught us about the body-brain circuits between the vagus nerve and the caudal Nucleus of the Solitary Tract (cNST) of the brain and how this is basically a master switch for the immune system. And so, the vagus nerve there and then you have this gut to brain story, which is the whole gut microbiome is talking to the brain through the vagus nerve. I mean, everything comes down to the vagus nerve. So you've been working all your career and now everything's coming into this vagus nerve kind of final common pathway that's connecting all sorts of parts of the body that we didn't truly understand before. So could you comment about this because it's pretty striking.Svetlana Blitshteyn (37:34):Absolutely. I think this pandemic is highlighting the pitfalls of everything we didn't know but should have in the past. And I think this is one of them. How important is the autonomic nervous system and how important is the vagus nerve that is the longest nerve in the body and carries the parasympathetic outflow. And I think this is a very important point that we have to move forward. We cannot stop at the autonomic knowledge that we've gained thus far. Autonomic neurology and autonomic medicine has always been the field with fellowship, and we have American Autonomic Society as well. But I think now is a great time to move forward and study how the autonomic nervous system communicates with the immunologic system. And again, Kevin Tracey's work was groundbreaking in the sense that he connected the dots and realized that if you stimulate the vagus nerve and the parasympathetic outflow, then you can reduce pro-inflammatory cytokines and that he has shown that you can also improve or significantly such disorders like rheumatoid arthritis and other autoimmune inflammatory conditions.Svetlana Blitshteyn (39:03):Now we have the invasive vagus nerve stimulation procedures, and quite honestly, we don't want that to be the mainstream because you don't want to have a neurosurgery as you go to treatment. Of course, you want the non-invasive vagus nerve stimulation being the mainstream therapy. But I think a lot of research needs to happen and it's going to be a very much a multidisciplinary field where we'll have immunology, translational sciences, we'll have neurosurgeons like Kevin Tracey, we'll have rheumatologists, neurologists, cardiologists. We'll have a multidisciplinary collaborative group to further understand what's going on in these autoimmune inflammatory disorders, including those of post-infectious origin.Eric Topol (40:02):I certainly agree with all of your points there. I mean, I'm really struck now because the immune system is front and center with so much of what we're seeing with of course Long Covid, but also things like Alzheimer's and Parkinson's and across the board with metabolic diseases. And here we have this connection with your sweet spot of the autonomic nervous system, and we have these pathways that had not been delineated before. I didn't know too much about the cNST of the brain to be such an important connect point for this. And I wonder, so here's another example. Concurrently the glucagon-like peptide 1 (GLP-1) drugs have this pronounced effect on reducing inflammation in the body before the weight loss and in the brain through the gut-brain axis, as we recently discussed with Dan Drucker, have you ever tried a GLP-1 drug or noticed that GLP-1 drugs help people with Long Covid or the POTS problem?Svetlana Blitshteyn (41:12):So I have heard anecdotally people with Long Covid using these drugs for other reasons, saying I feel much better. In fact, I recently had a woman who said, I have never been more productive than I am now on this medication. And she used the word productive, which is important because non-productive implies so many things. It's the brain fog, it's the physical fatigue, it's the mental fatigue. So I think we are, first of all, I want to say, I always said that the brain is not separate from the body. And neurologic manifestations of systemic disease is a very big untapped area. And I think it's not going to be surprising for me to see that these drugs can improve many brain parameters and possibly even neuroinflammation. We don't know, but we certainly need to study this.Eric Topol (42:15):Yeah, it's interesting because statins had been tried for multiple sclerosis, I think maybe not with very clear cut benefit effects, but here you have a new class of drugs which eventually are going to be in pills and not just one receptor but triple receptor, much more potent than what we're seeing in the clinic today. And you wonder if we're onto an anti-inflammatory for the brain and body that could help in this. I mean, we have a crisis here with Long Covid in POTS without a remedy, without adequate resources that are being dedicated to the clinical trials that are so vital to execute and find treatments. And that's just one candidate of many. I mean, obviously there's so many possible ones on the list. So if you could design studies now based on your extraordinary rich experience with Long Covid and POTS, what would you go after right now? What do you think is the thing that's, would it be to evaluate more of these noninvasive, non-pharmacologic treatments like the vagal nerve stimulation, or are there particular drugs that you find intriguing?Svetlana Blitshteyn (43:33):Well, a few years ago we published a case series of patients with severe POTS and nothing helped them, but they improved significantly and some even made close to recovery improvement and were able to return to their careers because they were treated with immunotherapy. So the paper is a subcutaneous immunoglobulin and plasmapheresis and the improvement was remarkable. I say there was one physician there who could not start her residency. She got sick in medical school and could not start her residency due to severe POTS and no amount of beta blockers, Midodrine or Florinef helped her get out the house and out of bed. And therefore, sheer luck, she was able to get subcutaneous immunoglobulin and she improved significantly, finished her residency and is now a practicing physician. So I think when we have these cases, it's important to bring them to scientific community. And I think I'm very excited that hopefully soon we're going to have trials of immunotherapy and immunomodulating treatment options for patients with Long Covid and hopefully POTS in general, I believe in novel, but also repurposed, repurposed treatment.Svetlana Blitshteyn (45:01):IVIG has been used for decades, so it's not a new medication. And contrary to popular belief, it's actually quite safe. It is expensive, it's a blood product, but we are very familiar with it in medicine and neurology. So I think we have to look forward to everything. And as I tell my patients, I'm always aggressive with medications when they come to me and their doctor said something like, well, let's see, it's going to go away on its own or keep doing your salt and fluids intake or wear compression sucks. Well, they're already doing it. It's not helping. And now it's a good time to try everything we have. And I would like to have more. I would like to have immunotherapy available. I would like to have immunosuppressants even tried potentially, and maybe we'll be able to try medication for possible viral persistence. Let's see how that works out. We have other inflammatory modalities out there that can potentially give us the tools. You see, I think being that it's a multifactorial disorder, that I don't think it's going to be one thing for everyone. We need to have a toolbox where we're going to choose what's best for your specific case because when we talk about Long Covid, we have to remember there are many different phenotypes under that umbrella.A Serious MatterEric Topol (46:40):Now, before we wrap up, I mean I guess I wanted to emphasize how there are clinicians out there who discount Long Covid in POTS. They think it's something that is a figment of imagination. Now, on the other hand, you and I especially, you know that people are totally disabled. Certain days they can't even get out of bed, they can't get back to their work, their life. And this can go on and on as we've been discussing. So can you set it straight about, I mean, you are seeing these people every day. What do you have to say to our fellow colleague physicians who tend to minimize and say, this is extremely rare, if it even exists, and that these people have some type of psychiatric problem. And it's really, it's distressing of course, but could you speak to that?Svetlana Blitshteyn (47:39):Absolutely. So as I always say, Long Covid is not a psychiatric or psychological disorder, and it's also not a functional neurologic disorder. Now, having said that, as I just mentioned, brain is not separate from the body. And neurologic manifestations of systemic disease are numerous. We just had a paper out on neurologic manifestations of mast cell activation syndrome. So certainly some patients will develop psychiatric manifestations and some patients will develop major depression, anxiety, OCD or functional neurologic disorder. But those are complications of systemic disease, meaning that you cannot diagnose a patient with anxiety and send them off to a psychologist or a psychiatrist without diagnosing POTS and treating it. And in many cases, when you approach an underlying systemic disorder with the right medications, like dysautonomia for example, all of the symptoms including psychological and psychiatric, tend to improve as well. And certainly, there is going to be a small subset of Long Covid patients whose primary problem is psychiatric.Svetlana Blitshteyn (49:01):And I think that's totally fine. That is not to say that all Long Covid is psychiatric. Some will have significant psychiatric manifestations. I mean, there are cases of post Covid psychosis and autoimmune encephalitis and all kinds of psychiatric problems that people may develop, but I think we can't really stratify well, this is physiologic and this word functional that I'm not a fan of. This is physiologic as we see it on MRI. But here, because we don't see anything on MRI, it means you are fine and can just exercise your way out of it. So I think with this Long Covid, hopefully we'll get answers as to the pathophysiology, but also most importantly, hopefully we'll get these therapies that millions of people before Covid pandemic were looking for.Eric Topol (50:02):Well, I just want to thank you because you were onto this well over 10, 15 years before there was such a thing as Covid, you've dedicated your career to this. These are some of the most challenging patients to try to help and has to be vexing, that you can't get their symptoms resolved no less the underlying problem. And we're indebted to you, Svetlana, because you've really been ahead of the curve here. You were writing a patient book before there were such things as patient activists in Long Covid, as we've seen, which have been so many of the heroes of this whole problem. But thank you for all the work you do. We'll continue to follow. We learned from you about POTS and Long Covid from your work and really appreciate everything you've done. Thank you.Svetlana Blitshteyn (50:58):Thank you so much, Eric, for having me. As I said, it's a great honor for me to be here. Remarkable, amazing. And thank you for all this work that you're doing and being an advocate for our field because we always need great champions to help us move forward in these complicated disorders.********************************The Ground Truths newsletters and podcasts are all free, open-access, without ads.Voluntary paid subscriptions all go to support Scripps Research. Many thanks for that—they greatly helped fund our summer internship programs for 2023 and 2024.Thanks to my producer Jessica Nguyen and Sinjun Balabanoff tor audio and video support at Scripps ResearchNote: you can select preferences to receive emails about newsletters, podcasts, or all I don't want to bother you with an email for content that you're not interested in. Get full access to Ground Truths at erictopol.substack.com/subscribe

Event Objectives:Review our experience so far pertaining to patient presentation and effective management of patients with postural orthostatic tachycardia syndrome (POTS).Review common co-existing conditions that occur with POTS.Understand the various physiologic alterations that predispose to the occurrence of POTS in the young.Claim CME Credit Here!

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GAIN Without Pain: Understanding The Vagus Nerve . If you've ever led others, felt burned out, had children, or survived a global lockdown, understanding the vagus nerve is well worth your attention. While the vagus nerve is a big deal in the world of #PTSD, it's also a critical component for you and me. .   In short, the vagus nerve is vital in regulating our stress response and emotional well- being. It's responsible for the mind-body connection and helps us distinguish between pain and suffering. . Educating ourselves about the vagus nerve can lead to better relationships with ourselves and others.  . Over the next two episodes of The Dov Baron Show, you'll discover the power of managing your vagus nerve and its impact on your life.  When it comes to Managing Stress, look no further than our guest for the next two episodes. Dr Greg Hammer. He is a Stanford University School of Medicine professor, a pediatric intensive care physician, and a pediatric anesthesiologist. He is also the author of "GAIN Without Pain, the Happiness Handbook" . Website  https://greghammermd.com . Social Media https://www.facebook.com/greghammermd        https://www.linkedin.com/in/greg-hammer-02b20422  https://www.instagram.com/greghammermd . Part 1: The Emotional Mathematics of Suffering Swimming in an Ocean of Grief Accepting death Discerning between Pain and Suffering Why Nothing is Real Until It's Subjectively Real Loving and Losing a Bipolar Beethoven The Suffering Equation Why Resisting the Uncomfortable Magnifies Suffering Where Positive Thinking Goes to Die Denial As a Form of Resistance Inside The Contemporary Teenage Mind Living and Breathing the Serenity Prayer What is the Vagus Nerve Understanding Both the Autonomic and Sympathetic Nervous System When Your Gut Knows Vagus Nerve Techniques for Managing Stress Ice, Ice Baby! . Dov Baron's brand new course has just been released on coursifyx.com/belonging ------------- Titled: "CREATING A CULTURE OF BELONGING." The course is separated into eight sections that will take you by the hand and walk you through exactly how to create a culture of belonging. Because: CREATING A CULTURE OF BELONGING MAXIMIZES PERSONAL AND CORPORATE SUCCESS. Get Ready to strap on the tanks and Dive Deep into, What it Takes to Create a Culture of Belonging in your organization! Curious to know more? coursifyx.com/belonging .  "Those Who Control Meaning for The Tribe, Also Control The Movement of That Tribe" #videopodcast #leadership #leadershipdevelopment #emotionsourcecode #neuroscience #emotional #meaning #emotional #logic #culture #curiosity #humanbehavior #purpose

In this compelling solo episode of The Yoga Therapy Hour, Amy Wheeler delves into the intricate relationship between the regulation of the autonomic nervous system and overall health. Amy illuminates how mastering this regulation through therapeutic yoga can profoundly impact various bodily systems—digestion, endocrine, immune, cardiovascular, and reproductive—thereby influencing our experiences with chronic pain, autoimmune diseases, and addiction. Her insights offer a transformative approach to health and happiness, guiding listeners towards living a life of coherence and well-being.Understanding Autonomic Regulation: Amy explains the significance of the autonomic nervous system in maintaining body homeostasis and its effect on health and disease.Therapeutic Yoga as a Tool: Discover how therapeutic yoga practices can be strategically used to manage the nervous system, promoting healing, and preventing illness.Personal Journey and Successes: Through personal anecdotes, Amy shares how yoga therapy has been pivotal in managing her health, providing practical examples that inspire.Patanjali's Insights on Suffering: Amy discusses the four symptoms of suffering outlined by Patanjali, offering a deeper understanding of how yoga philosophy can aid in overcoming life's challenges.The Path to Clarity and Regulation: Learn about the concept of viveka (clarity) and how moving from a place of regulation can lead to making choices that reduce suffering.Integrating Wisdom from Daniel Amen and Gabor Mate: Amy brings in the work of renowned figures like Daniel Amen and Gabor Mate to enrich the discussion on mental health, addiction, and the power of yoga therapy. This episode with Amy Wheeler serves not only as an educational journey into the depths of yoga therapy but also as a testament to the transformative power of yoga in achieving health and happiness. By bridging ancient wisdom with modern scientific understanding, Amy offers a holistic approach to living that prioritizes coherence and regulation. Whether you're navigating chronic conditions, seeking mental clarity, or simply aspiring for a healthier life, this episode provides valuable insights and practical tools to guide you on your path. Join us in exploring how therapeutic yoga can unlock the door to a balanced, fulfilling life, and inspire a journey towards self-regulation and profound well-being. If you would like to receive the free infographics and handouts that correspond to each episode on the Yoga Therapy Hour Podcast, please subscribe to our segmented email list. You will have the opportunity to determine the Infographic Topics that you would like to receive. When The Yoga Therapy Hour Podcast has a topic that corresponds to your choices, then you will receive an email for that week with the PDF's for download.·        Topics you can choose from include: ·        Yoga Therapy & Mental Health·        Yoga Therapy & Physical Health·        Social Justice in yoga & Yoga Therapy·        Yoga/Ayurveda Toolbox·        Yoga & Indian Philosophy·        Global & Trending Yoga Therapy TopicsClick the link below to subscribe. It takes 10 seconds total.https://amywheeler.com/subscribe Monday Night Yoga Therapy Clinics with Amy Wheeler:Email amy@amywheeler.com for more information www.TheOptimalState.com & www.AmyWheeler.com Institute App Link to Join:https://polyvagal-institute.mn.co/spaces/10721610/feed University of Minnesota Therapeutic Yoga Classes: https://csh.umn.edu/for-community/wellbeing-workshops/online-therapeutic-yoga-series

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In this podcast episode recorded in Mumbai during a tour of biohacking events, the speakers delve into the concept of biohacking and its implications for modern life. They explore how modern conveniences, while seemingly making life easier, have contributed to declining health due to a lack of physical activity and poor dietary choices. They emphasize the need for individuals to take control of their biology through education, accountability, and leveraging technology for health monitoring and optimization. The discussion touches on various aspects of biohacking, including optimizing the environment for better health outcomes, such as purifying indoor air, filtering water, and minimizing exposure to artificial light and electromagnetic fields. The speakers stress the importance of prioritizing mental health alongside physical health, advocating for practices like discipline, mindfulness, and focusing on long-term well-being over short-term gratification. Key Takeaways: Biohacking involves actively hacking one's biology to optimize health outcomes in the modern world. Modern lifestyles characterized by sedentary behavior, poor dietary choices, and environmental toxins contribute to declining health. Education, accountability, and leveraging technology for health monitoring are crucial for making informed decisions about lifestyle choices.           Optimizing the environment, including purifying indoor air, filtering water, and minimizing exposure to artificial light, is essential for better health outcomes.          Prioritizing mental health alongside physical health through practices like discipline, mindfulness, and long-term focus is crucial for overall well-being.          NAD Regen by BioStack Labs offers a cost-effective supplement solution for improving NAD levels, endorsed by Tony Robbins and Ben Greenfield.         Visual Chemistry Skin provides skincare free from harmful chemicals, promoting skin rejuvenation with plant stem cells and antioxidants.          Prioritizing self-care and efficient time management are essential for incorporating health practices into daily routines for long-term wellness. ---- Purchase Kris's new Legacy Fat Loss trainer: https://www.krisgethinlegacy.com/ Save on all BiOptimizers products by using code KRIS10 at checkout https://bioptimizers.com/ To apply to train with Kris online 1-on-1 email info@krisgethin.com ---- Follow me on Instagram and feel free to DM about 1-1 online training @krisgethin For my preferred Biohacking and anti-aging supplements, go to https://bit.ly/kgbiostacklabs

Dr Thomas Chelimsky, Professor of Neurology and Director of VCU's autonomic laboratory, is a specialist in autonomic dysfunction and a vocal advocate for considering the mind and body as one cohesive system.  He, along with his team at the VCU clinic, take a unique brain-body approach to treating Long Covid patients, with success.In this week's episode he discusses the autonomic issues faced by Long Covid patients including migraine, which he believes is prevalent in c. 50% of patients, and POTS which he discusses ‘almost never shows up alone', linking  it with the migraine, fibromyalgia and IBS (irritable bowel syndrome).  He explains the roles of the periaqueductal gray region of the brain and the vagus nerve, alongside the implications of trauma (both physical and mental) on the autonomic system, and the role that it plays in Long Covid. Living with Long Covid? How was your week?Website - https://www.tlcsessions.net/Twitter - @SessionsTlc https://twitter.com/sessionstlcInsta - @tlcsessions https://www.instagram.com/tlcsessions

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Dr. Gerard Farrell (E-mail, X) is interviewed by Stephen M. Shaffer on his recent manuscript, "Autonomic nervous system and endocrine system response to upper and lower cervical spine mobilization in healthy male adults: a randomized crossover trial." This paper was published in the Journal of Manual and Manipulative Therapy. This interview will be interesting for the practitioner looking to improve their understanding of a normal vs dysfunctional stress response in the body and the potential impact of cervical spine manual therapy. Find out more about the Foundation for Orthopaedic Manual Physical Therapy (FOMPT) and the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT) at the following links:Foundation website: www.aaompt.org/foundationAcademy website: www.aaompt.orgTwitter: @AAOMPTFacebook: https://www.facebook.com/aaompt/Instagram: https://www.instagram.com/officialaaompt/?hl=enPodcast e-mail: aaomptpodcast@gmail.comPodcast website: https://aaomptpodcast.simplecast.fm

Dr. Gerard Farrell is interviewed by Stephen M. Shaffer on his recent manuscript, "Autonomic nervous system and endocrine system response to upper and lower cervical spine mobilization in healthy male adults: a randomized crossover trial."

In today's episode I am joined by clinician, author, and nervous system expert, Deb Dana as she talks about Polyvagal Theory and befriending the nervous system.    Topics Include: 1. Deb's journey to Polyvagal Theory and Stephen Porges 2. How the stuckness leads to suffering 3. Your state creates your story 4. Power of curiosity to shift into ventral 5. What is Polyvagal Theory and its three principles 6. Power of resilience 7. How the nervous system is impacted by trauma 8. Genetics and the nervous system. Autonomic family tree 9. Befriending your nervous system with BASICS   Deb Dana, LCSW is a clinician, consultant, author and speaker specializing in complex trauma. Her work is focused on using the lens of Polyvagal Theory to understand and resolve the impact of trauma in our lives. She is a founding member of the Polyvagal Institute, consultant to Khiron Clinics, and advisor to Unyte. Deb's work shows how an understanding of Polyvagal Theory is applicable across the board to relationships, mental health, and trauma. She delves into the intricacies of how we can all use an understanding of the organizing principles of Polyvagal Theory to change the ways we navigate our daily lives. Deb is well known for translating Polyvagal Theory into a language and application that is both clear and accessible and for pioneering Rhythm of Regulation® methodology, tools, techniques and practices which continue to open up the power of Polyvagal Theory for professionals and curious people from diverse backgrounds and all walks of life.   Deb Dana: Website: https://www.rhythmofregulation.com/ Trainings: https://www.rhythmofregulation.com/training Resources: https://www.rhythmofregulation.com/resources     Natalie Deering:  Website: https://www.ndwellnessservices.com/ Email: ndwellness.services@therapysecure.com Instagram: @nataliedeering   Interested in sponsoring an episode of the podcast? Upgrade your business and let more people know about your amazing services or products by reaching hundreds to thousands of people by sponsoring an episode for only $100!  Please email ndwellness.services@therapysecure.com for more information.  Thank you for the support!    *Please support the podcast by following, rating, and leaving a review*    

I have been laid up with a serious back problem for nearly two weeks now and haven't been able to record a new episode in that time. But fear not, because we are taking this opportunity to revisit one of absolute my favourite episodes of the show, all the way back to February 2022. Fingers crossed we will be back with a new episode next week!--From episode 006 (Feb 2022): dBridge is an unequivocal legend of Drum n Bass. From his work as part of Future Forces Inc. on Renegade Hardware in the mid 90s, through the supergroup Bad Company and the Autonomic project with Instra:mental, right up to releasing 4 albums since 2018 on his own Exit Records label, he has been right at the cutting edge of the genre, and of electronic music generally for more than 25 years. We talk about the early Jungle scene, subgenre fragmentation, DnB politics, the tyranny of rewinds, and making peace with your own musical output. If you're into what we're doing here on the pod then you can support the show on Patreon! There are two tiers - "Solidarity" for $4 a month, which features the show without ads, regular bonus podcasts, and extra content. And "Musicality" which for a mere $10 a month gets you all the music we release on Hotflush and affiliate labels AND other music too, some of which never comes out anywhere else.You can also make a one-off donation to the podcast using either a credit or debit card, or with Paypal. Head over to scubaofficial.io/support.Plus there's also a private area for Patreon supporters in the Hotflush Discord Server... but anyone can join the conversation there in the public channels, so please do!Listen to all (most of) the music discussed on the show via the Not A Diving Podcast Spotify playlistFollow Scuba: twitter instagram bandcamp spotify apple music beatport Hosted on Acast. See acast.com/privacy for more information.

In this episode of HSS Presents, Dr. Matt Conti, an orthopedic surgeon specializing in foot and ankle surgery and treats a wide range of both non-operative and operative foot and ankle issues, talks about Autonomic downregulation and Communication under stress with Steve Forti, the Chief Wellness and Resiliency Officer at the Hospital for Special Surgery. Steve is responsible for creating and managing programs designed to promote the mental and physical health and well-being of the medical staff, clinicians, and employees across the enterprise.

As host Sarah Lorenzini insightfully explains, “think of autonomic dysreflexia symptoms as the body's way of telling you something is wrong.” Autonomic dysreflexia is a medical emergency that occurs in patients with a spinal cord injury, but it can be hard to recognize because of the body's confusing responses to stimulation. That's why it's crucial for nurses to understand this syndrome and prevent patients from developing any life-threatening complications.In this episode, host Sarah Lorenzini gives listeners an inside look at a case of autonomic dysreflexia in a quadriplegic patient. She breaks down the patient's symptoms, medical history and presentation, then shares what helped her recognize the signs of autonomic dysreflexia. As she dives into the pathophysiology of autonomic dysreflexia, you'll gain a better understanding of this syndrome, including how to manage the symptoms and treat patients.At first perplexed by this case, it was Sarah's knowledge and critical thinking that led her to suspect autonomic dysreflexia. Tune in now and take notes so you can diagnose autonomic dysreflexia and deliver timely intervention the next time you encounter it!Topics discussed in this episode:The patient's symptoms and initial assessmentIdentifying the problem and starting treatmentUnderstanding autonomic dysreflexiaCauses and management of autonomic dysreflexiaMentioned in this episode:AND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!Rapid Response and Rescue Intro CourseCONNECT

Polyvagal theory (PVT) isn't validated by neuroscientists but we can definitely learn from the theory itself. According to the theory, three organizational principles can be distinguished:Explanatory diagram:Hierarchy: The autonomic nervous system reacts in three reaction patterns, which are activated in a specific order.Neuroception: In contrast to perception, it is here a cognition without awareness, triggered by a stimulus such as danger.[14][19]Co-regulation: The need to feel safe enough to allow oneself to be in relationships, which is difficult for traumatized people.[20RESOURCE: https://en.wikipedia.org/wiki/Polyvagal_theoryhttps://www.justinlmft.com/post/dorsal-vagal-shutdownhttps://ct.counseling.org/2016/06/polyvagal-theory-practice/GET THE OCCASIONAL PERSONAL EMAIL FROM ME: www.makeyourdamnbedpodcast.comTUNE IN ON INSTAGRAM FOR COOL CONTENT: www.instagram.com/mydbpodcastOR BE A REAL GEM + TUNE IN ON PATREON: www.patreon.com/MYDBpodcastOR WATCH ON YOUTUBE: www.youtube.com/juliemerica The opinions expressed by Julie Merica and Make Your Damn Bed Podcast are intended for entertainment purposes only. Make Your Damn Bed podcast is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Get bonus content on PatreonSupport this show http://supporter.acast.com/make-your-damn-bed. Hosted on Acast. See acast.com/privacy for more information.

POTS expert that diagnosis and treats POTS discusses all aspect of POTS with Lisa. You don't want to miss this one. https://dralo.net/links

The Episode made possible by BIRTHFIT | Immune Intel AHCCMonique Andrews, MSc DC, DNM, and Tamara MacIntyre, MS, DC are embodiments of personal empowerment. In this episode, they offer clinical insight into polyvagal theory and how it contrasts with the over-simplistic view of the nervous system. Dr. Mac, a seasoned End of Life Doula (CEOLD) and doctor of natural medicine, is on a lifelong mission to deepen our understanding of the human body. Her latest quest encourages us to embrace curiosity over fear, guiding us through life's full spectrum, from birth to farewell. Dr. Mo is a trailblazing educator in embodied neuroscience. She leads transformative global seminars and co-founded innovative projects Cōpe and The Prana Foundation. Visit the show notes for more.Special offer from guests:Check out their new mindfulness and embodiment platform CōPE: An interactive online community whose purpose is to ease the path for those struggling with chronic illness or navigating a life-changing diagnosis. You can become an affiliate here.The Prana Foundation & Education Coursework and Retreats: Polyvagal vagal and Trauma Informed coursesOther references from the show:Polyvagal Institute and Stephen PorgesThe Body Keeps the Score, by Bessel van der Kolk M.DConnect with guests:Monique AndrewsTamara MacIntyreConnect with Nathan:Instagram | Twitter | YoutubeMidwife in need of collaboration?Want to consult with Nathan?My courses:Born Free Method: Pregnancy and Postpartum SupportClear + Free: Your Holistic Solution to Persistent HPVThis episode was made possible by:Immune Intel AHCC® - code BELOVED for 10% off⁠BIRTHFIT⁠ - code BELOVED to get one month FREE in their B! Community!Medical Disclaimer: The Holistic OBGYN Podcast is an educational program. No information conveyed through this podcast should be construed as medical advice. These conversations are available to the public for educational and entertainment purposes only.Music provided by EdvardGaresPremium / Pond5Send me a

Today we're going to talk about an overlooked cause of coronary artery calcification: lactic acidosis. Lactic acidosis occurs as a byproduct of glucose metabolism. Both lactic acidosis and lactate in the blood are associated with various health issues, including: • Heart attacks • Thrombosis • Panic attacks • Autonomic nervous system dysfunction • Bipolar disorder • Schizophrenia • Sepsis • Arrhythmia problems • Liver disease • Diabetes • Cancer • Restless leg syndrome Calcification in the arteries is not just caused by old age, consuming too much calcium, or even a vitamin K2 deficiency. It turns out that one cause of vascular calcification is hypoxia in the arteries. Hypoxia is a lack of oxygen, and this lack of oxygen in the arteries can be caused by lactic acidosis. The top causes of lactic acidosis: • A high-carb diet • An overactive sympathetic dominance situation (chronic stress) • Metformin • Warfarin • Statins • Alcohol • Overtraining The top symptoms of lactic acidosis are breathing problems and restlessness, especially in the leg muscles. How to get rid of lactic acidosis: 1. Get on the keto diet 2. Reduce your stress 3. Consume natural vitamin B1 (thiamine) DATA: https://assets.cureus.com/uploads/cas... https://www.ahajournals.org/doi/10.11... https://www.hormonesmatter.com/covid-... https://www.liebertpub.com/doi/10.108..

What is the relationship between nonsuicidal self-injury (NSSI) and pain? Are individuals who self-injure less sensitive to pain than those who don't self-injure? What are the ethics involved in conducting research on pain? In this episode, Dr. Julian Koenig describes the research on the experience of pain among those who self-harm. Learn more about Dr. Koenig and his research lab at www.koeniglab.de, and follow him on Twitter/X at @koeniglab.Below are links to some of the research referenced in this episode:Koenig, J., Thayer, J. F., & Kaess, M. (2016). A meta-analysis on pain sensitivity in self-injury. Psychological Medicine, 46(8), 1597-1612.Koenig, J., Klier, J., Parzer, P., Santangelo, P., Resch, F., Ebner-Priemer, U., & Kaess, M. (2021). High-frequency ecological momentary assessment of emotional and interpersonal states preceding and following self-injury in female adolescents. European Child & Adolescent Psychiatry, 30(8), 1299-1308.Kaess, M., Hooley, J. M., Klimes-Dougan, B., Koenig, J., Plener, P. L., Reichl, C., Robinson, K., Schmahl, C., Sicorello, M., Schreiner, M. W., & Cullen, K. R. (2021). Advancing a temporal framework for understanding the biology of nonsuicidal self-injury: An expert review. Neuroscience and Biobehavioral Reviews, 130, 228-239.Störkel, L. M., Karabatsiakis, A., Hepp, J., Kolassa, I.-T., Schmahl, C., & Niedtfeld, I. (2021). Salivary beta-endorphin in nonsuicidal self-injury: an ambulatory assessment study. Neuropsychopharmacology, 46(7), 1357-1363.Sigrist, C., Kaess, M., & Koenig, J. (2023). Autonomic nervous system function in nonsuicidal self-injury—A Research Domain Criteria perspective on the arousal/regulatory systems. In E. E. Lloyd-Richardson, I. Baetens, & J. Whitlock (Eds.), The Oxford handbook of nonsuicidal self-injury (pp. C18S1–C18S23). Oxford University Press.Naoum, J., Reitz, S., Krause-Utz, A., Kleindienst, N., Willis, F., Kuniss, S., Baumgärtner, U., Mancke, F., Treede, R.-D., & Schmahl, C. (2016). The role of seeing blood in non-suicidal self-injury in female patients with borderline personality disorder. Psychiatry Research, 246, 676-682.Follow Dr. Westers on Instagram and Twitter/X (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and TwitterX (@ITripleS).The Psychology of Self-Injury podcast has been rated #1 by Feedspot  in their list of "10 Best Self Harm Podcasts" and #5 in their "20 Best Clinical Psychology Podcasts." It has also been featured in Audible's "Best Mental Health Podcasts to Defy Stigma and Begin to Heal."If you or someone you know should be interviewed on the podcast, we want to know! Please fill out this form, and we will be in touch with more details if it's a good fit.

Dr. Seager discusses science and best-practices with cold immersions for supporting hormonal health. Sponsored: Support your Workout Sessions and Healthy Hydration with this Creatine Electrolyte Combo by MYOXCIENCE: bit.ly/electrolyte-stix Save 12% with code podcast at checkout Save $350 off an amazing Cold Water Immersion tank with code HIH350: morozkoforge.com Show Notes:   2:25 Surprise is a basic human emotion that opens all your senses. Surprise updates your belief systems. 03:20 Complete freedom from stress is death. Stress is part of what makes us alive. There is a systemic beneficial response. 03:40 Thermal contrast is used to measure physiologic responses to stress. Adapting to this kind of stress is a measure of your resilience. 04:40 It is your beliefs about stress being harmful that cause harm to your health. 05:00 Our ancestors lived in discomfort and sought comfort. We should be seeking discomfort. Intentional discomfort with recovery makes us more resilient. 07:10 Water cold as 60 degrees will help your metabolism. Psychological resilience begins at water about 39 degrees. 09:50 HRV improves with cold exposure. Your heart rate should expand or contract to adjust to the demands of your body. HRV is a physiologic measure of your psychological resilience. It makes your heart more resilient. 11:30 Ice cold water exposure activates thermogenesis, the autonomic nervous system, and production of neurotransmitters and hormones that your body needs when your fight/flight system is on high alert. 13:10 When you come out of the ice water, you feel like superman. 14:30 Autonomic conflict theory: You will gasp. Gasp reflex activates fight/flight, increases your heart rate. If you cannot calm your breath, you may hyperventilate. A countervailing reflex is the dive reflex where you automatically shut down your breath and metabolism goes into conservation mode. It conserves oxygen and builds up carbon dioxide and slows your metabolism. 61:10 Your heart rate goes up In an ice water bath, and your liver releases glycogen into your bloodstream to fuel your muscles. 16:30 Tipton's hypothesis is that if you are subject to both the gasp and the dive at the same time, it will create an autonomic conflict that may cause your heart to skip a beat. It is potentially an issue with people with arrythmia. However, there are no documented cases of heart arrythmia and cold emersion causing issues. 17:25 Contraindications of cold exposure: drowning, hyperventilation, and breath hold. Hyperventilation purges the carbon dioxide from your system and can shut down the receptors that give you the urge to breathe. 18:40 Go feet first. Bathe sober. Breathe continuously. 20:25 Primary Raynaud is a complex extreme over reaction to cold. It is partly physiological and part psychological. In general, cold induces vasal restriction. To protect your core, your body changes the circulation of your blood, shutting off circulation to your fingers, toes, and limbs. It reduces heat extraction.  Secondary Raynaud is a vascular disorder caused by some other disease. 22:10 Anxiety makes a Raynaud response worse, which makes the anxiety worse. 22:25 Exposure therapy has been a successful method for overcoming primary Raynaud. 28:40 You can micro dose cold exposure. The first 15 seconds bring on an autonomic response, fight/flight. Consistency is important. 32:14 Tom brought down his PSA to 0.8 with keto and more consistent ice baths. 32:40 Testosterone goes up when a cold bath is done before exercise. Do not ice bath for recovery if you are trying to build muscle mass. 36:00 Precool (cold exposure) before exercise for peak muscle power, endurance. Precooling protects mitochondria. Testosterone response goes way up. 36:55 Cold stimulation in women raises saliva testosterone. Testosterone is the dominant sex hormone in women, but not to the same levels as men. Testosterone is important for women at all ages. Menopausal women who experience a testosterone deficiency have no FDA approved treatments. 42:40 Brown fat is an essential organ. 30% of babies' weight is brown fat. 43:40 Without regular cold exposure, you will lose all your brown fat. By age 40, 95% of Americans have 0 detectable brown fat. 43:55 Metabolic disorders are associated with a lack of brown fat. It is a secretory organ. It makes hormones. It makes more thyroid stimulating hormone than any other thing in your body.  Thyroid and brown fat work together. If your brown fat has dissipated, there is nothing to modulate thyroid activity.  Hyper or hypothyroidism is common in people with no brown fat. 44:40 Cold exposure is a potential remedy for thyroid disorder that does not require a lifetime of RX meds. 45:00 Beiging white fat, recruits more brown fat into your body. Brown fat produces neuroprotective hormones for your brain, thyroid stimulating hormone, and it will modulate your metabolism to bring it back to order. 46:55 Everyone's body is evolutionarily designed to expect cold exposure, exercise, and certain nutrition. 48:25 People who live in thermal neutral environments generally have a higher rate of adiposity. 49:00 Cold exposure burns fat and calories when you are in it, but your body compensates for the caloric deficit after.  50:10 Cold exposure remodels your fat. It changes visceral fat into subcutaneous fat. Subcutaneous fat can be benign. Visceral fat (pot belly fat) can kill you. 50:40 Electrical impedance meter is not calibrated for brown fat. Don't worry about absolute numbers. 54:40 Eleven minutes a week is enough time to keep brown fat working. 59:44 Ice bath can provide the emotional arousal needed to consolidate short-term memory into vivid long-term memory. 01:00:40 Shivering can be for thermogenesis, and it can be for nervous system release. Your nervous system can release trauma via trembling. PTSD is unresolved stress. Trauma is when stress has no release or resolution. 01:06:55When buying an ice bath: What is its temperature? Is it grounded? The tub must be electrically connected to the earth. What kind of water treatment does it have? Ozone is the most powerful water disinfectant for cold water. 01:10:40 Tom adds Epsom salt, potassium sulfate, zinc sulfate, and he does not shower after. Magnesium is stored in your bones, not your blood. Keep chloride out of your ice bath.