Podcasts about drg

THANK YOU TO OUR SPONSORS! Visit timeline.com/DRG and use code DRG to get 20% OFF Sign up for our newsletter! https://drchristiangonzalez.com/newsletter/ What if I told you there's a food that's up to 100 times more nutritious than regular vegetables, can be grown without soil or sunshine, and transforms your health in just one week? Meet sprouts; the original superfood that's been hiding in plain sight. In this episode, Doug Evans, author of the national bestseller "The Sprout Book" and founder of The Sprouting Company, reveals why sprouts are the most nutrient-dense food on the planet. From broccoli sprouts with over 2,000 peer-reviewed studies on sulforaphane to the simple magic of turning 35g of seeds into 350g of nutrition in just 5 days, Doug shares the science and practical wisdom behind this ancient superfood. We dive deep into how sprouts naturally trigger GLP-1 peptide secretion for weight management, provide chemoprotective properties against cancer, support hormone regulation, and deliver every essential amino acid your body needs. Doug also shares his holistic approach to vitality at 59, from desert living and daily friendships to optimal sleep and natural bathing rituals. Whether you're looking to upgrade your nutrition, support your health naturally, or discover the most accessible superfood that anyone can grow on their kitchen counter, this conversation will transform how you think about food and healing. Hosted by Doctor Christian Gonzalez N.D.  Follow Doctor G on Instagram @doctor.gonzalez⁠ ⁠ ⁠https://www.instagram.com/doctor.gonzalez/ Timestamps: 00:00 - Introduction 08:02 - The Science Breakthrough 15:15 - From Seed to Superfood 25:56 - Cancer Protection & Hormone Balance 35:03 - Social Survival Guide 42:15 - Desert Living Secrets 50:16 - The Friendship Formula 57:25 - From Zero to 100M Views

THANK YOU TO OUR SPONSORS! Visit ⁠jaspr.co/DRG⁠ and use code DRG for $300 OFF for a limited timeVisit ⁠bioptimizers.com/drg⁠ and use code DRG to get 10% OFF in any orderSign up for our newsletter! https://drchristiangonzalez.com/newsletter/ What if the traditional therapy model is fundamentally broken? In this eye-opening episode, I sit down with my co-founders from the Integrative Psychology Institute - Adam Carney, President & Co-Founder of the Institute For Integrative Trauma, and Molly Mendoza, Founder of the Integrative Psychology Institute. We expose the critical flaws in traditional therapy education and reveal our revolutionary 18-month masters program that's changing everything.  Discover why most therapists graduate unprepared for real-world practice, how our competency-based model prioritizes embodied learning over test performance, and why addressing biology alongside psychology is essential for true healing.  We explore the connection between authenticity and nervous system regulation, how business can be a mirror for personal growth, and why the future of therapy requires practitioners who have mastered their own embodied presence first. If you're interested in mental health, considering therapy training, or curious about the intersection of psychology, biology, and spirituality, this episode reveals a completely new paradigm for healing. Timestamps: 0:00 - Introduction & Purpose  2:54 - Why Traditional Therapy Isn't Working  15:51 - The Broken System: Why It's Nearly Impossible to Become a Therapist  22:25 - The New Paradigm: Embodied Learning vs. Academia  31:16 - Stress Redefined: Dr. G's Breakthrough Moment  47:47 - Business as Mirror: What Your Company Reflects About You  1:07:17 - The Authenticity Trend vs. Real Connection  1:14:33 - Nervous System Mastery in Relationships  1:30:23 - What Makes an Integrative Therapist

Thank you to our sponsors! Visit calroy.com/drg and save over $50 and get a free Canister of 2-in-1 Nitric Oxide Test Strips with a 3-Pack Bundle Purchase Visit cornbreadhemp.com/drg and use code DRG for 30% OFF your first order Sign up for our newsletter! - drchristiangonzalez.com/newsletter What if shame is the #1 block to pleasure, intimacy, and authentic connection? In this groundbreaking episode, I welcome Dr. Danielle Harel and Celeste Hirschman, founders of the revolutionary Somatica Method, to explore how pleasure, embodiment, and emotional expression can transform your sexual experiences and relationships. We dive deep into why performance-based sexuality kills intimacy, how shame disconnects us from our bodies, and why pleasure can be a powerful entry point for healing trauma. Discover why many people don't know what they want sexually, how kinks and fantasies can become tools for emotional liberation, and practical techniques using breath, sound, and body awareness to unlock blocked energy.  Whether you're struggling with intimacy, recovering from sexual trauma, or simply want to deepen your connection with pleasure and your partner, this episode offers a compassionate, body-based approach to sexual healing that goes far beyond traditional therapy. Be sure to like and subscribe to #HealThySelf  Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/ Timestamps: 0:00 - Introduction - Why Sexual Healing Changes Everything 2:40 - The Biggest Misconception: Starting with Trauma vs. Pleasure 5:26 - Shame: The #1 Block to Sexual Pleasure & Intimacy 9:12 - How to Slow Down Performance Anxiety in the Bedroom 18:30 - Understanding Your Sexual Desires as a Path to Healing 25:04 - Exploring Kinks & How Trauma Can Be Healthy Expression 29:15 - Common Blocks Men Face in Sexual Expression 34:02 - Breaking the Ice: When You Can't Feel Pleasure Anymore 43:25 - Why Women Can't Orgasm & Taking Ownership of Your Pleasure 48:10 - Technology, Porn & The Crisis of Real Intimacy 56:55 - Following Pleasure as Your Life & Business Guide 1:01:09 - Their Method, Training & Virgin Island TV Show

Thank you to our sponsors! Visit vinia.com/HealThySelf and use discount code HTS10 for 10% OFF Visit jaspr.co/drg and use code DRG for $300 OFF for a limited time. Visit puori.com/drg and use code DRG for 20% OFF the already discounted subscription prices. Sign up for our newsletter! - https://drchristiangonzalez.com/newsletter/ Blood flow is the foundation of nearly every biological function - from digestion and brain clarity to energy production and detoxification. As we age, blood flow naturally decreases, contributing to chronic health issues and reduced quality of life.  In this fascinating episode, I sit down with Ilan Sobel, CEO of BioHarvest Sciences, to explore how revolutionary plant cell technology is transforming longevity science. We dive deep into Venia, a breakthrough supplement made from red grape cells that delivers superior resveratrol without soil, pesticides, or heavy metals. Ilan shares how their patented process creates the most bioavailable form of resveratrol ever developed, clinically proven to improve arterial dilation, increase nitric oxide, cross the blood-brain barrier, and support overall cardiovascular health. Whether you're interested in longevity, brain health, or simply optimizing your daily energy, this episode reveals how blood flow optimization could be the missing piece in your wellness puzzle. Be sure to like and subscribe to #HealThySelf  Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/ Timestamps: 0:00 - The Critical Role of Blood Flow in Health  4:27 - The French Paradox Explained  8:47 - Revolutionary Plant Cell Technology  12:58 - Clinical Proof: Arterial Dilation Results  24:14 - Coffee & Tea Product Innovation  31:25 - The Mechanism: How Blood Flow Actually Works  40:48 - Real Customer Results & Business Growth  46:16 - Future Products: Hydration & Liver Health  52:39 - Heroes Program & Company Values  57:18 - Product Tasting & Final Thoughts

In der neuen Folge "Hot Pink" diskutieren Britt-Marie, Nils und ihr Gast Kai u.a. über David Beckham im Krankenhaus, LeAnn Rimes Zähne, Sean Combs Gerichtsverhandlung, Martin Koves Beißwütigkeit, Jimi Blue Ochsenknechts Verhaftung, Eric Danes messy Privatleben, Katy Perrys & Orlando Blooms Trennung, Anna Wintours Rücktritt, Jonathan Baileys Klarinette, Erin Krakows & Ben Rosenbaums Hochzeit sowie Montana Jordans & Jenna Weeks Hochzeit. Hört rein!*Wer noch mehr von Britt-Marie und Nils hören möchte, kann das in Ihrem Spin-Off-Podcast "Hot Pink schaut..." tun.- Britt-Marie und Marcel haben die 18. Staffel von "Let's Dance" in zusammenfassenden Folgen alle paar Wochen besprochen. Hier ist Episode 1: "Hot Pink schaut Lets Dance" - Podcast-Folge 1 zu LD 18x00-18x02- Wir haben die 17. Staffel von "Let's Dance" geschaut und mit Marcel wöchentlich darüber diskutiert."Hot Pink schaut Lets Dance" - Podcast-Folge 1 zu LD 17x00- Daneben haben wir bereits die 1. Staffel von "Drag Race Germany" geschaut und die komplette Show besprochen."Hot Pink schaut Drag Race Germany" - Podcast-Folge 1 zu DRG

THANK YOU TO OUR SPONSORS Head to boncharge.com and use code DRG for 15% off. Visit bioptimizers.com/drg and use code DRG10 to get 10% off of any order. Visit supermush.com and use code DRG20 to get 20% off. Sign up for our newsletter! https://drchristiangonzalez.com/newsletter/ What if the key to lasting transformation isn't just somatic work or mindset shifts alone? What if you need all five dimensions working together? In this groundbreaking episode, I sit down with master coach Alyssa Nobriga, one of the most sought-after transformation experts in the world. We explore her revolutionary SHAMBU framework—the five levels of change that create sustainable healing. Alyssa reveals why most people get stuck using only one approach, the exact questions to ask yourself when triggered for instant breakthroughs, and how to stop abandoning yourself while building a thriving business that doesn't burn you out. From understanding your Enneagram type to transcending your personality, from healing core wounds to creating conscious relationships, this episode delivers multi-layered medicine for anyone ready to break through their patterns and step into their full potential. Hosted by Doctor Christian Gonzalez N.D.  Follow Doctor G on Instagram @doctor.gonzalez  https://www.instagram.com/doctor.gonzalez/ Timestamps: 02:10 - Grounding Practice 05:27 - Rapid Fire: The Truth About Somatic Therapy's Limitations  07:46 - Meet Alyssa Nobrega: From Therapist to Master Coach  10:51 - The 5 Dimensions of Change 14:25 - Breaking Identity Patterns  19:17 - The Enneagram Revealed  22:28 - Spiritual Awakening  29:40 - The Resistance Trap  33:17 - Essential Self-Regulation Tools for Triggered Moments  36:39 - The Power Questions That Unlock Your Unconscious Blocks  39:20 - Meditation: The Non-Negotiable Practice for Mental Freedom  43:50 - Dancing and Singing: Ancient Medicine for Modern Healing  52:26 - Breaking Through Business Plateaus and Upper Limits  58:12 - The Four Stages of Love 1:03:06 - Relationship Medicine

Summary In this episode of the Pain Exam Podcast, Dr. David Rosenblum provides a comprehensive review of herpes zoster and postherpetic neuralgia (PHN), focusing on pathophysiology, diagnosis, and treatment options. Dr. Rosenblum explains that postherpetic neuralgia affects approximately 25% of patients with acute herpes zoster, causing debilitating unilateral chronic pain in one or more dermatomes. He discusses the three phases of herpes zoster: acute (up to 30 days), subacute (up to 3 months), and postherpetic neuralgia (pain continuing beyond 3 months). Dr. Rosenblum identifies risk factors for developing PHN, including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. He details the pathophysiology involving peripheral and central sensitization, and explains different phenotypes of PHN that can guide treatment approaches. For treatment, Dr. Rosenblum reviews various options including antiviral medications (which should be started within 72 hours of onset), corticosteroids, opioids, antidepressants (particularly tricyclics and SNRIs), antiepileptics (gabapentin and pregabalin), topical agents (lidocaine and capsaicin), and interventional procedures such as epidural injections and pulsed radiofrequency. He emphasizes that prevention through vaccination with Shingrix is highly effective, with 97% effectiveness in preventing herpes zoster in patients 50-69 years old and 89% effectiveness in those over 70. Dr. Rosenblum mentions that he's currently treating a patient with trigeminal postherpetic neuralgia and is considering a topical sphenopalatine ganglion block as a minimally invasive intervention before attempting more invasive procedures. Chapters Introduction to the Pain Exam Podcast and Topic Overview Dr. David Rosenblum introduces the Pain Exam Podcast, mentioning that it covers painful disorders, alternative treatments, and practice management. He explains that this episode focuses on herpes zoster and postherpetic neuralgia as board preparation for fellows starting their programs, with ABA boards coming up in September. Dr. Rosenblum notes that he's not only preparing listeners for boards but also seeking the latest information to help treat his own patients with this notoriously difficult disease. Upcoming Conferences and Educational Opportunities Dr. Rosenblum announces several upcoming conferences including Aspen in July, Pain Week in September, and events with NYSIP and the Latin American Pain Society. He mentions he'll be teaching ultrasound and regenerative medicine at these events. Dr. Rosenblum invites listeners to sign up at nrappain.org to access a community discussing regenerative medicine, ultrasound-guided pain medicine, regional anesthesia, and board preparation. He also offers ultrasound training in New York and elsewhere, with upcoming sessions in Manhattan on July 12th and October 4th, plus private shadowing opportunities. Overview of Postherpetic Neuralgia Dr. Rosenblum defines postherpetic neuralgia as typically a unilateral chronic pain in one or more dermatomes after acute herpes zoster infection. He states that the incidence of acute herpes zoster ranges between 3-5 patients per thousand person-years, and one in four patients with acute herpes zoster-related pain will transition into postherpetic neuralgia. Dr. Rosenblum emphasizes that while this condition won't kill patients, it can be extremely debilitating and significantly reduce quality of life. Treatment Options Overview Dr. Rosenblum reviews treatment options according to the WHO pain ladder, including tricyclics like nortriptyline and antiepileptic drugs such as gabapentin. He explains that if pain is not significantly reduced, interventional treatments like epidural injections with local anesthetics and corticosteroids or pulsed radiofrequency of the dorsal root ganglion are options. For postherpetic neuralgia specifically, Dr. Rosenblum notes that preferred treatments include transdermal capsaicin, lidocaine, or oral drugs such as antidepressants or antiepileptics. Phases of Herpes Zoster and Definitions Dr. Rosenblum outlines the three phases during herpes zoster reactivation: acute herpes zoster-related pain (lasting maximum 30 days), subacute herpes zoster-related pain (pain after healing of vesicles but disappearing within 3 months), and postherpetic neuralgia (typically defined as pain continuing after 3 months). He mentions that acute herpes zoster pain often begins with prodromal pain starting a few days before the appearance of the rash. Incidence and Risk Factors Dr. Rosenblum states that the incidence of herpes zoster ranges between 3-5 patients per 1,000 person-years, with approximately 5-30% of cases leading to postherpetic neuralgia. He identifies risk factors including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. Dr. Rosenblum describes the clinical manifestations as a mosaic of somatosensory symptoms including burning, deep aching pain, tingling, itching, stabbing, often associated with tactile and cold allodynia. Impact on Quality of Life Dr. Rosenblum emphasizes that postherpetic neuralgia can be debilitating, impacting both physical and emotional functioning and causing decreased quality of life. He notes that it leads to fatigue, insomnia, depression, anorexia, anxiety, and emotional distress. Dr. Rosenblum stresses the importance of exploring methods for prevention of postherpetic neuralgia and optimizing pain treatment for both subacute herpes zoster-related pain and postherpetic neuralgia. Literature Review and Pathophysiology Dr. Rosenblum mentions that he's discussing a literature review from 2024 that updates previous practical guidelines published in 2011. He explains the pathophysiology of postherpetic neuralgia, which involves sensitization of peripheral and sensory nerves from damage. Dr. Rosenblum describes how inflammatory mediators reduce the stimulus threshold of nociceptors and increase responsiveness, resulting in pathological spontaneous discharges, lower thresholds for thermal and mechanical stimuli, and hyperalgesia. Central Sensitization and Nerve Damage Dr. Rosenblum explains that central sensitization results from peripheral nociceptor hyperactivity leading to plastic changes in the central nervous system, involving amplification of pain signals and reduced inhibition. He describes how nerve damage in postherpetic neuralgia patients results from neuronal death due to severe inflammatory stimuli or secondary to neuronal swelling. Dr. Rosenblum notes that motor defects occur in 0.05% of patients with herpes zoster, observed as abdominal pseudohernias or motor weakness of limbs limited to the affected myotome. Different Phenotypes and Classification Dr. Rosenblum discusses different phenotypes of postherpetic neuralgia and how phenotyping can determine treatment. He explains that there are several ways to classify the phenotypes, with one categorizing patients into three subtypes: sensory loss (most common), thermal gain, and thermal loss with mechanical gain. Dr. Rosenblum describes the mechanistic categorization, including the irritable nociceptive phenotype characterized by preserved sensation, profound dynamic mechanical allodynia, reduced pressure pain threshold, and relief with local anesthetic infiltration. Deafferentation Phenotype Dr. Rosenblum explains that a deafferentation phenotype may arise from destruction of neurons by the virus in the dorsal root ganglion. This phenotype is characterized by sensory loss, including thermal and vibratory sensation without prominent thermal allodynia. He notes that mechanical allodynia can occur secondary to A-beta fibers activating spinothalamic pathways (known as phenotypic switches), along with pressure hyperalgesia and temporal summation suggesting central sensitization. Dr. Rosenblum mentions that in one study, this phenotype was present in 10.8% of individuals, and for those with deafferentation pain, gabapentinoids, antidepressants, and neuromodulatory therapies like repetitive transcranial magnetic stimulation may be beneficial. Diagnosis and Physical Examination Dr. Rosenblum discusses the diagnosis of herpes zoster and postherpetic neuralgia, emphasizing the importance of physical examination. He explains that diagnosis is based on the rash, redness, papules, and vesicles in the painful dermatomes, with healing vesicles showing crust formation. Dr. Rosenblum notes that the rash is generally unilateral and does not cross the midline of the body. In postherpetic neuralgia patients, he mentions that scarring, hyper or hypopigmentation is often visible, with allodynia present in 45-75% of affected patients. Sensory Testing and Assessment Dr. Rosenblum explains that in patients with postherpetic neuralgia, a mosaic of somatosensory alterations can occur, manifesting as hyperalgesia, allodynia, and sensory loss. These can be quantified by quantitative sensory testing, which assesses somatosensory functions, dermal detection thresholds for perception of cold, warmth, and paradoxical heat sensations. He notes that testing can provide clues regarding underlying mechanisms of pain, impaired conditioned pain modulation, temporal summation suggesting central sensitization, and information about the type of nerve damage and surviving afferent neurons. Prevention Through Vaccination Dr. Rosenblum discusses prevention of acute herpes zoster through vaccination, noting that the risk increases with reduced immunity. He highlights studies evaluating Shingrix, a vaccine for herpes zoster, which showed 97% effectiveness in preventing herpes zoster in patients 50-69 years old with healthy immune systems and 89% effectiveness in patients over 70. Dr. Rosenblum states that Shingrix is 89-91% effective in preventing postherpetic neuralgia development in patients with healthy immune systems and 68-91% effective in those with weakened or underlying conditions. Treatment Objectives Dr. Rosenblum outlines the treatment objectives for herpes zoster and postherpetic neuralgia. For acute herpes zoster, objectives include relieving pain, reducing severity and duration of pain, accelerating recovery of epidermal defects, and preventing secondary infections. For postherpetic neuralgia, the objectives are pain alleviation and improved quality of life. Dr. Rosenblum lists available treatments including psychotherapy, opiates, antidepressants, antiepileptics, NMDA antagonists, topical agents, and interventional treatments such as epidurals, pulsed radiofrequency, nerve blocks, and spinal cord stimulation. Antiviral Medications Dr. Rosenblum emphasizes that antiviral drugs should be started within 72 hours of clinical onset, mentioning famciclovir, valacyclovir, and acyclovir. He notes there is no evidence for effectiveness after 72 hours in patients with uncomplicated herpes zoster. Dr. Rosenblum provides dosing information: for immunocompetent patients, famciclovir 500mg and valacyclovir 1000mg three times daily for seven days; for immunocompromised patients, famciclovir 1000mg three times daily for 10 days, while acyclovir should be given IV in the immunocompromised. Benefits of Antiviral Therapy Dr. Rosenblum explains that antiviral medication accelerates the disappearance of vesicles and crusts, promotes healing of skin lesions, and prevents new lesions from forming. By inhibiting viral replication, he notes that antiviral therapy likely reduces nerve damage, resulting in reduced incidence of postherpetic neuralgia, and should be started as soon as possible. Corticosteroids and Opioids Dr. Rosenblum discusses the use of corticosteroids, noting that when added to antiviral medications, they may reduce the severity of acute herpes zoster-related pain, though increased healing of skin lesions was not observed in one study. He mentions that a Cochrane review found oral corticosteroids ineffective in preventing postherpetic neuralgia. Regarding opioids, Dr. Rosenblum states they are commonly used alongside antivirals for controlling acute herpes zoster pain, with tramadol having a number needed to treat (NNT) of 4.7 and strong opioids having an NNT of 4.3 for 50% pain reduction. Methadone and Antidepressants Dr. Rosenblum discusses methadone as an NMDA receptor antagonist used in acute and chronic pain management, though he notes there are no randomized controlled trials determining its efficacy in acute herpes zoster pain or postherpetic neuralgia. He explains that methadone can modulate pain stimuli by inhibiting the uptake of norepinephrine and serotonin, resulting in decreased development of hyperalgesia and opioid tolerance, but has side effects including constipation, nausea, sedation, and QT prolongation that can trigger torsades de pointes. Dr. Rosenblum identifies antidepressants as first-line therapy for postherpetic neuralgia, including tricyclics and SNRIs, with tricyclics having an NNT of 3 and SNRIs an NNT of 6.4 for 50% pain reduction. Antiepileptics and Pharmacological Treatment Summary Dr. Rosenblum discusses antiepileptics like gabapentin and pregabalin for postherpetic neuralgia. He cites two trials measuring gabapentin's effect, concluding it was effective compared to placebo with a pooled NNT of 4.4, while pregabalin had an NNT of 4.9. Dr. Rosenblum summarizes that pharmacological treatment is well established for subacute herpes zoster pain, though new high-quality evidence has been lacking since the last update in 2011. Topical Agents Dr. Rosenblum discusses local anesthetic topical agents including lidocaine and capsaicin creams and patches. He notes that 8% capsaicin provided significant pain reduction during 2-8 weeks, while 5% lidocaine patches provided moderate pain relief after eight weeks of treatment. Dr. Rosenblum also mentions acute herpes zoster intracutaneous injections, citing a study where single intracutaneous injection with methylprednisolone combined with ropivacaine versus saline alone showed significant difference in VAS score at 1 and 4 weeks post-intervention favoring the intervention group. Intracutaneous Injections Dr. Rosenblum discusses the effect of repetitive intracutaneous injections with ropivacaine and methylprednisolone every 48 hours for one week. He cites a randomized control trial comparing antivirals plus analgesics to antivirals plus analgesics and repeat injections, finding the intervention group had significantly shorter duration of pain, lower VAS scores, and lower incidence of postherpetic neuralgia (6.4% vs 28% at 3 months). Dr. Rosenblum notes that a potential side effect of cutaneous methylprednisolone injection is fat atrophy, though this wasn't reported in the study. Summary of Local Anesthetics Dr. Rosenblum summarizes that there are no new studies reporting the efficacy of capsaicin 8% for postherpetic neuralgia, but it remains widely used in clinical practice and is approved in several countries. He notes that lidocaine patches can reduce pain intensity in patients with postherpetic neuralgia but may be more beneficial in patients with allodynia. Dr. Rosenblum adds that intracutaneous injections may be helpful for short periods, while repetitive injections with local anesthetics may reduce VAS scores for up to six months but can cause subcutaneous fat atrophy. Interventional Treatments: Epidural and Paravertebral Injections Dr. Rosenblum discusses interventional treatments, noting that previous guidelines found epidural injection with corticosteroids and local anesthetic as add-on therapy superior to standard care alone for up to one month in managing acute herpes zoster pain. He mentions a randomized controlled trial showing no difference between interlaminar and transforaminal epidural steroid injections for up to three months after the procedure. Dr. Rosenblum adds that previous guidelines reported high-quality evidence that paravertebral injections of corticosteroids or local anesthetic reduces pain in the active phase of herpes zoster. Comparative Studies on Injection Approaches Dr. Rosenblum discusses a trial comparing efficacy of repetitive paravertebral blocks with ropivacaine versus dexmedetomidine to prevent postherpetic neuralgia, which showed significantly lower incidence of zoster-related pain one month after therapy in the dexmedetomidine group, with effects still significant at three months. He also mentions a study comparing steroid injections administered via interlaminar versus transforaminal approaches, finding both groups had significantly lower VAS scores at 1 and 3 months follow-up compared to baseline, though this could align with the natural course of herpes zoster. Timing of Interventions and Continuous Epidural Blockade Dr. Rosenblum cites a retrospective study showing that transforaminal epidural injections administered for acute herpes zoster-related pain were associated with significantly shorter time to pain relief compared to those performed in the subacute phase. He also mentions a randomized controlled trial finding that continuous epidural blockade combined with opioids and gabapentin reduced NRS pain scores more than analgesic drug treatments alone during three-day follow-up, though both studies were low-quality. Interventions for Postherpetic Neuralgia Dr. Rosenblum discusses interventions specifically for postherpetic neuralgia, citing a small randomized controlled trial that demonstrated decreased NRS pain scores six months post-treatment for repeat versus single epidural steroid injections (15mg vs 5mg dexamethasone) administered over 24 days. The trial also found increased likelihood of complete remission during 6-month follow-up in the group receiving repeat epidural dexamethasone, though this was low-quality evidence. Summary of Epidural and Paravertebral Injections Dr. Rosenblum summarizes that epidural or paravertebral injections of local anesthetic and/or glucocorticoids could be considered in treating acute herpes zoster-related pain. For subacute postherpetic neuralgia pain, he notes low-quality evidence supporting epidural injections, while for postherpetic neuralgia, evidence supports continuous epidural infusion, though also of low quality. Dr. Rosenblum emphasizes that none of the included studies for postherpetic neuralgia investigating epidural or paravertebral injections resulted in decreased pain compared to standard therapy. Pulsed Radiofrequency (PRF) Evidence Dr. Rosenblum discusses pulsed radiofrequency (PRF), noting that previous guidelines indicated moderate quality evidence that PRF of the intercostal nerve reduces pain for 6 months in patients with postherpetic neuralgia, and very low-quality evidence that PRF to the dorsal root ganglion (DRG) reduces pain for 6 months. He mentions that multiple studies have been published since then assessing PRF efficacy. PRF Studies for Acute Herpes Zoster Dr. Rosenblum discusses a randomized controlled trial with 60 patients comparing high-voltage bipolar PRF of the cervical sympathetic chain versus sham, with treatment repeated after three days in both groups. He reports that VAS scores in the PRF group at each post-interventional point (1 day, 2 days, 1 month, 2 months, 3 months) were significantly lower than in the sham group, and at 3 months, the incidence of postherpetic neuralgia was 16.7% in the PRF group compared to 40% in the sham group. PRF for Trigeminal Neuralgia Dr. Rosenblum cites another randomized controlled trial evaluating high-voltage long-duration PRF of the Gasserian ganglion in 96 patients with subacute herpes-related trigeminal neuralgia, which found decreased VAS pain scores at all post-interventional time points (3, 7, 14 days and 1, 3, and 6 months) compared to the sham group. He also mentions a randomized comparative effectiveness study in 120 patients with subacute trigeminal herpes zoster, comparing a single application of high-voltage PRF to the Gasserian ganglion versus three cycles of conventional PRF treatment, finding significantly lower mean VAS pain scores for up to six months in the high-voltage PRF group. PRF Compared to Other Interventions Dr. Rosenblum discusses a randomized controlled trial comparing PRF to short-term spinal cord stimulation, which found decreased pain and improved 36-item short-form health survey scores in both groups at six months. He also mentions a randomized controlled trial in 72 patients where PRF of spinal nerves or peripheral branches of cranial nerves combined with five-day infusion of IV lidocaine resulted in greater pain reduction, less rescue analgesia, and reduced inflammatory cytokines at two months compared to PRF with saline infusions. Dr. Rosenblum notes a major limitation of this study was not accounting for the high natural recovery rate. Summary of PRF and Final Recommendations Dr. Rosenblum summarizes that PRF provides significant pain relief lasting over three months in patients with subacute herpes zoster and postherpetic neuralgia. He notes that since few studies have compared PRF versus sham, it's not possible to calculate an accurate number needed to treat. Dr. Rosenblum mentions there are no comparative studies comparing PRF to the intercostal nerves versus PRF of the DRG, but both preclinical and clinical studies suggest superiority of the DRG approach. He adds that evidence for spinal cord stimulation for postherpetic neuralgia is of low quality, and more research is needed given its invasive nature. Sympathetic Blocks and Conclusion Dr. Rosenblum notes there is low-quality evidence for using sympathetic blocks to treat acute herpes zoster-related pain, but no evidence for their use in postherpetic neuralgia. He mentions that risks of treatment with intrathecal methylprednisolone are unclear and therefore not recommended. Dr. Rosenblum concludes by praising the comprehensive article he's been discussing and mentions it provides insight for treating his patients, including a recent case of trigeminal postherpetic neuralgia. Personal Clinical Approach and Closing Dr. Rosenblum shares that he doesn't currently perform PRF in his practice, partly because it's not standard of care and not well reimbursed, creating barriers to implementation. However, he notes that PRF is a very safe procedure as it doesn't involve burning tissue. For his patient with trigeminal neuralgia pain, Dr. Rosenblum plans to try a topical sphenopalatine ganglion block as the least invasive intervention before considering injecting the trigeminal nerves at the foramen, in addition to pharmacotherapy. He concludes by thanking listeners, encouraging them to check the show notes and links, mentioning institutional memberships and shadowing opportunities, and asking listeners to rate and share the podcast. Q&A No Q&A session in this lecture Pain Management Board Prep   Ultrasound Training REGISTER TODAY!   Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights     David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care.  As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures.   Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023   Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology.  He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures.  He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more!   Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy  and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques.  Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office.  For an appointment go to AABPpain.com or call Brooklyn     718 436 7246 Reference Adriaansen, E. J., Jacobs, J. G., Vernooij, L. M., van Wijck, A. J., Cohen, S. P., Huygen, F. J., & Rijsdijk, M. (2025). 8. Herpes zoster and post herpetic neuralgia. Pain Practice, 25(1), e13423.

Summary In this episode of the Pain Exam Podcast, Dr. David Rosenblum provides a comprehensive review of herpes zoster and postherpetic neuralgia (PHN), focusing on pathophysiology, diagnosis, and treatment options. Dr. Rosenblum explains that postherpetic neuralgia affects approximately 25% of patients with acute herpes zoster, causing debilitating unilateral chronic pain in one or more dermatomes. He discusses the three phases of herpes zoster: acute (up to 30 days), subacute (up to 3 months), and postherpetic neuralgia (pain continuing beyond 3 months). Dr. Rosenblum identifies risk factors for developing PHN, including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. He details the pathophysiology involving peripheral and central sensitization, and explains different phenotypes of PHN that can guide treatment approaches. For treatment, Dr. Rosenblum reviews various options including antiviral medications (which should be started within 72 hours of onset), corticosteroids, opioids, antidepressants (particularly tricyclics and SNRIs), antiepileptics (gabapentin and pregabalin), topical agents (lidocaine and capsaicin), and interventional procedures such as epidural injections and pulsed radiofrequency. He emphasizes that prevention through vaccination with Shingrix is highly effective, with 97% effectiveness in preventing herpes zoster in patients 50-69 years old and 89% effectiveness in those over 70. Dr. Rosenblum mentions that he's currently treating a patient with trigeminal postherpetic neuralgia and is considering a topical sphenopalatine ganglion block as a minimally invasive intervention before attempting more invasive procedures. Chapters Introduction to the Pain Exam Podcast and Topic Overview Dr. David Rosenblum introduces the Pain Exam Podcast, mentioning that it covers painful disorders, alternative treatments, and practice management. He explains that this episode focuses on herpes zoster and postherpetic neuralgia as board preparation for fellows starting their programs, with ABA boards coming up in September. Dr. Rosenblum notes that he's not only preparing listeners for boards but also seeking the latest information to help treat his own patients with this notoriously difficult disease. Upcoming Conferences and Educational Opportunities Dr. Rosenblum announces several upcoming conferences including Aspen in July, Pain Week in September, and events with NYSIP and the Latin American Pain Society. He mentions he'll be teaching ultrasound and regenerative medicine at these events. Dr. Rosenblum invites listeners to sign up at nrappain.org to access a community discussing regenerative medicine, ultrasound-guided pain medicine, regional anesthesia, and board preparation. He also offers ultrasound training in New York and elsewhere, with upcoming sessions in Manhattan on July 12th and October 4th, plus private shadowing opportunities. Overview of Postherpetic Neuralgia Dr. Rosenblum defines postherpetic neuralgia as typically a unilateral chronic pain in one or more dermatomes after acute herpes zoster infection. He states that the incidence of acute herpes zoster ranges between 3-5 patients per thousand person-years, and one in four patients with acute herpes zoster-related pain will transition into postherpetic neuralgia. Dr. Rosenblum emphasizes that while this condition won't kill patients, it can be extremely debilitating and significantly reduce quality of life. Treatment Options Overview Dr. Rosenblum reviews treatment options according to the WHO pain ladder, including tricyclics like nortriptyline and antiepileptic drugs such as gabapentin. He explains that if pain is not significantly reduced, interventional treatments like epidural injections with local anesthetics and corticosteroids or pulsed radiofrequency of the dorsal root ganglion are options. For postherpetic neuralgia specifically, Dr. Rosenblum notes that preferred treatments include transdermal capsaicin, lidocaine, or oral drugs such as antidepressants or antiepileptics. Phases of Herpes Zoster and Definitions Dr. Rosenblum outlines the three phases during herpes zoster reactivation: acute herpes zoster-related pain (lasting maximum 30 days), subacute herpes zoster-related pain (pain after healing of vesicles but disappearing within 3 months), and postherpetic neuralgia (typically defined as pain continuing after 3 months). He mentions that acute herpes zoster pain often begins with prodromal pain starting a few days before the appearance of the rash. Incidence and Risk Factors Dr. Rosenblum states that the incidence of herpes zoster ranges between 3-5 patients per 1,000 person-years, with approximately 5-30% of cases leading to postherpetic neuralgia. He identifies risk factors including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. Dr. Rosenblum describes the clinical manifestations as a mosaic of somatosensory symptoms including burning, deep aching pain, tingling, itching, stabbing, often associated with tactile and cold allodynia. Impact on Quality of Life Dr. Rosenblum emphasizes that postherpetic neuralgia can be debilitating, impacting both physical and emotional functioning and causing decreased quality of life. He notes that it leads to fatigue, insomnia, depression, anorexia, anxiety, and emotional distress. Dr. Rosenblum stresses the importance of exploring methods for prevention of postherpetic neuralgia and optimizing pain treatment for both subacute herpes zoster-related pain and postherpetic neuralgia. Literature Review and Pathophysiology Dr. Rosenblum mentions that he's discussing a literature review from 2024 that updates previous practical guidelines published in 2011. He explains the pathophysiology of postherpetic neuralgia, which involves sensitization of peripheral and sensory nerves from damage. Dr. Rosenblum describes how inflammatory mediators reduce the stimulus threshold of nociceptors and increase responsiveness, resulting in pathological spontaneous discharges, lower thresholds for thermal and mechanical stimuli, and hyperalgesia. Central Sensitization and Nerve Damage Dr. Rosenblum explains that central sensitization results from peripheral nociceptor hyperactivity leading to plastic changes in the central nervous system, involving amplification of pain signals and reduced inhibition. He describes how nerve damage in postherpetic neuralgia patients results from neuronal death due to severe inflammatory stimuli or secondary to neuronal swelling. Dr. Rosenblum notes that motor defects occur in 0.05% of patients with herpes zoster, observed as abdominal pseudohernias or motor weakness of limbs limited to the affected myotome. Different Phenotypes and Classification Dr. Rosenblum discusses different phenotypes of postherpetic neuralgia and how phenotyping can determine treatment. He explains that there are several ways to classify the phenotypes, with one categorizing patients into three subtypes: sensory loss (most common), thermal gain, and thermal loss with mechanical gain. Dr. Rosenblum describes the mechanistic categorization, including the irritable nociceptive phenotype characterized by preserved sensation, profound dynamic mechanical allodynia, reduced pressure pain threshold, and relief with local anesthetic infiltration. Deafferentation Phenotype Dr. Rosenblum explains that a deafferentation phenotype may arise from destruction of neurons by the virus in the dorsal root ganglion. This phenotype is characterized by sensory loss, including thermal and vibratory sensation without prominent thermal allodynia. He notes that mechanical allodynia can occur secondary to A-beta fibers activating spinothalamic pathways (known as phenotypic switches), along with pressure hyperalgesia and temporal summation suggesting central sensitization. Dr. Rosenblum mentions that in one study, this phenotype was present in 10.8% of individuals, and for those with deafferentation pain, gabapentinoids, antidepressants, and neuromodulatory therapies like repetitive transcranial magnetic stimulation may be beneficial. Diagnosis and Physical Examination Dr. Rosenblum discusses the diagnosis of herpes zoster and postherpetic neuralgia, emphasizing the importance of physical examination. He explains that diagnosis is based on the rash, redness, papules, and vesicles in the painful dermatomes, with healing vesicles showing crust formation. Dr. Rosenblum notes that the rash is generally unilateral and does not cross the midline of the body. In postherpetic neuralgia patients, he mentions that scarring, hyper or hypopigmentation is often visible, with allodynia present in 45-75% of affected patients. Sensory Testing and Assessment Dr. Rosenblum explains that in patients with postherpetic neuralgia, a mosaic of somatosensory alterations can occur, manifesting as hyperalgesia, allodynia, and sensory loss. These can be quantified by quantitative sensory testing, which assesses somatosensory functions, dermal detection thresholds for perception of cold, warmth, and paradoxical heat sensations. He notes that testing can provide clues regarding underlying mechanisms of pain, impaired conditioned pain modulation, temporal summation suggesting central sensitization, and information about the type of nerve damage and surviving afferent neurons. Prevention Through Vaccination Dr. Rosenblum discusses prevention of acute herpes zoster through vaccination, noting that the risk increases with reduced immunity. He highlights studies evaluating Shingrix, a vaccine for herpes zoster, which showed 97% effectiveness in preventing herpes zoster in patients 50-69 years old with healthy immune systems and 89% effectiveness in patients over 70. Dr. Rosenblum states that Shingrix is 89-91% effective in preventing postherpetic neuralgia development in patients with healthy immune systems and 68-91% effective in those with weakened or underlying conditions. Treatment Objectives Dr. Rosenblum outlines the treatment objectives for herpes zoster and postherpetic neuralgia. For acute herpes zoster, objectives include relieving pain, reducing severity and duration of pain, accelerating recovery of epidermal defects, and preventing secondary infections. For postherpetic neuralgia, the objectives are pain alleviation and improved quality of life. Dr. Rosenblum lists available treatments including psychotherapy, opiates, antidepressants, antiepileptics, NMDA antagonists, topical agents, and interventional treatments such as epidurals, pulsed radiofrequency, nerve blocks, and spinal cord stimulation. Antiviral Medications Dr. Rosenblum emphasizes that antiviral drugs should be started within 72 hours of clinical onset, mentioning famciclovir, valacyclovir, and acyclovir. He notes there is no evidence for effectiveness after 72 hours in patients with uncomplicated herpes zoster. Dr. Rosenblum provides dosing information: for immunocompetent patients, famciclovir 500mg and valacyclovir 1000mg three times daily for seven days; for immunocompromised patients, famciclovir 1000mg three times daily for 10 days, while acyclovir should be given IV in the immunocompromised. Benefits of Antiviral Therapy Dr. Rosenblum explains that antiviral medication accelerates the disappearance of vesicles and crusts, promotes healing of skin lesions, and prevents new lesions from forming. By inhibiting viral replication, he notes that antiviral therapy likely reduces nerve damage, resulting in reduced incidence of postherpetic neuralgia, and should be started as soon as possible. Corticosteroids and Opioids Dr. Rosenblum discusses the use of corticosteroids, noting that when added to antiviral medications, they may reduce the severity of acute herpes zoster-related pain, though increased healing of skin lesions was not observed in one study. He mentions that a Cochrane review found oral corticosteroids ineffective in preventing postherpetic neuralgia. Regarding opioids, Dr. Rosenblum states they are commonly used alongside antivirals for controlling acute herpes zoster pain, with tramadol having a number needed to treat (NNT) of 4.7 and strong opioids having an NNT of 4.3 for 50% pain reduction. Methadone and Antidepressants Dr. Rosenblum discusses methadone as an NMDA receptor antagonist used in acute and chronic pain management, though he notes there are no randomized controlled trials determining its efficacy in acute herpes zoster pain or postherpetic neuralgia. He explains that methadone can modulate pain stimuli by inhibiting the uptake of norepinephrine and serotonin, resulting in decreased development of hyperalgesia and opioid tolerance, but has side effects including constipation, nausea, sedation, and QT prolongation that can trigger torsades de pointes. Dr. Rosenblum identifies antidepressants as first-line therapy for postherpetic neuralgia, including tricyclics and SNRIs, with tricyclics having an NNT of 3 and SNRIs an NNT of 6.4 for 50% pain reduction. Antiepileptics and Pharmacological Treatment Summary Dr. Rosenblum discusses antiepileptics like gabapentin and pregabalin for postherpetic neuralgia. He cites two trials measuring gabapentin's effect, concluding it was effective compared to placebo with a pooled NNT of 4.4, while pregabalin had an NNT of 4.9. Dr. Rosenblum summarizes that pharmacological treatment is well established for subacute herpes zoster pain, though new high-quality evidence has been lacking since the last update in 2011. Topical Agents Dr. Rosenblum discusses local anesthetic topical agents including lidocaine and capsaicin creams and patches. He notes that 8% capsaicin provided significant pain reduction during 2-8 weeks, while 5% lidocaine patches provided moderate pain relief after eight weeks of treatment. Dr. Rosenblum also mentions acute herpes zoster intracutaneous injections, citing a study where single intracutaneous injection with methylprednisolone combined with ropivacaine versus saline alone showed significant difference in VAS score at 1 and 4 weeks post-intervention favoring the intervention group. Intracutaneous Injections Dr. Rosenblum discusses the effect of repetitive intracutaneous injections with ropivacaine and methylprednisolone every 48 hours for one week. He cites a randomized control trial comparing antivirals plus analgesics to antivirals plus analgesics and repeat injections, finding the intervention group had significantly shorter duration of pain, lower VAS scores, and lower incidence of postherpetic neuralgia (6.4% vs 28% at 3 months). Dr. Rosenblum notes that a potential side effect of cutaneous methylprednisolone injection is fat atrophy, though this wasn't reported in the study. Summary of Local Anesthetics Dr. Rosenblum summarizes that there are no new studies reporting the efficacy of capsaicin 8% for postherpetic neuralgia, but it remains widely used in clinical practice and is approved in several countries. He notes that lidocaine patches can reduce pain intensity in patients with postherpetic neuralgia but may be more beneficial in patients with allodynia. Dr. Rosenblum adds that intracutaneous injections may be helpful for short periods, while repetitive injections with local anesthetics may reduce VAS scores for up to six months but can cause subcutaneous fat atrophy. Interventional Treatments: Epidural and Paravertebral Injections Dr. Rosenblum discusses interventional treatments, noting that previous guidelines found epidural injection with corticosteroids and local anesthetic as add-on therapy superior to standard care alone for up to one month in managing acute herpes zoster pain. He mentions a randomized controlled trial showing no difference between interlaminar and transforaminal epidural steroid injections for up to three months after the procedure. Dr. Rosenblum adds that previous guidelines reported high-quality evidence that paravertebral injections of corticosteroids or local anesthetic reduces pain in the active phase of herpes zoster. Comparative Studies on Injection Approaches Dr. Rosenblum discusses a trial comparing efficacy of repetitive paravertebral blocks with ropivacaine versus dexmedetomidine to prevent postherpetic neuralgia, which showed significantly lower incidence of zoster-related pain one month after therapy in the dexmedetomidine group, with effects still significant at three months. He also mentions a study comparing steroid injections administered via interlaminar versus transforaminal approaches, finding both groups had significantly lower VAS scores at 1 and 3 months follow-up compared to baseline, though this could align with the natural course of herpes zoster. Timing of Interventions and Continuous Epidural Blockade Dr. Rosenblum cites a retrospective study showing that transforaminal epidural injections administered for acute herpes zoster-related pain were associated with significantly shorter time to pain relief compared to those performed in the subacute phase. He also mentions a randomized controlled trial finding that continuous epidural blockade combined with opioids and gabapentin reduced NRS pain scores more than analgesic drug treatments alone during three-day follow-up, though both studies were low-quality. Interventions for Postherpetic Neuralgia Dr. Rosenblum discusses interventions specifically for postherpetic neuralgia, citing a small randomized controlled trial that demonstrated decreased NRS pain scores six months post-treatment for repeat versus single epidural steroid injections (15mg vs 5mg dexamethasone) administered over 24 days. The trial also found increased likelihood of complete remission during 6-month follow-up in the group receiving repeat epidural dexamethasone, though this was low-quality evidence. Summary of Epidural and Paravertebral Injections Dr. Rosenblum summarizes that epidural or paravertebral injections of local anesthetic and/or glucocorticoids could be considered in treating acute herpes zoster-related pain. For subacute postherpetic neuralgia pain, he notes low-quality evidence supporting epidural injections, while for postherpetic neuralgia, evidence supports continuous epidural infusion, though also of low quality. Dr. Rosenblum emphasizes that none of the included studies for postherpetic neuralgia investigating epidural or paravertebral injections resulted in decreased pain compared to standard therapy. Pulsed Radiofrequency (PRF) Evidence Dr. Rosenblum discusses pulsed radiofrequency (PRF), noting that previous guidelines indicated moderate quality evidence that PRF of the intercostal nerve reduces pain for 6 months in patients with postherpetic neuralgia, and very low-quality evidence that PRF to the dorsal root ganglion (DRG) reduces pain for 6 months. He mentions that multiple studies have been published since then assessing PRF efficacy. PRF Studies for Acute Herpes Zoster Dr. Rosenblum discusses a randomized controlled trial with 60 patients comparing high-voltage bipolar PRF of the cervical sympathetic chain versus sham, with treatment repeated after three days in both groups. He reports that VAS scores in the PRF group at each post-interventional point (1 day, 2 days, 1 month, 2 months, 3 months) were significantly lower than in the sham group, and at 3 months, the incidence of postherpetic neuralgia was 16.7% in the PRF group compared to 40% in the sham group. PRF for Trigeminal Neuralgia Dr. Rosenblum cites another randomized controlled trial evaluating high-voltage long-duration PRF of the Gasserian ganglion in 96 patients with subacute herpes-related trigeminal neuralgia, which found decreased VAS pain scores at all post-interventional time points (3, 7, 14 days and 1, 3, and 6 months) compared to the sham group. He also mentions a randomized comparative effectiveness study in 120 patients with subacute trigeminal herpes zoster, comparing a single application of high-voltage PRF to the Gasserian ganglion versus three cycles of conventional PRF treatment, finding significantly lower mean VAS pain scores for up to six months in the high-voltage PRF group. PRF Compared to Other Interventions Dr. Rosenblum discusses a randomized controlled trial comparing PRF to short-term spinal cord stimulation, which found decreased pain and improved 36-item short-form health survey scores in both groups at six months. He also mentions a randomized controlled trial in 72 patients where PRF of spinal nerves or peripheral branches of cranial nerves combined with five-day infusion of IV lidocaine resulted in greater pain reduction, less rescue analgesia, and reduced inflammatory cytokines at two months compared to PRF with saline infusions. Dr. Rosenblum notes a major limitation of this study was not accounting for the high natural recovery rate. Summary of PRF and Final Recommendations Dr. Rosenblum summarizes that PRF provides significant pain relief lasting over three months in patients with subacute herpes zoster and postherpetic neuralgia. He notes that since few studies have compared PRF versus sham, it's not possible to calculate an accurate number needed to treat. Dr. Rosenblum mentions there are no comparative studies comparing PRF to the intercostal nerves versus PRF of the DRG, but both preclinical and clinical studies suggest superiority of the DRG approach. He adds that evidence for spinal cord stimulation for postherpetic neuralgia is of low quality, and more research is needed given its invasive nature. Sympathetic Blocks and Conclusion Dr. Rosenblum notes there is low-quality evidence for using sympathetic blocks to treat acute herpes zoster-related pain, but no evidence for their use in postherpetic neuralgia. He mentions that risks of treatment with intrathecal methylprednisolone are unclear and therefore not recommended. Dr. Rosenblum concludes by praising the comprehensive article he's been discussing and mentions it provides insight for treating his patients, including a recent case of trigeminal postherpetic neuralgia. Personal Clinical Approach and Closing Dr. Rosenblum shares that he doesn't currently perform PRF in his practice, partly because it's not standard of care and not well reimbursed, creating barriers to implementation. However, he notes that PRF is a very safe procedure as it doesn't involve burning tissue. For his patient with trigeminal neuralgia pain, Dr. Rosenblum plans to try a topical sphenopalatine ganglion block as the least invasive intervention before considering injecting the trigeminal nerves at the foramen, in addition to pharmacotherapy. He concludes by thanking listeners, encouraging them to check the show notes and links, mentioning institutional memberships and shadowing opportunities, and asking listeners to rate and share the podcast. Q&A No Q&A session in this lecture Pain Management Board Prep   Ultrasound Training REGISTER TODAY!   Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights     David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care.  As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures.   Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023   Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology.  He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures.  He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more!   Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy  and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques.  Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office.  For an appointment go to AABPpain.com or call Brooklyn     718 436 7246 Reference Adriaansen, E. J., Jacobs, J. G., Vernooij, L. M., van Wijck, A. J., Cohen, S. P., Huygen, F. J., & Rijsdijk, M. (2025). 8. Herpes zoster and post herpetic neuralgia. Pain Practice, 25(1), e13423.

Summary In this episode of the Pain Exam Podcast, Dr. David Rosenblum provides a comprehensive review of herpes zoster and postherpetic neuralgia (PHN), focusing on pathophysiology, diagnosis, and treatment options. Dr. Rosenblum explains that postherpetic neuralgia affects approximately 25% of patients with acute herpes zoster, causing debilitating unilateral chronic pain in one or more dermatomes. He discusses the three phases of herpes zoster: acute (up to 30 days), subacute (up to 3 months), and postherpetic neuralgia (pain continuing beyond 3 months). Dr. Rosenblum identifies risk factors for developing PHN, including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. He details the pathophysiology involving peripheral and central sensitization, and explains different phenotypes of PHN that can guide treatment approaches. For treatment, Dr. Rosenblum reviews various options including antiviral medications (which should be started within 72 hours of onset), corticosteroids, opioids, antidepressants (particularly tricyclics and SNRIs), antiepileptics (gabapentin and pregabalin), topical agents (lidocaine and capsaicin), and interventional procedures such as epidural injections and pulsed radiofrequency. He emphasizes that prevention through vaccination with Shingrix is highly effective, with 97% effectiveness in preventing herpes zoster in patients 50-69 years old and 89% effectiveness in those over 70. Dr. Rosenblum mentions that he's currently treating a patient with trigeminal postherpetic neuralgia and is considering a topical sphenopalatine ganglion block as a minimally invasive intervention before attempting more invasive procedures. Chapters Introduction to the Pain Exam Podcast and Topic Overview Dr. David Rosenblum introduces the Pain Exam Podcast, mentioning that it covers painful disorders, alternative treatments, and practice management. He explains that this episode focuses on herpes zoster and postherpetic neuralgia as board preparation for fellows starting their programs, with ABA boards coming up in September. Dr. Rosenblum notes that he's not only preparing listeners for boards but also seeking the latest information to help treat his own patients with this notoriously difficult disease. Upcoming Conferences and Educational Opportunities Dr. Rosenblum announces several upcoming conferences including Aspen in July, Pain Week in September, and events with NYSIP and the Latin American Pain Society. He mentions he'll be teaching ultrasound and regenerative medicine at these events. Dr. Rosenblum invites listeners to sign up at nrappain.org to access a community discussing regenerative medicine, ultrasound-guided pain medicine, regional anesthesia, and board preparation. He also offers ultrasound training in New York and elsewhere, with upcoming sessions in Manhattan on July 12th and October 4th, plus private shadowing opportunities. Overview of Postherpetic Neuralgia Dr. Rosenblum defines postherpetic neuralgia as typically a unilateral chronic pain in one or more dermatomes after acute herpes zoster infection. He states that the incidence of acute herpes zoster ranges between 3-5 patients per thousand person-years, and one in four patients with acute herpes zoster-related pain will transition into postherpetic neuralgia. Dr. Rosenblum emphasizes that while this condition won't kill patients, it can be extremely debilitating and significantly reduce quality of life. Treatment Options Overview Dr. Rosenblum reviews treatment options according to the WHO pain ladder, including tricyclics like nortriptyline and antiepileptic drugs such as gabapentin. He explains that if pain is not significantly reduced, interventional treatments like epidural injections with local anesthetics and corticosteroids or pulsed radiofrequency of the dorsal root ganglion are options. For postherpetic neuralgia specifically, Dr. Rosenblum notes that preferred treatments include transdermal capsaicin, lidocaine, or oral drugs such as antidepressants or antiepileptics. Phases of Herpes Zoster and Definitions Dr. Rosenblum outlines the three phases during herpes zoster reactivation: acute herpes zoster-related pain (lasting maximum 30 days), subacute herpes zoster-related pain (pain after healing of vesicles but disappearing within 3 months), and postherpetic neuralgia (typically defined as pain continuing after 3 months). He mentions that acute herpes zoster pain often begins with prodromal pain starting a few days before the appearance of the rash. Incidence and Risk Factors Dr. Rosenblum states that the incidence of herpes zoster ranges between 3-5 patients per 1,000 person-years, with approximately 5-30% of cases leading to postherpetic neuralgia. He identifies risk factors including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. Dr. Rosenblum describes the clinical manifestations as a mosaic of somatosensory symptoms including burning, deep aching pain, tingling, itching, stabbing, often associated with tactile and cold allodynia. Impact on Quality of Life Dr. Rosenblum emphasizes that postherpetic neuralgia can be debilitating, impacting both physical and emotional functioning and causing decreased quality of life. He notes that it leads to fatigue, insomnia, depression, anorexia, anxiety, and emotional distress. Dr. Rosenblum stresses the importance of exploring methods for prevention of postherpetic neuralgia and optimizing pain treatment for both subacute herpes zoster-related pain and postherpetic neuralgia. Literature Review and Pathophysiology Dr. Rosenblum mentions that he's discussing a literature review from 2024 that updates previous practical guidelines published in 2011. He explains the pathophysiology of postherpetic neuralgia, which involves sensitization of peripheral and sensory nerves from damage. Dr. Rosenblum describes how inflammatory mediators reduce the stimulus threshold of nociceptors and increase responsiveness, resulting in pathological spontaneous discharges, lower thresholds for thermal and mechanical stimuli, and hyperalgesia. Central Sensitization and Nerve Damage Dr. Rosenblum explains that central sensitization results from peripheral nociceptor hyperactivity leading to plastic changes in the central nervous system, involving amplification of pain signals and reduced inhibition. He describes how nerve damage in postherpetic neuralgia patients results from neuronal death due to severe inflammatory stimuli or secondary to neuronal swelling. Dr. Rosenblum notes that motor defects occur in 0.05% of patients with herpes zoster, observed as abdominal pseudohernias or motor weakness of limbs limited to the affected myotome. Different Phenotypes and Classification Dr. Rosenblum discusses different phenotypes of postherpetic neuralgia and how phenotyping can determine treatment. He explains that there are several ways to classify the phenotypes, with one categorizing patients into three subtypes: sensory loss (most common), thermal gain, and thermal loss with mechanical gain. Dr. Rosenblum describes the mechanistic categorization, including the irritable nociceptive phenotype characterized by preserved sensation, profound dynamic mechanical allodynia, reduced pressure pain threshold, and relief with local anesthetic infiltration. Deafferentation Phenotype Dr. Rosenblum explains that a deafferentation phenotype may arise from destruction of neurons by the virus in the dorsal root ganglion. This phenotype is characterized by sensory loss, including thermal and vibratory sensation without prominent thermal allodynia. He notes that mechanical allodynia can occur secondary to A-beta fibers activating spinothalamic pathways (known as phenotypic switches), along with pressure hyperalgesia and temporal summation suggesting central sensitization. Dr. Rosenblum mentions that in one study, this phenotype was present in 10.8% of individuals, and for those with deafferentation pain, gabapentinoids, antidepressants, and neuromodulatory therapies like repetitive transcranial magnetic stimulation may be beneficial. Diagnosis and Physical Examination Dr. Rosenblum discusses the diagnosis of herpes zoster and postherpetic neuralgia, emphasizing the importance of physical examination. He explains that diagnosis is based on the rash, redness, papules, and vesicles in the painful dermatomes, with healing vesicles showing crust formation. Dr. Rosenblum notes that the rash is generally unilateral and does not cross the midline of the body. In postherpetic neuralgia patients, he mentions that scarring, hyper or hypopigmentation is often visible, with allodynia present in 45-75% of affected patients. Sensory Testing and Assessment Dr. Rosenblum explains that in patients with postherpetic neuralgia, a mosaic of somatosensory alterations can occur, manifesting as hyperalgesia, allodynia, and sensory loss. These can be quantified by quantitative sensory testing, which assesses somatosensory functions, dermal detection thresholds for perception of cold, warmth, and paradoxical heat sensations. He notes that testing can provide clues regarding underlying mechanisms of pain, impaired conditioned pain modulation, temporal summation suggesting central sensitization, and information about the type of nerve damage and surviving afferent neurons. Prevention Through Vaccination Dr. Rosenblum discusses prevention of acute herpes zoster through vaccination, noting that the risk increases with reduced immunity. He highlights studies evaluating Shingrix, a vaccine for herpes zoster, which showed 97% effectiveness in preventing herpes zoster in patients 50-69 years old with healthy immune systems and 89% effectiveness in patients over 70. Dr. Rosenblum states that Shingrix is 89-91% effective in preventing postherpetic neuralgia development in patients with healthy immune systems and 68-91% effective in those with weakened or underlying conditions. Treatment Objectives Dr. Rosenblum outlines the treatment objectives for herpes zoster and postherpetic neuralgia. For acute herpes zoster, objectives include relieving pain, reducing severity and duration of pain, accelerating recovery of epidermal defects, and preventing secondary infections. For postherpetic neuralgia, the objectives are pain alleviation and improved quality of life. Dr. Rosenblum lists available treatments including psychotherapy, opiates, antidepressants, antiepileptics, NMDA antagonists, topical agents, and interventional treatments such as epidurals, pulsed radiofrequency, nerve blocks, and spinal cord stimulation. Antiviral Medications Dr. Rosenblum emphasizes that antiviral drugs should be started within 72 hours of clinical onset, mentioning famciclovir, valacyclovir, and acyclovir. He notes there is no evidence for effectiveness after 72 hours in patients with uncomplicated herpes zoster. Dr. Rosenblum provides dosing information: for immunocompetent patients, famciclovir 500mg and valacyclovir 1000mg three times daily for seven days; for immunocompromised patients, famciclovir 1000mg three times daily for 10 days, while acyclovir should be given IV in the immunocompromised. Benefits of Antiviral Therapy Dr. Rosenblum explains that antiviral medication accelerates the disappearance of vesicles and crusts, promotes healing of skin lesions, and prevents new lesions from forming. By inhibiting viral replication, he notes that antiviral therapy likely reduces nerve damage, resulting in reduced incidence of postherpetic neuralgia, and should be started as soon as possible. Corticosteroids and Opioids Dr. Rosenblum discusses the use of corticosteroids, noting that when added to antiviral medications, they may reduce the severity of acute herpes zoster-related pain, though increased healing of skin lesions was not observed in one study. He mentions that a Cochrane review found oral corticosteroids ineffective in preventing postherpetic neuralgia. Regarding opioids, Dr. Rosenblum states they are commonly used alongside antivirals for controlling acute herpes zoster pain, with tramadol having a number needed to treat (NNT) of 4.7 and strong opioids having an NNT of 4.3 for 50% pain reduction. Methadone and Antidepressants Dr. Rosenblum discusses methadone as an NMDA receptor antagonist used in acute and chronic pain management, though he notes there are no randomized controlled trials determining its efficacy in acute herpes zoster pain or postherpetic neuralgia. He explains that methadone can modulate pain stimuli by inhibiting the uptake of norepinephrine and serotonin, resulting in decreased development of hyperalgesia and opioid tolerance, but has side effects including constipation, nausea, sedation, and QT prolongation that can trigger torsades de pointes. Dr. Rosenblum identifies antidepressants as first-line therapy for postherpetic neuralgia, including tricyclics and SNRIs, with tricyclics having an NNT of 3 and SNRIs an NNT of 6.4 for 50% pain reduction. Antiepileptics and Pharmacological Treatment Summary Dr. Rosenblum discusses antiepileptics like gabapentin and pregabalin for postherpetic neuralgia. He cites two trials measuring gabapentin's effect, concluding it was effective compared to placebo with a pooled NNT of 4.4, while pregabalin had an NNT of 4.9. Dr. Rosenblum summarizes that pharmacological treatment is well established for subacute herpes zoster pain, though new high-quality evidence has been lacking since the last update in 2011. Topical Agents Dr. Rosenblum discusses local anesthetic topical agents including lidocaine and capsaicin creams and patches. He notes that 8% capsaicin provided significant pain reduction during 2-8 weeks, while 5% lidocaine patches provided moderate pain relief after eight weeks of treatment. Dr. Rosenblum also mentions acute herpes zoster intracutaneous injections, citing a study where single intracutaneous injection with methylprednisolone combined with ropivacaine versus saline alone showed significant difference in VAS score at 1 and 4 weeks post-intervention favoring the intervention group. Intracutaneous Injections Dr. Rosenblum discusses the effect of repetitive intracutaneous injections with ropivacaine and methylprednisolone every 48 hours for one week. He cites a randomized control trial comparing antivirals plus analgesics to antivirals plus analgesics and repeat injections, finding the intervention group had significantly shorter duration of pain, lower VAS scores, and lower incidence of postherpetic neuralgia (6.4% vs 28% at 3 months). Dr. Rosenblum notes that a potential side effect of cutaneous methylprednisolone injection is fat atrophy, though this wasn't reported in the study. Summary of Local Anesthetics Dr. Rosenblum summarizes that there are no new studies reporting the efficacy of capsaicin 8% for postherpetic neuralgia, but it remains widely used in clinical practice and is approved in several countries. He notes that lidocaine patches can reduce pain intensity in patients with postherpetic neuralgia but may be more beneficial in patients with allodynia. Dr. Rosenblum adds that intracutaneous injections may be helpful for short periods, while repetitive injections with local anesthetics may reduce VAS scores for up to six months but can cause subcutaneous fat atrophy. Interventional Treatments: Epidural and Paravertebral Injections Dr. Rosenblum discusses interventional treatments, noting that previous guidelines found epidural injection with corticosteroids and local anesthetic as add-on therapy superior to standard care alone for up to one month in managing acute herpes zoster pain. He mentions a randomized controlled trial showing no difference between interlaminar and transforaminal epidural steroid injections for up to three months after the procedure. Dr. Rosenblum adds that previous guidelines reported high-quality evidence that paravertebral injections of corticosteroids or local anesthetic reduces pain in the active phase of herpes zoster. Comparative Studies on Injection Approaches Dr. Rosenblum discusses a trial comparing efficacy of repetitive paravertebral blocks with ropivacaine versus dexmedetomidine to prevent postherpetic neuralgia, which showed significantly lower incidence of zoster-related pain one month after therapy in the dexmedetomidine group, with effects still significant at three months. He also mentions a study comparing steroid injections administered via interlaminar versus transforaminal approaches, finding both groups had significantly lower VAS scores at 1 and 3 months follow-up compared to baseline, though this could align with the natural course of herpes zoster. Timing of Interventions and Continuous Epidural Blockade Dr. Rosenblum cites a retrospective study showing that transforaminal epidural injections administered for acute herpes zoster-related pain were associated with significantly shorter time to pain relief compared to those performed in the subacute phase. He also mentions a randomized controlled trial finding that continuous epidural blockade combined with opioids and gabapentin reduced NRS pain scores more than analgesic drug treatments alone during three-day follow-up, though both studies were low-quality. Interventions for Postherpetic Neuralgia Dr. Rosenblum discusses interventions specifically for postherpetic neuralgia, citing a small randomized controlled trial that demonstrated decreased NRS pain scores six months post-treatment for repeat versus single epidural steroid injections (15mg vs 5mg dexamethasone) administered over 24 days. The trial also found increased likelihood of complete remission during 6-month follow-up in the group receiving repeat epidural dexamethasone, though this was low-quality evidence. Summary of Epidural and Paravertebral Injections Dr. Rosenblum summarizes that epidural or paravertebral injections of local anesthetic and/or glucocorticoids could be considered in treating acute herpes zoster-related pain. For subacute postherpetic neuralgia pain, he notes low-quality evidence supporting epidural injections, while for postherpetic neuralgia, evidence supports continuous epidural infusion, though also of low quality. Dr. Rosenblum emphasizes that none of the included studies for postherpetic neuralgia investigating epidural or paravertebral injections resulted in decreased pain compared to standard therapy. Pulsed Radiofrequency (PRF) Evidence Dr. Rosenblum discusses pulsed radiofrequency (PRF), noting that previous guidelines indicated moderate quality evidence that PRF of the intercostal nerve reduces pain for 6 months in patients with postherpetic neuralgia, and very low-quality evidence that PRF to the dorsal root ganglion (DRG) reduces pain for 6 months. He mentions that multiple studies have been published since then assessing PRF efficacy. PRF Studies for Acute Herpes Zoster Dr. Rosenblum discusses a randomized controlled trial with 60 patients comparing high-voltage bipolar PRF of the cervical sympathetic chain versus sham, with treatment repeated after three days in both groups. He reports that VAS scores in the PRF group at each post-interventional point (1 day, 2 days, 1 month, 2 months, 3 months) were significantly lower than in the sham group, and at 3 months, the incidence of postherpetic neuralgia was 16.7% in the PRF group compared to 40% in the sham group. PRF for Trigeminal Neuralgia Dr. Rosenblum cites another randomized controlled trial evaluating high-voltage long-duration PRF of the Gasserian ganglion in 96 patients with subacute herpes-related trigeminal neuralgia, which found decreased VAS pain scores at all post-interventional time points (3, 7, 14 days and 1, 3, and 6 months) compared to the sham group. He also mentions a randomized comparative effectiveness study in 120 patients with subacute trigeminal herpes zoster, comparing a single application of high-voltage PRF to the Gasserian ganglion versus three cycles of conventional PRF treatment, finding significantly lower mean VAS pain scores for up to six months in the high-voltage PRF group. PRF Compared to Other Interventions Dr. Rosenblum discusses a randomized controlled trial comparing PRF to short-term spinal cord stimulation, which found decreased pain and improved 36-item short-form health survey scores in both groups at six months. He also mentions a randomized controlled trial in 72 patients where PRF of spinal nerves or peripheral branches of cranial nerves combined with five-day infusion of IV lidocaine resulted in greater pain reduction, less rescue analgesia, and reduced inflammatory cytokines at two months compared to PRF with saline infusions. Dr. Rosenblum notes a major limitation of this study was not accounting for the high natural recovery rate. Summary of PRF and Final Recommendations Dr. Rosenblum summarizes that PRF provides significant pain relief lasting over three months in patients with subacute herpes zoster and postherpetic neuralgia. He notes that since few studies have compared PRF versus sham, it's not possible to calculate an accurate number needed to treat. Dr. Rosenblum mentions there are no comparative studies comparing PRF to the intercostal nerves versus PRF of the DRG, but both preclinical and clinical studies suggest superiority of the DRG approach. He adds that evidence for spinal cord stimulation for postherpetic neuralgia is of low quality, and more research is needed given its invasive nature. Sympathetic Blocks and Conclusion Dr. Rosenblum notes there is low-quality evidence for using sympathetic blocks to treat acute herpes zoster-related pain, but no evidence for their use in postherpetic neuralgia. He mentions that risks of treatment with intrathecal methylprednisolone are unclear and therefore not recommended. Dr. Rosenblum concludes by praising the comprehensive article he's been discussing and mentions it provides insight for treating his patients, including a recent case of trigeminal postherpetic neuralgia. Personal Clinical Approach and Closing Dr. Rosenblum shares that he doesn't currently perform PRF in his practice, partly because it's not standard of care and not well reimbursed, creating barriers to implementation. However, he notes that PRF is a very safe procedure as it doesn't involve burning tissue. For his patient with trigeminal neuralgia pain, Dr. Rosenblum plans to try a topical sphenopalatine ganglion block as the least invasive intervention before considering injecting the trigeminal nerves at the foramen, in addition to pharmacotherapy. He concludes by thanking listeners, encouraging them to check the show notes and links, mentioning institutional memberships and shadowing opportunities, and asking listeners to rate and share the podcast. Q&A No Q&A session in this lecture Pain Management Board Prep   Ultrasound Training REGISTER TODAY!   Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights     David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care.  As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures.   Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023   Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology.  He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures.  He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more!   Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy  and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques.  Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office.  For an appointment go to AABPpain.com or call Brooklyn     718 436 7246 Reference Adriaansen, E. J., Jacobs, J. G., Vernooij, L. M., van Wijck, A. J., Cohen, S. P., Huygen, F. J., & Rijsdijk, M. (2025). 8. Herpes zoster and post herpetic neuralgia. Pain Practice, 25(1), e13423.

THANK YOU TO OUR SPONSORS Visit jaspr.co/drg and use code DRG for $300 off for a limited time. Visit calroy.com/drg and save over $50 and get a free canister of 2-in-1 Nitric Oxide Test Strips with a 3-Pack Bundle Purchase. Sign up for our newsletter! https://drchristiangonzalez.com/newsletter/ What if your chronic fatigue, autoimmune symptoms, and people-pleasing patterns aren't random? What if they're your body remembering something your mind forgot? In this groundbreaking episode, I sit down with Brittany Piper, a somatic experiencing practitioner and trauma educator for the Department of Justice and U.S. military. We explore how trauma lives in the nervous system, why traditional talk therapy often falls short, and how somatic work can rewire your body's stress responses. Brittany shares her personal journey of healing from complex trauma and reveals why most people pleasers are secretly angry, how childhood experiences shape our adult relationships, and practical tools to reconnect with your body's wisdom. If you've ever felt stuck in therapy or trapped in survival mode, this episode offers a revolutionary approach to healing through nervous system regulation and somatic awareness. Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/ Timestamps: 00:00 - Opening: Can Chronic Illness Be Rooted in Repressed Emotions? 06:00 - Rapid Fire Questions: People Pleasers, Men's Disconnection & Childhood Expression 11:39 - The Dance Floor Moment: How a 5-Year-Old Loses Wholeness and Authentic Expression 21:36 - Brittany's Trauma Story: Birth, Foster Care, and the Body's Memory of Not Belonging 26:01 - From Sexual Assault to Purpose: Turning Pain into Prevention Education Work 30:20 - Body Patterns and Procedural Memory: How to Start Recognizing Trauma in Your Body 35:17 - Building Body Awareness: From Head-Up Living to Somatic Intelligence 38:46 - Raising Emotionally Healthy Boys: Validating Emotions Without Fixing Them 47:12 - People Pleasers Are Silently Angry: The Fight-Flight-Shutdown Response Explained 51:17 - The Connection Between Emotional Suppression and Autoimmune Disease in Women 56:21 - Success Story: From Bedridden with Lyme/Mold to Recovery Through Nervous System Work 1:01:03 - How Trauma Lives in the Body: Physical Pain vs. Emotional Numbness as Warning Signs 1:07:47 - "Body First Healing" Book: A Somatic Roadmap for Healing Trauma and Nervous System Recovery

In der neuen Folge "Hot Pink" diskutieren Britt-Marie und Nils u.a. über den bewaffneten Raubüberfall auf die Geissens, Diego Lunas Blaster, Pedro Pascals Lookalike Contest und den überraschenden Gewinner, Taylor Swifts Eras Pur Cocktailbuch, Ozzy Osbournes DNA-Dosen-Merch, Aubrey Anderson-Emmons Coming Out, die Ehrenoscars, Jason Segals Verlobung und Kelsey Grammers 8. Baby. Hört rein!*Wer noch mehr von Britt-Marie und Nils hören möchte, kann das in Ihrem Spin-Off-Podcast "Hot Pink schaut..." tun.- Britt-Marie und Marcel haben die 18. Staffel von "Let's Dance" in zusammenfassenden Folgen alle paar Wochen besprochen. Hier ist Episode 1: "Hot Pink schaut Lets Dance" - Podcast-Folge 1 zu LD 18x00-18x02- Wir haben die 17. Staffel von "Let's Dance" geschaut und mit Marcel wöchentlich darüber diskutiert."Hot Pink schaut Lets Dance" - Podcast-Folge 1 zu LD 17x00- Daneben haben wir bereits die 1. Staffel von "Drag Race Germany" geschaut und die komplette Show besprochen."Hot Pink schaut Drag Race Germany" - Podcast-Folge 1 zu DRG

This episode is sponsored by Puori Creatine+ Looking to support your strength, recovery, and cognitive function with clean, high-quality ingredients? You can try Puori Creatine+ and experience the difference yourself. Right now, you can get 20% off your Puori order, including their already discounted subscription. Go to Puori.com/DRG and use promo code DRG. Visit cornbreadhemp.com/drg and use code DRG for 30% off your first order. Visit supermush.com and use code DRG20 to get 20% off. Join thousands getting weekly health insights → https://drchristiangonzalez.com/newsletter/ Most fish oils on the market are contaminated, oxidized, and lack therapeutic value. In this episode, Pure founder Oliver Amstrup reveals the three critical factors that determine fish oil quality: potency (EPA/DHA concentration), purity (absence of heavy metals and toxins), and freshness (low oxidation levels). Learn the at-home test to spot rancid fish oil, what labels to look for, why 83% of protein powders contain dangerous heavy metals, and how European health standards compare to American ones. Oliver also shares insights on raising healthier kids, the transparency crisis in supplements, and why Denmark consistently ranks as one of the world's happiest countries. Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/ Timestamps: 00:00 - The Fish Oil Quality Crisis: What Labels Don't Tell You 02:43 - At-Home Test to Spot Rancid Fish Oil (Chew Method) 08:41 - Why Kids in Europe Are Healthier Than American Kids 15:32 - Denmark's Happiness Secret: Safety, Education & Community 22:48 - The Protein Powder Heavy Metal Problem (83% Contaminated) 35:17 - Transparency vs. Marketing: How to Read Supplement Labels 42:15 - Raising Healthy Kids: European vs. American Approaches 52:30 - The Supplement Industry's Dirty Secrets Exposed 58:45 - Building a Transparent Company: Pure's 15-Year Journey

If you're struggling with manifesting money, love, or success, it might be because you're spiritually blocked. In this powerful throwback conversation, David Ghiyam, co-founder of Mary Ruth Organics and leading Kabbalah teacher, reveals the ancient spiritual principles that govern abundance and why most people unknowingly sabotage their own manifestation. David breaks down: – Why your soul chooses specific challenges to accelerate your growth – The two biggest spiritual blocks preventing you from receiving abundance – How judgment creates karmic debt and keeps you stuck in painful cycles – Why competing desires sabotage your manifestation (and how to align them) – The spiritual flywheel: creating unstoppable momentum in 24 hours – How childhood trauma and family dynamics shape your vessel for receiving – The difference between punishment-based religion and true spiritual transformation This isn't your typical manifestation content. David shares profound insights from Kabbalah that explain why some people effortlessly attract success while others struggle despite doing "all the right things." He reveals how taking complete responsibility for your reality and transforming your spiritual baggage opens the floodgates to receiving everything you desire. Whether you're an entrepreneur, parent, or anyone seeking deeper fulfillment, this conversation will shift how you understand success, relationships, and your soul's purpose. #kabbalah #manifestation #spirituality David Ghiyam Instagram: @davidghiyam ==== Thank You To Our Sponsors! Go to birchliving.com/healtyself and get 27% off your Birch matress, plus gifts! Visit timeline.com/drg and use code DRG to get 20% off Visit jaspr.co/drg and use code DRG to get $300 off for a limited time Timestamps:  00:00 - Spiritual Blocks to Manifestation 06:42 - Soul's Purpose & Choosing Your Challenges18:01 - Personal Responsibility vs Victim Consciousness 25:00 - Judgment Creates Karmic Debt 32:30 - Childhood Trauma & Soul Corrections 40:20 - Manifestation: Vision & Spiritual Flywheel 45:48 - Relationship Dynamics & Sacred Partnerships 55:00 - Physical Body as Temple for the Soul 1:02:32 - Healing Through Awareness & Transformation Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/ Sign up for our newsletter! https://drchristiangonzalez.com/newsletter/

In der neuen Folge "Hot Pink" diskutieren Britt-Marie und Nils u.a. über Brian Wilsons und Carlo von Tiedemanns Tod, den Einbruch bei Macklemore, Abors homophobe und misogynistische Kommentare, Katy Perrys & Orlando Blooms eventuelle Trennung, die Tony Awards 2025, Billie Eilishs Freund, Dua Lipas Verlobung, Bill Kaulitz auf dem Cover der deutschen Vogue sowie Zawe Ashtons & Tom Hiddlestons Baby. Hört rein!*Wer noch mehr von Britt-Marie und Nils hören möchte, kann das in Ihrem Spin-Off-Podcast "Hot Pink schaut..." tun.- Britt-Marie und Marcel haben die 18. Staffel von "Let's Dance" in zusammenfassenden Folgen alle paar Wochen besprochen. Hier ist Episode 1: "Hot Pink schaut Lets Dance" - Podcast-Folge 1 zu LD 18x00-18x02- Wir haben die 17. Staffel von "Let's Dance" geschaut und mit Marcel wöchentlich darüber diskutiert."Hot Pink schaut Lets Dance" - Podcast-Folge 1 zu LD 17x00- Daneben haben wir bereits die 1. Staffel von "Drag Race Germany" geschaut und die komplette Show besprochen."Hot Pink schaut Drag Race Germany" - Podcast-Folge 1 zu DRG

In this highly anticipated annual episode, Dr. G delivers the 2025 Heal Thy Self Cacao Product Review. After weeks of testing, lab document requests, and direct communication with brands, Dr. G exposes the shocking truth about your favorite cacao products. Not all cacao is created equal. Some brands are loaded with heavy metals like lead and cadmium. Others are contaminated with mold and mycotoxins. And some companies won't even respond to basic safety questions about what's actually in their products. Dr. G breaks down: Why even organic cacao can exceed safe heavy metal levels The brands that completely ignored transparency requests (red flag!) Which companies provided full certificates of analysis and passed with flying colors How mycotoxins from improperly stored cacao beans can cause liver toxicity and immune suppression The difference between fermented, raw, and roasted cacao and why it matters His complete transparency protocol: what questions every cacao company should answer. This isn't just about flavor; it's about your long-term health. Cacao is medicine, but sourcing matters. Transparency is the new baseline for quality. From the brands that made the top tier to the ones you should avoid completely, this episode will change how you choose your cacao forever. #cacao #chocolate #wellness ==== Thank You To Our Sponsors! Head to boncharge.com and use the coupon code DRG for 15% off. Visit supermush.com and use code DRG20 to get 20% off. Timestamps: 00:00:00 - 2025 Cacao Review Introduction 00:03:00 - The Heavy Metal Problem in Cacao 00:06:00 - Mycotoxins: The Hidden Danger 00:09:00 - Our Transparency Protocol Explained 00:12:00 - Brands That Didn't Respond (Avoid These) 00:15:00 - Mid-Tier Brands: Incomplete Responses 00:18:00 - TOP TIER: The Cleanest Cacao Brands 00:22:00 - Pending Brands & Final Thoughts Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/ Sign up for our newsletter! https://drchristiangonzalez.com/newsletter/

In this eye-opening episode, Dr. G sits down with Dr. Sara Reardon, a pelvic floor physical therapist with 18 years of experience, to discuss the health issues that 1 in 3 women face but rarely talk about. From painful sex to urinary leakage, painful orgasms to constipation—these aren't just "normal parts of aging" that you have to accept. Dr. Sara breaks down: - Why most women don't even know what their pelvic floor is (and why that's a problem) - The shocking connection between trauma and pelvic floor dysfunction - Why you should NEVER push when you pee (and how it's weakening your pelvic floor) / How breathing exercises can literally heal your vagina - The truth about painful periods and what they're really telling you - Why Kegels aren't the answer for everyone (and what to do instead) - How menopause affects your pelvic floor and what you can do about it This conversation will change how you think about your body. Whether you're dealing with pain, leakage, or just want to understand this crucial part of your anatomy, this episode gives you the knowledge and tools to reclaim your pelvic health at any age. Your pelvic floor affects everything; from your mood to your confidence to your relationships. It's time to stop suffering in silence. #pelvicfloor #womenshealth #wellness ==== Thank You To Our Sponsors! Visit cornbreadhemp.com/drg and use code DRG to get 30% off your first order. Visit bioptimizers.com/drg and use code DRG10 to get 10% off. Visit supermush.com and use code DR20 to get 20% off. Timestamps: 00:00:00 - Pelvic Floor Health Basics 00:04:00 - Most Common Symptoms Women Ignore 00:08:00 - Painful Orgasms & Sexual Dysfunction 00:15:00 - The Trauma-Pelvic Floor Connection 00:22:00 - Why You Shouldn't Push When You Pee 00:28:00 - Breathing Exercises for Vaginal Health 00:35:00 - Menopause & Pelvic Floor Changes 00:42:00 -At-Home Pelvic Floor Assessment 00:48:00 - Treatment Options & Resources Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/ Sign up for our newsletter! https://drchristiangonzalez.com/newsletter/

In this powerful episode, Dr. G exposes the most dangerous form of narcissism hiding in plain sight—spiritual narcissism. Inspired by recent events in the spiritual community, this episode breaks down the clinical truth about narcissistic patterns, red flags, and the subtle manipulation tactics that leave people confused, emotionally wrecked, and doubting their own intuition. Dr. G dives deep into: – The neurobiological roots of narcissism and childhood trauma patterns – Love bombing vs. genuine connection: how to tell the difference – Spiritual bypassing and weaponized healing language – The idealize-devalue-discard cycle that keeps you addicted to toxic people – Why "I'm triggered" and "shadow work" become tools of manipulation – How to trust your nervous system when something feels off. This isn't pop psychology—it's clinical truth mixed with somatic wisdom. Whether you've dated a narcissist, live with one, or recognize these patterns in yourself, this episode will help you unhook from toxic dynamics and rebuild your relationship with your own intuition. The most sacred relationship is the one between you and your body, your truth, your gut. No one has the right to distort you from that. #narcissism #spirituality #relationships ==== Thank You To Our Sponsors! Go to birchliving.com/healthyself and use promo code BIRCHPARTNER27 to get 27% off plus 2 free pillows with your mattress purchase. Visit jaspr.co/DRG and use code DRG to get $300 off for a limited time. Timestamps: 00:00:00 - Spiritual Narcissism Exposed 00:01:05 - What Is Narcissism Really? 00:05:00 - Childhood Trauma & Narcissistic Patterns 00:10:00 - Red Flags: Love Bombing & Manipulation 00:15:00 - The Spiritual Narcissist Evolution 00:20:00 - Weaponized Healing Language 00:24:00 - Trusting Your Nervous System Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram  https://www.instagram.com/doctor.gonzalez/ Sign up for our newsletter! https://drchristiangonzalez.com/newsletter/

In this episode, Dr. G dives into the overlooked science behind timing your phone use. Research shows that the most damaging effects on your brain, mood, and digestion aren't caused by how long you're on your phone but when you reach for it. Dr. G breaks down: – Why checking your phone right after waking can spike anxiety – How screen time during peak cognitive hours (9 AM–12 PM) disrupts focus and performance – The impact of phone use during meals on digestion and hormonal balance – The ideal windows to use your phone without draining your energy or attention This episode isn't about quitting your phone. It's about aligning your habits with your body's natural rhythms for better mental clarity, reduced stress, and stronger emotional fitness. ==== Thank you to our Sponsor! BON CHARGE Go to https://boncharge.com/products/red-light-face-mask and use code DRG for 15% off storewide ==== Timestamps: 00:00:00 - Phone Use: Nervous System Impact 00:03:18 - Worst Times to Use Your Phone 06:30:00 - Mindful Phone Use: Best & Worst 09:42:35 - Intentional Phone Use & Rhythms Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/ Sign up for our newsletter! https://drchristiangonzalez.com/newsletter/

Zákaz krížového vlastníctva medzi zdravotnými poisťovňami a nemocnicami, ale aj zrušenie odvodov a ich prerod na dane, čo by vyšachovalo súkromné poisťovne z biznisu s našimi odvodmi. I to sú témy, ktoré by mohli zásadne posunúť naše zlyhávajúce zdravotníctvo. Tvrdí to poslanec PS Oskar Dvořák. Nie je však politická scéna až príliš prepletená so záujmami tzv. Pentagelu? Zdravotníctvo nebolo nikdy prioritou tohto štátu. Priznáva to dnes otvorene už aj premiér Fico, keď zdravotníctvo ako premiérsku tému opakovane odmieta, tvrdí v rozhovore pre Aktuality poslanec PS Oskar Dvořák.Privatizáciou zdravotných odvodov sme si v zdravotníctve vyrobili peklo, hovorí na margo zajacovej reformy, ktorou sa umožnilo vytváranie zisku z verejných zdrojov, bývalá šéfka Úradu pre dohľad nad zdravotnou starostlivosťou Renáta Bláhová. Dnes, po vyše 20tich rokov vidíme výsledky:Štát na verejný záujem v zdravotníctve rezignoval, pacienti ho nezaujímajú a ministerstvo zdravotníctva ovládli lobisti, hovorí v až šokujúco otvorenej kritike pre Ráno Nahlas šéf Najvyššieho kontrolného úradu Ľubomír Andrassy.Napriek tomu, že zdravotníctvo patrí medzi kľúčové oblasti, ktoré nás ako občanov trápia a napriek tomu, že do zdravotníctva neliavame každoročne čoraz viac miliárd, efektivita, kvalita i dostupnosť zdravotných služieb sa pre pacientov nelepšia, ba práve naopak. Navyše, systém, ktorý nás čoraz častejšie núti zháňať peniaze na inovatívne lieky či modernú liečbu po všakovakých zbierkach, stále umožňuje súkrormných finančným žralokom generovať z našich verejných zdrojov ich súkromné zisky.Je toto naozaj v poriadku alebo už dozrel čas na skutočne zásadnú zmenu slovenského zdravotníctva? Bolo by krokom vpred zrušenie zdravotných odvodov či zákaz krížového vlastníctva? Naozaj podľahol štát - i politici naprieč stranami, lobistom z finančných skupín a ako vlastne osedlať a zregulovať záujmy predátorského kapitálu v tejto tak citlivej sfére?"Máme už analýzy Útvaru hodnoty za peniaze, ako i Úradu pre Dohľad nad zdravotnou starostlivosťou no a teraz to hovorí už aj NKÚ, že skutočne sú tu niektorí hráči, ktorí zo zdravotníckeho systému dokážu vyťažiť viac. No a kto má dnes prísť a riešiť to? Má prísť štát - ako regulátor, a využiť napríklad programovú vyhlášku, má si pohnúť so zavádzaním DRG a má opraviť všetky tieto nedostatky. Ak doteraz nekonal, ja by som to nazval spolupáchateľstvo. Neviem či vedome alebo nevedome, ale je to spolupáchateľstvo," tvrdí poslanec Progresívneho Slovenska Oskar Dvořák.Ráno Nahlas s expertom na zdravotníctvo a poslancom Progresívneho Slovenska Oskarom Dvořákom. Pekný deň a pokoj v duši praje Braňo Dobšinký. P.S.Spomínanú liekovú vyhlášku minister zdravotníctva napokon nepodpísal. Kamil Šaško vyhlásil, že vyhláška nevstúpi do platnosti, kým - jeho slovami, nedosiahne "odbornú zhodu."

Zákaz krížového vlastníctva medzi zdravotnými poisťovňami a nemocnicami, ale aj zrušenie odvodov a ich prerod na dane, čo by vyšachovalo súkromné poisťovne z biznisu s našimi odvodmi. I to sú témy, ktoré by mohli zásadne posunúť naše zlyhávajúce zdravotníctvo. Tvrdí to poslanec PS Oskar Dvořák. Nie je však politická scéna až mocš prepletená so záujmami tzv. Pentagelu? Zdravotníctvo nebolo nikdy prioritou tohto štátu. Priznáva to dnes otvorene už aj premiér Fico, keď zdravotníctvo ako premiérsku tému opakovane odmieta, tvrdí v rozhovore pre Aktuality poslanec PS Oskar Dvořák.Privatizáciou zdravotných odvodov sme si v zdravotníctve vyrobili peklo, hovorí na margo zajacovej reformy, ktorou sa umožnilo vytváranie zisku z verejných zdrojov, bývalá šéfka Úradu pre dohľad nad zdravotnou starostlivosťou Renáta Bláhová. Dnes, po vyše 20tich rokov vidíme výsledky:Štát na verejný záujem v zdravotníctve rezignoval, pacienti ho nezaujímajú a ministerstvo zdravotníctva ovládli lobisti, hovorí v až šokujúco otvorenej kritike pre Ráno Nahlas šéf Najvyššieho kontrolného úradu Ľubomír Andrassy.Napriek tomu, že zdravotníctvo patrí medzi kľúčové oblasti, ktoré nás ako občanov trápia a napriek tomu, že do zdravotníctva nelievame každoročne čoraz viac miliárd, efektivita, kvalita i dostupnosť zdravotných služieb sa pre pacientov nelepšia, ba práve naopak. Navyše, systém, ktorý nás čoraz častejšie núti zháňať peniaze na inovatívne lieky či modernú liečbu po všakovakých zbierkach, stále umožňuje súkromných finančným žralokom generovať z našich verejných zdrojov ich súkromné zisky.Je toto naozaj v poriadku alebo už dozrel čas na skutočne zásadnú zmenu slovenského zdravotníctva? Bolo by krokom vpred zrušenie zdravotných odvodov či zákaz krížového vlastníctva? Naozaj podľahol štát - i politici naprieč stranami, lobistom z finančných skupín a ako vlastne osedlať a zregulovať záujmy predátorského kapitálu v tejto tak citlivej sfére?"Máme už analýzy Útvaru hodnoty za peniaze, ako i Úradu pre Dohľad nad zdravotnou starostlivosťou no a teraz to hovorí už aj NKÚ, že skutočne sú tu niektorí hráči, ktorí zo zdravotníckeho systému dokážu vyťažiť viac. No a kto má dnes prísť a riešiť to? Má prísť štát - ako regulátor, a využiť napríklad programovú vyhlášku, má si pohnúť so zavádzaním DRG a má opraviť všetky tieto nedostatky. Ak doteraz nekonal, ja by som to nazval spolupáchateľstvo. Neviem či vedome alebo nevedome, ale je to spolupáchateľstvo," tvrdí poslanec Progresívneho Slovenska Oskar Dvořák.Ráno Nahlas s expertom na zdravotníctvo a poslancom Progresívneho Slovenska Oskarom Dvořákom. Pekný deň a pokoj v duši praje Braňo Dobšinký. P.S.Spomínanú liekovú vyhlášku minister zdravotníctva napokon nepodpísal. Kamil Šaško vyhlásil, že vyhláška nevstúpi do platnosti, kým - jeho slovami, nedosiahne "odbornú zhodu."

In this powerful episode of Heal Thyself, Dr. G explores the gut-brain connection and why your gut may be the real driver of your physical and emotional health. Joined by world-renowned microbiome expert Dr. Tim Spector, they dive deep into the truth about the carnivore diet—exposing how it may harm gut microbiome diversity and increase long-term health risks. Together, they break down why diversity is key—not just in your life, but in your gut. Expect practical, science-backed insights on how fiber, polyphenols, fermented foods, and even everyday spices can transform your gut health and, by extension, your mood, immune system, and even your cancer risk. Dr. G and Dr. Spector also unpack the role of prebiotics like Zoe's Daily 30 and shift the conversation away from restrictive diets and calorie-counting toward a holistic, food-quality-first approach. If you're ready to fuel your emotional and physical vitality from the inside out, this episode is your gut check. #guthealth #wellness #diet Dr. Tim Spector @tim.spector ==== Thank You To Our Sponsors! BiOptimizers Go to https://bioptimizers.com/drg and use promo code DRG10 to get 10% any order. BON CHARGE Go to https://boncharge.com/products/red-light-face-mask and use code DRG for 15% off storewide Cornbread Hemp Use code DRG to save 30% off your order at cornbreadhemp.com/drg ==== Timestamps: 00:00:00 - Gut Microbiome & Mental Health 03:48 - Diet's Impact on Gut & Brain 08:05 - Food Quality & Brain Sensitivity 14:38 - Diet, Protein, Fiber & Sleep 20:50 - Carnivore Diet: Risks & Benefits 28:24 - Probiotics: Do They Work? 35:59 - Prebiotics & Fiber Benefits 41:58 - Fermented Foods: Benefits 52:46 - Stress, Immunity & Nutrition Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/ Sign up for our newsletter! https://drchristiangonzalez.com/newsletter/

This episode explores chrono-nutrition, the science of aligning meal timing with your body's natural rhythms (circadian clock). Studies show that eating breakfast is linked to significantly greater weight loss and improved metabolic health compared to eating dinner. The episode emphasizes the importance of understanding your chronotype (Lion, Bear, Wolf, or Dolphin) to optimize meal timing for better energy, digestion, sleep, and overall well-being. Irregular eating patterns disrupt internal clocks, leading to issues like insulin resistance, poor sleep, and weight gain. #weightloss #diet #wellness ==== Thank You To Our Sponsors! Birch Check out birchliving.com/healthyself and use my exclusive code BIRCHPARTNER27 to get 27% off plus 2 free pillows with your mattress purchase during their Memorial Day Sale. Puori Click here https://puori.com/drg and use code DRG for 20% off the already discounted subscription prices. ==== Show Notes: 00:00:00 - Eat in Sync with Chronotype 03:14 - Chrono-Nutrition Basics 06:27 - Circadian Rhythms & Nutrition 12:43 - Early Eating Benefits 15:48:09 - Chronotype & Weight Loss 22:04 - Chronotype Diets & Timing 30:36 - Chronotypes: Lions, Bears, etc Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/ Sign up for our newsletter! https://drchristiangonzalez.com/newsletter/

Today's episode explores infertility, childbirth trauma, and empowerment, featuring Dr. Elizabeth Wade, who shares her transformative birth experiences—a traumatic first birth followed by a calm, solo home birth. The discussion covers various topics including: overcoming infertility, trusting intuition, the global fertility decline, the impact of birth control, gut health's crucial role in fertility, and the importance of preconception education. Dr. Wade details her solo home birth, contrasting it with her first experience, emphasizing the importance of feeling safe and connected to one's body during labor. #pregnancy #fertility #womenshealth Dr. Elizabeth Wade IG: @dr.elizabethwade === Thank You To Our Sponsor! Jaspr Go to jaspr.co/DRG and use code DRG for $300 off for a limited time. === Timestamps: 00:00:00 - Fertility, Birth, & Lessons 03:00 - Home Birth Experiences 12:25 - Unassisted Birth & Power 18:33 - Comparing Births & Development 24:10 - Home vs. Hospital Birth 32:30 - Declining Fertility Rates 41:44 - Womb Wellness & Pelvic Care 56:52 - Trauma & Fertility 1:00:27 - Healthy Periods & Hormones 1:12:43 - Optimizing Fertility Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/ Sign up for our newsletter! https://drchristiangonzalez.com/newsletter/

Dr. G dives deep into the hidden dangers of mainstream hair dyes, exposing chemicals found in brands like L'Oréal, Clairol, and Revlon that are linked to hormonal disruption, cancer, and premature graying. Blending science with real-life impact, he unpacks the emotional ties to hair color and reveals the biological drivers of graying, from oxidative stress and hydrogen peroxide buildup to the decline of melanocyte activity. Dr. G then shares a powerful five-part protocol to support natural hair color, covering internal nutrients, lifestyle shifts, topical solutions, and regenerative therapies like red light and PRP. He also reviews cleaner dye alternatives and challenges conventional beauty norms, promoting a holistic approach to hair health rooted in overall well-being. #grayhair #productreview #hairdye Timestamps: 00:00:00 - Hair Dye & Graying 05:10 - Gray Hair Science & Fear 06:27 - Graying, Stress, & Health 13:00 - Harmful Hair Dye Chemicals 16:19 - Toxic Dyes & Alternatives 19:15 - Safer Dyes & Graying Protocol 22:18 - Vitamins & Stress for Gray Hair 25:25 - Reversing Gray Hair 28:28 - Ditch Toxic Hair Products ==== Thank You To Our Sponsors! BiOptimizers Go to https://bioptimizers.com/drg and use promo code DRG10 to get 10% any order. BON CHARGE Go to https://boncharge.com/products/red-light-face-mask and use code DRG for 15% off storewide ==== Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/ Sign up for our newsletter! https://drchristiangonzalez.com/newsletter/

This week Brooke McPoyle, a fascial educator and breathwork teacher, discusses the crucial role of fascia in overall health and well-being. The conversation explores fascia's impact on chronic pain, mood, brain fog, and chronic diseases, highlighting its often-overlooked importance. McPoyle explains fascia's structure and function, emphasizing the significance of hydration, movement, and breathwork for maintaining healthy fascia. The discussion delves into the effects of aging, modern footwear, and environmental factors on fascia, offering practical advice for improving fascial health through self-massage techniques (specifically, the "Fascial Flow" method), mindful breathing exercises, and conscious hydration with high-quality water. #fascia #relief #massage ==== Thank You To Our Sponsors! Timeline Go to timeline.com/DRG for 10% off your order! Puori Click here https://puori.com/drg and use code DRG for 20% off the already discounted subscription prices. Cornbread Hemp Use code DRG to save 30% off your order at cornbreadhemp.com/drg ==== Website: musicalbreathwork.com Instagram: @musicalbreathwork YouTube: Musical Breathwork Vicus Water: Discount code 15% Off: VICUSBROOKE Timestamps: 00:00:00 - Fascia, Breathwork, Body Awareness 03:25 - Fascia, Mood, Chronic Pain 09:12 - Fascia, Structure, Aging 16:00 - Foot Health & Tech Dangers 22:17 - Hyaluronic Acid & Water's Role 28:29 - Body Awareness & Inner Energy 34:53 - Breath Control for Athletes 41:08 - Breathwork, Fascia, Trauma 56:28 - Fascia Release Techniques 1:04:59 - Breathwork Course Offerings 1:13:15 - Body Awareness Workshop Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/ Sign up for our newsletter! https://drchristiangonzalez.com/newsletter/

In this insightful podcast episode, we delve into the world of Heart Rate Variability (HRV) and its profound impact on our overall well-being. Join us as we explore how HRV can help you counter grind culture, optimize your nervous system, and unlock your true potential. I sit down with Jessica Corbin, an expert on energetics, leadership, and nervous system intelligence. Jessica Corbin @iamjessicacorbin ==== Thank You To Our Sponsor! Jaspr Go to jaspr.co/DRG and use code DRG for $300 off for a limited time. ==== Timestamps: 00:00:00 - HRV, Grind Culture & Nervous System 00:07:02 - HRV, Diet & Home Health 00:09:39 - HRV: A Daily Readiness Gauge 00:13:17 - Measuring HRV with a Smartphone 00:16:28 - HRV & Sleep Data 00:19:46 - HRV, Self-Discovery & Grind 00:23:06 - HRV, Willpower & Alignment 00:30:08 - HRV, Authenticity & Integrity 00:33:18 - Mind-Body Connection & Self-Care 00:44:28 - Regenerative Business & Culture Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/ Sign up for our newsletter! https://drchristiangonzalez.com/newsletter/

There's a silent crisis happening right now: male fertility is collapsing. In just 40 years, sperm counts have dropped nearly 50% worldwide, reflecting a deeper disconnection from our health, environment, and future. In this powerful episode, Dr. G dives into the hidden factors destroying sperm health from poor diet, alcohol, smoking, stress, sleep deprivation, porn addiction, and environmental toxins and shares the 90-Day "Heal Thyself" Protocol to reclaim strength, vitality, and resilience. You'll learn why sperm health matters even beyond fertility, how to rebuild it through diet, supplementation, sleep, and lifestyle changes, and why reconnecting to your health is essential for a life of purpose and energy. #sperm #fertility #menshealth === Thank You To Our Sponsor! BON CHARGE go to https://boncharge.com/products/ use code DRG for 15% off storewide === Timestamps: 00:00:00 - Declining Sperm Counts & Health 00:03:23 - Sperm Health & Epigenetics 06:40 - Male Fertility Crisis 10:00:00 - Factors Impacting Sperm Quality 13:48 - Paternal Stress & Sperm Health 17:27 - Sperm Health: Biomarker of Well-being 23:45 - Boosting Sperm Health 34:34:58 - 90-Day Improvement Plan Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/ Sign up for our newsletter! https://drchristiangonzalez.com/newsletter/

In this episode, I sat down with Dr. Heather Sandison to talk about something that needs more attention Alzheimer's disease, and whether it can actually be reversed. She challenges the conventional belief that it's irreversible and dives into how environmental toxins, poor lifestyle habits, and hidden infections can drive cognitive decline. We broke it all down using the acronym "TNSSS-I" — Toxins, Nutrients, Stressors, Structure, Signaling, and Infections. Dr. Sandison shares powerful recommendations: an organic ketogenic diet, dual-task exercises, proper sleep, and detoxing from things like heavy metals, mold, and chemicals. We also touched on gut health, oral hygiene, blood sugar balance, and the role of APOE gene testing. If you've been impacted by Alzheimer's or want to protect your brain for the long run this episode gives you the practical tools and real hope. #alzheimer #wellness #antiaging Dr. Heather Sandison IG: @dr.heathersandison ==== Thank You To Our Sponsors! Calroy Head on over to at calroy.com/drg and Save over $50 when you purchase the Vascanox and Arterosil bundle at https://calroy.com/rachel. Cornbread Hemp Head to cornbreadhemp.com/DRG and use code DRG at checkout for a special discount—Cornbread Hemp: This is the good life. ==== Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/ Sign up for our newsletter! https://drchristiangonzalez.com/newsletter/

In this episode of Heal Thyself, I dive deep into the hidden dangers of deodorants—specifically the presence of PFAS, also known as “forever chemicals.” A recent study by Mamavation (March 2025) revealed that 40% of tested deodorants contained PFAS, with some brands showing shockingly high levels—Little Seed Farm came in at 103 ppm. I break down which brands passed and failed PFAS testing and explain why this matters—PFAS can be absorbed through the thin skin of the underarm, leading to serious health issues like cancer, infertility, and thyroid dysfunction. I also share actionable detox strategies you can use right now, including sweating regularly, taking binders, staying hydrated, and supporting your liver. I strongly recommend avoiding the following brands due to PFAS concerns: Little Seed Farm, doTERRA, Dr Teal's, Lume, Hello, Kopari, and Secret. Instead, here are some safer deodorant alternatives I trust: Bello Tallow, Primally Pure, Pretty Frank, and Truvani. Don't forget to check your product labels for synthetic fragrances, aluminum salts, and other toxic ingredients. #deodorant #toxic #productreview ==== Thank You To Our Sponsors! BiOptimizers Go to https://bioptimizers.com/drg and use promo code DRG10 to get 10% any order. LMNT Visit DrinkLMNT.com/DRG to claim your free sample pack for Heal Thy Self listeners only. ===== 00:00:00 - Deodorant's PFAS Dangers 03:18 - PFAS Detox & Health Risks 06:29 - Deodorant Dangers: PFAS Concerns 09:42 - Contaminated Deodorants & PFAS 13:01 - Detox Strategies for PFAS 16:12 - Safe Deodorant Buying Guide 19:51 - Safe Ingredients & Detox Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/ Sign up for our newsletter! https://drchristiangonzalez.com/newsletter/

In this powerful conversation, Dr. G is joined by renowned bioenergetics expert Dr. Sue Morter to explore the missing link in modern medicine: energy. Together, they break down how disruptions in energetic flow—often caused by subconscious blocks, unresolved trauma, and negative self-perception—can manifest as physical and mental illness. Dr. Morter shares her groundbreaking approach to healing, offering practical techniques like slow belly breathing and her signature “object-subject” energy exercise. These tools help listeners rewire their internal energy systems, reclaim personal power, and activate the body's natural self-healing capabilities. The episode also dives into the role of childhood trauma, epigenetics, and the mind-body connection in the development of chronic disease, including cancer. Dr. G and Dr. Morter emphasize the importance of self-awareness, authenticity, and cultivating a positive internal environment to support lifelong health. #wellness #mentalhealth #healing Episode Resources: https://drsuemorter.com Free Extravaganza happening on April 26 https://nt113.isrefer.com/go/HYHYLExtra/Healthyself/ Heal Your Self Page https://nt113.isrefer.com/go/HYHYL/Healthyself/ ==== Thank You To Our Sponsors! Puori Click here https://puori.com/drg and use code DRG for 20% off the already discounted subscription prices. Birch Click here https://birchliving.com/healthyself to get 20% off your Birch mattress plus two free pillows. ==== Timestamps: 00:00:00 - Subconscious Healing & Energy Medicine 06:48 - Surrender, Healing, & Evolution 13:33 - Body's Energy & Trauma's Impact 17:06 - Fitness, Supplements & Mattress Advice 23:29 - Feminine Energy Blockages & Healing 36:19 - Cancer: Energetic & Psychosomatic Aspects 42:56 - Energy Flow & Epigenetics in Disease 49:30 - Reclaiming Your Energy & Power 56:07 - Breathing Exercises for Energy Flow 01:01:09 - Life Changes, Healing & Gratitude Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/

In this episode, Dr. G dives deep into the ancient and modern science of semen retention. He explores its historical roots in traditions like Taoism and Hinduism, where semen was seen as a sacred life force, and contrasts that with today's research—some of which links frequent ejaculation (21+ times per month) to a reduced risk of prostate cancer. Dr. G breaks down the short-term effects of retention, such as possible testosterone surges, and takes a clear-eyed look at the long-term data—revealing there's no strong evidence for sustained physiological benefits. At the same time, he explores the spiritual and energetic practices that have long been paired with retention, including breathwork, meditation, and intentional abstinence. #menshealth #fertility #wellness ==== Thank You To Our Sponsors! LMNT Visit DrinkLMNT.com/DRG to claim your free sample pack for Heal Thy Self listeners only. BON CHARGE Go to https://boncharge.com/products/red-light-face-mask and use code DRG for 15% off storewide ==== Timestamps: 00:00:00 - Ancient Wisdom & Modern Science 05:11 - Semen Retention Across Cultures 06:37 - Red Light & Retention Science 09:15 - Science vs. Anecdotes 13:01 - Science, Spirituality & Choice 16:25 - Benefits, Risks & Practices 19:45 - Benefits & Cautions 23:05 - Personal Choice, Not Rules Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/

In this podcast Dr. Jenelle Kim, a ninth-generation Traditional Oriental Medicine practitioner, explains how she assesses a patient's health through observation, pulse, and tongue diagnosis, focusing on the balance of yin and yang. She details the concept of yin and yang, explaining how imbalances manifest physically and emotionally, providing examples like dry, cracked tongues (yin deficiency) and fat, wet tongues (spleen deficiency). The interview explores the importance of Qi (vital energy), its flow through meridians, and how stagnation leads to various health problems. Dr. Kim emphasizes the three M's: medicine, movement (like Qigong), and meditation (mindset), highlighting the crucial role of self-awareness and self-regulation in maintaining balance and preventing burnout. #chinesemedicine #naturalmedicine #healing ==== Dr. Jenelle Kim IG: @drjenellemkim ==== Thank You To Our Sponsors! Timeline Timeline is offering 10% off your order of Mitopure! Go to timeline.com/DRG. BiOptimizers Go to https://bioptimizers.com/drg and use promo code DRG10 to get 10% any order. Cornbread Hemp Go to cornbreadhemp.com/drg for 30% off your first order with code DRG ==== Show Notes: 00:00:00 - Holistic Well-being & Chinese Medicine 06:00 - Traditional Oriental Medicine 11:02:53 - Qi, Stagnation, & Body Flow 15:48 - Supplements & Yin Deficiency 21:07 - Dampness & Environmental Impact 28:30 - Holistic Wellness Practices 36:39 - Mindful Living & Parenting 43:05 - Maintaining Balance & Longevity 54:37 - Integrative Cancer Treatment 01:07:54 - Expert Interview: Longevity Potions Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/

Studies show mouth breathing is linked to increased cavities, periodontal disease, sleep apnea, and higher stress levels, while nasal breathing offers numerous advantages including improved oxygenation, nitric oxide production, and better sleep.  Mouth taping, by encouraging nasal breathing, may alleviate these issues. Dr. G discusses how mouth taping works, its potential benefits (improved sleep, reduced snoring, better athletic performance, reduced anxiety), who should and shouldn't try it, how to choose a safe product, and caution for proper usage.  #sleep #mouthtape #breathing === Thank You To Our Sponsors! Puori  Click here https://puori.com/drg and use code DRG for 20% off the already discounted subscription prices. Calroy Head on over to calroy.com/drg and Save over $50 when you purchase the Vascanox and Arterosil bundle at https://calroy.com/rachel. === Show Notes: 00:00:00 - Mouth Taping: Fact or Fad? 05:33 - Nasal Breathing Benefits 09:37 - Sleep, Apnea & Performance 13:08 - Mouth Taping: Benefits & Risks 16:15 - Mouth Taping Cautions

Dr. Brian Licuanan, a psychologist, discussing the root causes of anxiety, depression, and addiction. Dr. Licuanan emphasizes that addiction stems from attempting to alleviate pain, often rooted in unresolved childhood trauma. He offers practical advice for parents on identifying early signs of addiction in children, stressing open communication and engaging with their children's interests. #anxious #wellness #addiction Dr. Brian Licuanan @drlicuanan ==== Thank You To Our Sponsor! Jaspr Go to jaspr.co/DRG and use code DRG for $300 off for a limited time. ==== Timestamps: 00:00:00 - Addiction, Anxiety, and Purpose 03:28 - Addiction: Root Causes & Signs 07:08 - Engaging Kids Through Interests 10:24 - Understanding Kids' Communication 13:21 - Family Tech & Air Quality 16:25 - Youth Mental Health Impacts 19:48 - Anxiety & Celebrity Influence 22:37 - Men's Struggles & Social Media 25:15 - Childhood & Self-Worth 29:13 - Power of Self-Talk 38:04 - Mindfulness & Acceptance 44:37 - Finding Life's Purpose

In this video, Dr. G explores the alarming rise in allergies and offers natural solutions. Dr. G discusses the hygiene hypothesis – how overly clean environments weaken immune systems, leading to increased allergy and autoimmune disease risk. He highlights the dangers of conventional allergy medications and advocates for a holistic approach, emphasizing the importance of early childhood exposure to diverse environments and gut health. The video details five science-backed natural allergy remedies: quercetin, stinging nettle, butterbur, bromelain, and N-acetylcysteine, explaining their mechanisms of action and recommended dosages. #allergies #natural #wellness ==== Thank You To Our Sponsor! Jaspr Go to jaspr.co/DRG and use code DRG for $300 off for a limited time. ==== Timestamps: 00:00:00 - Allergies: Hygiene Hypothesis 05:07 - Immune System & Environment 06:23 - Air Quality & Home Health 09:26 - Quercetin & Nettle for Allergies 12:31 - Natural Allergy Remedies 15:40 - NAC, Allergies & Immunity Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/

Are you struggling with sexual disconnect or intimacy issues? In this insightful episode, we delve into the often-overlooked role of shame in hindering sexual pleasure and healthy relationships. Dr. Emily Morse, renowned sex therapist and podcast host, joins us to explore practical solutions and empowering strategies for a more fulfilling sex life. #sexlife #wellness #intimacy Emily Morse IG:  @SexWithEmilyOfficial  ==== Thank You To Our Sponsors! BON CHARGE Go to https://boncharge.com/products/ use code DRG for 15% off storewide LMNT Visit DrinkLMNT.com/DRG to claim your free sample pack for Heal Thy Self listeners only. Calroy Head on over to at calroy.com/drg and Save over $50 when you purchase the Vascanox and Arterosil bundle at https://calroy.com/rachel. ==== Timestamps 00:00:16 - Shame, Pleasure & Sexual Health 05:41 - Shame's Impact on Sex 09:24 - Shame & Disconnected Sex 15:10 - Improving Sexual Wellness 21:54 - Better Sexual Communication 27:49 - Female Orgasm & Pressure 31:44 - Vascular Health & Supplements 37:29 - Understanding Sexual Needs 40:02 - Maintaining Sexual Intimacy 48:38 - Embodied Presence & Positivity 51:22 - Pleasure, Empowerment & Events Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/

In this deeply personal and reflective episode of Heal Thyself, we explore the transformative experience of attending a men's retreat. Dr. G opens up about his journey of emotional growth, nervous system healing, and the importance of true masculine connection. He shares powerful insights on the emotional struggles men face, the lack of real community, and how healing in a brotherhood setting can change lives. #men #lonelines #wellness ==== Thank You To Our Sponsors! Puori  Click here https://puori.com/drg and use code DRG for 20% off the already discounted subscription prices. BiOptimizers Go to https://bioptimizers.com/drg and use promo code DRG10 to get 10% any order.  ==== Show Notes: The importance of sharing and supporting Heal Thyself to expand life-changing knowledge. Dr. G's experience attending a men's retreat hosted by Meld Men. Observations on the emotional struggles men face in isolation. The lack of deep, meaningful male friendships and emotional support systems. How vulnerability and emotional embodiment define true masculinity. The healing power of brotherhood and how it transforms personal and family life. The societal expectation of men to suppress emotions and the impact on mental health. The importance of finding a supportive community for emotional well-being.

Discover the hidden dangers of antacids, the critical role of nitric oxide in health, and how to naturally boost its production for longevity and disease prevention. In this deep dive, we explore the science behind gut health, nutrient deficiencies, the oral microbiome, and cutting-edge biohacking strategies. Learn how lifestyle choices, diet, and supplements impact nitric oxide levels and overall well-being. Don't miss this essential guide to optimizing your health from the inside out! #nitricoxide #disease #wellness Dr. Nathan Bryan IG: @drnathansbryan ==== Thank You To Our Sponsors! Birch Click here https://birchliving.com/healthyself to get 20% off your Birch mattress plus two free pillows. Jaspr Go to jaspr.co/DRG and use code DRG for $300 off for a limited time. ==== Timestamps: 00:00:00 - The Danger of Antacids and Inhibiting Stomach Acid 00:00:38 - Nitric Oxide: The Molecule Connected to All Disease 00:03:28 - How to Stimulate and Activate Nitric Oxide Production 00:06:11 - Nitric Oxide's Implication in Longevity and Telomeres 00:07:28 - Restoring Nitric Oxide Production for Biohacking 00:09:45 - Three-Step Activation of Nitric Oxide 00:11:42 - Decline in Micronutrients in Food Over Time 00:13:28 - Naturopathic Philosophy: Give the Body What It Needs 00:17:56 - Restrictions on Adding Nitrogen-Based Fertilizer 00:20:01 - Growing Your Own Food and Soil Samples 00:23:23 - The Oral Microbiome and Nitric Oxide Production 00:25:10 - The Effects of Mouthwash and Fluoride on Blood Pressure 00:29:06 - Cardio Smile Toothpaste 00:30:44 - Suppressing Stomach Acid and Nitric Oxide Production 00:33:47 - Overcoming Heartburn with Apple Cider Vinegar 00:35:26 - SPECT Scans and Brain Perfusion 00:37:23 - Alzheimer's as a Metabolic Disease 00:39:54 - Nasal Breathing and Oxygenation 00:42:09 - Nitric Oxide Is a Gas 00:44:28 - Developing Safe and Effective Drug Therapy 00:47:14 - Destroying Nitric Oxide Production 00:48:47 - The Book Launch Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/

Cold water immersion has taken the wellness world by storm, but is it safe for women? In this video, Dr. G breaks down the science of cold exposure, how it affects hydration, hormones, and nervous system regulation, and when it can do more harm than good. Learn how to do it safely, the best techniques, and who should avoid it. Don't jump into cold tubs without watching this first. ==== Thank You To Our Sponsors: LMNT Visit DrinkLMNT.com/DRG to claim your free sample pack for Heal Thy Self listeners only. Cornbread Hemp Cornbread Hemp Head to https://cornbreadhemp.com/drg and use code DRG at checkout. ==== Timestamps: 00:00:00 - Cold Tub Considerations for Women 00:01:28 - Introduction to Cold Water Immersion 00:02:35 - The Trending Popularity of Cold Water Immersion 00:04:07 - The Importance of Hydration and Electrolytes 00:06:21 - The Body's Shock Response to Cold Water 00:08:55 - Benefits of Cold Water Immersion 00:13:15 - Who Should Avoid Cold Water Immersion 00:16:19 - Cold Tubs and Pregnancy 00:18:50 - Starting with Cold Showers 00:19:49 - Breathing Techniques and Wim Hof 00:21:56 - Pay Attention to Your Body's Recovery 00:22:49 - Contrast Immersion in the Shower 00:23:58 - The Psychological Factor of Cold Water Immersion 00:27:41 - Final Thoughts Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/

Your nervous system plays a powerful role in your relationships, attachment patterns, and emotional health. In this episode, Dr. G sits down with Dr. Jessica McGuire to explore childhood attachment, generational trauma, and how to build healthier connections by understanding your body's signals. #wellness #podcast #childhood Dr. Jessica McGuire IG: @ repairing_the_nervous_system ==== Thank You To Our Sponsors! BON CHARGE Go https://boncharge.com/ to and use code DRG for 15% off storewide SuppCo Get 100% free access today at supp.co/ DRG Birch Click here https://birchliving.com/healthyself to get 20% off your Birch mattress plus two free pillows. Calroy Head on over to at calroy.com/drg and Save over $50 when you purchase the Vascanox and Arterosil bundle at https://calroy.com/rachel. ==== Timestamps: 00:01:54 - Attachment Patterns and Nervous System States 00:05:45 - Abandoning Yourself in Relationships 00:06:04 - The Role of Safety and Attachment in Childhood 00:09:17 - Interoception and Its Importance 00:11:30 - Impact of Narcissistic Parents on Children's Nervous Systems 00:13:01 - Developing Awareness of Your Nervous System 00:14:42 - Generational Trauma and Over-Coddling Children 00:18:02 - The Importance of Allowing Children to Feel Sadness 00:21:06 - Balancing Children's Emotions with Parental Mental Health 00:24:03 - Good Enough Parenting and Repairing Ruptures 00:26:39 - Making Children Feel Secure and Connected 00:31:31 - Misbehavior as a Bid for Connection 00:33:39 - Parenting and Accountability 00:34:18 - The Newborn's Nervous System and the Mother's Role 00:45:26 - The Impact of Home Environment on the Nervous System 00:48:21 - Understanding the Vagus Nerve 00:57:23 - The Nervous System of a Narcissistic Parent 01:06:15 - External Factors That Deregulate Us 01:08:29 - The Sophisticated Intelligence of the Nervous System 01:11:21 - Conclusion and Gratitude Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/

Want to live longer and feel better? Dr. G breaks down the top 5 science-backed strategies to increase longevity and boost your health. From strength training to cardiovascular fitness, social connections, and better sleep, this is your ultimate guide to aging well. Plus, learn about key supplements that can support your journey! #health #antiaging #wellness  ==== Thank You To Our Sponsors!  Timeline  Visit https://timelinenutrition.com/drg and use code DRG to get 10% off BiOptimizers Go to https://bioptimizers.com/drg and use promo code DRG10 to get 10% any order.  ==== Timestamps: 00:00:00 - Introduction: The Importance of Muscle Mass and Longevity 00:01:00 - The Five Evidence-Based Ways to Extend Your Life 00:02:33 - #5: Strength Training for Longevity 00:09:36 - #4: Sleep Quality and Duration 00:11:36 - #3: Caloric Restriction and Fasting 00:15:14 - #2: Social Connection and Purpose 00:18:26 - #1: Cardiovascular Fitness 00:20:14 - Conclusion: Taking Control of Your Longevity

In this episode, we dive deep into somatic therapy with Hala Khouri—the key to healing beyond traditional talk therapy. We explore how the body holds trauma, the power of rewilding, and how reconnecting with our physical selves can transform mental health. Hala Khouri  IG: @halakhouri_somatics ==== Thank You To Our Sponsors!  Jaspr Go to jaspr.co/DRG and use code DRG for $300 off for a limited time. Puori  Click here https://puori.com/drg and use code DRG for 20% off the already discounted subscription prices. ==== Timestamps: 00:00:04 - Introduction to Somatics and Mental Health 00:02:12 - Somatics: Finding Home in Your Body 00:07:49 - Rewilding Ourselves: Reconnecting with Ancient Practices 00:13:15 - The Wisdom Within: Honoring Your Body's Needs 00:16:49 - The Body Keeps the Score: Imprints of Experiences 00:22:52 - Finding Purpose When Your Nervous System is Dysregulated 00:29:01 - Physical Healing Through Somatic Practices 00:34:17 - Strengthening Relationships Through Deeper Feelings 00:42:52 - Bringing More Community to Ourselves 00:49:02 - Leaning into What Feels Good and Safe 00:54:23 - Signs That Somatic Process is Working 00:58:52 - Where to Find Hala

In this episode, Dr. G dives deep into some of the most controversial health trends—raw milk, the carnivore diet, alkaline water, sunscreen myths, and even the dangerous trend of dry scooping pre-workouts. Are these trends backed by science, or are they just clever marketing? Dr. G breaks it all down with research, safer alternatives, and the real impact on your health. Don't fall for the hype—watch this before trying any of these trends! #carnivore #diet #wellness ==== Thank You To Our Sponsors! SuppCo Listeners can get 100% free access today at supp.co/DRG. Jaspr Go to jaspr.co/DRG and use code DRG for $300 off for a limited time. ==== Timestamps: 00:00:00 - Raw Milk Safety Concerns 00:03:52 - Carnivore Diet: Science vs Hype 00:07:16 - Research on the Carnivore Diet 00:12:55 - Essential Nutrients and the Carnivore Diet 00:14:30 - Raw Milk: Nutrient-Rich or Bacteria Bomb? 00:16:28 - Science Behind Raw Milk 00:19:29 - Alkaline Water: Scam or Solution? 00:22:35 - Sunscreen Myths and Skin Cancer 00:27:49 - Dangers of Misinformation About Sunscreen 00:28:34 - Dry Scooping Pre-Workouts: Heart Attack in a Scoop? 00:31:45 - Health is Not One Size Fits All Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/

Navigating difficult conversations, emotional regulation, and personal growth, this episode covers it all. Dr. G sits down to discuss the power of psychological immunity, handling disagreement with grace, and why people just want to be seen and heard. From emotional dysregulation and cold water therapy to building deeper connections and understanding the mind-body connection, this episode is packed with insights to help you become more resilient in life and relationships. #emotionalhealth #wellness #spirtuality Jeff Krasno IG: @jeffkrasno ==== Thank You To Our Sponsors! LMNT Visit DrinkLMNT.com/DRG to claim your free sample pack for Heal Thy Self listeners only. BiOptimizers Go to https://bioptimizers.com/drg and use promo code DRG10 to get 10% any order. Calroy Head on over to at calroy.com/drg and Save over $50 when you purchase the Vascanox and Arterosil bundle ==== Show Notes: Interviewing People Who Disagree with Me Applying Physiological Stressors Writing About Controversial Issues Dealing with Negative Emails Growing Up as a People Pleaser Building Psychological Immunity Creating a Safe Space for Difficult Conversations People Just Want to Be Seen and Heard Having Difficult Conversations with Loved Ones Healing Yourself Before Healing Relationships Somatic Practices for Emotional Regulation Cold Water Therapy and Emotional Resilience Emotional Regulation and Mental Resilience Seeking Connection, Not Solution Listen to Understand, Not to Respond Dousing the Flames of Anger The Mind-Body Connection The Stress of Unresolved Conversations The Hard Work of Intimacy Bridging Mysticism and Medicine Studying the Physical to Understand the Spiritual Agency Over Your Fate The Philosophy of the Middle Way Good Stress and Healthier Homeostasis Personal Health Transformation Social Fitness and Mental Health Good Stress Book Coming Out Social Media and Website Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/

Is social media hijacking your brain? In this video, we break down how constant phone usage and social media exposure rewire your brain, affect your dopamine levels, and impact your mental and physical health. Learn how to regain control with dopamine fasting, digital detox strategies, and practical tips to reset your brain for focus, balance, and overall well-being. #phone #socialmedia #mentalhealth ==== Thank You To Our Sponsors! BON CHARGE Go to https://boncharge.com/products/red-light-face and use code DRG for 15% off storewide ==== Sign Up For Our Newsletter: https://drchristiangonzalez.com/newsletter Show Notes: Introduction: The Impact of Phone Usage Prioritizing Dopamine Fasting and Digital Detox Setting Time Limits on Social Media Understanding How Phones Rewire the Brain Regaining Autonomy of Your Brain The Striatum and Habit Formation Dopamine Receptors and Social Media Use How Social Media Platforms Hack Your Focus Social Media as a Toxin Constant Social Media Exposure and Fight or Flight Melatonin Suppression Rewiring and Regaining Balance Setting Time Limits and Restoring Balance The Importance of Blue Light Blockers Increasing Real Life Oxytocin The Benefits of Sunlight Brain Reset Challenge Final Thoughts and Gratitude Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/

Dr. G and Dr. Cathleen King explore the complexities of nervous system regulation and healing. Together, they delve into personal experiences, including the effects of environmental stressors like mold and digital technology on our nervous systems. The episode covers practical tools for rebalancing, including eye yoga, breathwork, and somatic practices that help individuals reconnect with their bodies. They also discuss the importance of forgiveness, identity shifts, and mental disruptions in the healing process. Tune in for a deep dive into how to reset your nervous system and reclaim your health. #wellness #nervoussystem #anxietyrelief Dr. Cathleen King IG: @primaltrust_official ==== Thank You To Our Sponsors! SuppCo Listeners can get 100% free access today at supp.co/DRG. Cornbread Hemp Head to https://cornbreadhemp.com/drg and use code DRG at checkout. ==== Show Notes: Introduction: Healing the Nervous System Personal Experience: Mold and Nervous System Overdrive Practical Tools: Rebalancing the Nervous System Eye Yoga: Using Eye Exercises for Brain Stimulation Cell Phones: A Dysregulating Influence Symptoms of Dysregulation Tool for Breath: The Voo Breath Nervous System: Mental Disruptions and Contractions Identity: Chronic Disease & Creating Our Reality Nervous System: External Toxins Retraining: The World is Safe Forgiveness: Letting Go of Past Relationships Shame & Religious Trauma Cartman's Triangle: Victim, Perpetrator, Savior Relationships: Attachment Wounds Dimensional Shift: Mindset & Spiritual Connection Primal Trust: Regulating Everything Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/

Most people think weight gain is all about diet and exercise—but what if something else is secretly making you fat? In this episode, Dr. G exposes obesogens—environmental toxins hiding in your food, water, and everyday products that hijack your metabolism, disrupt hormones and make fat loss nearly impossible. #diet #toxins #wellness ==== Thank You To Our Sponsors! BiOptimizers Go to https://bioptimizers.com/drg and use promo code DRG10 to get 10% any order. Puori Click here https://puori.com/drg and use code DRG for 20% off the already discounted subscription prices. ==== Show Notes: Introduction to Obesogens and Weight Gain Binding and Eliminating Toxins: Activated Charcoal and Fiber-Rich Foods Liver Detoxification: Sulforaphane Understanding Obesogens and Their Impact on Metabolism What are Obesogens? Research on Obesogens and Their Effects Where are Obesogens Found? Avoiding Obesogens: Plastics, Personal Care Products, and Home Building Materials Ditching Plastic Food Storage Avoiding Plastic Water Bottles and Canned Foods Choosing Safe Personal Care Products and Organic Foods Filtering Water and Eating Pasture-Raised Meats Avoiding Non-Stick and Stain-Resistant Chemicals Choosing Natural Fibers and Avoiding Water-Resistant Gear Avoiding Fragrances and Synthetic Chemicals Heavy Metals as Obesogens Avoiding Heavy Metals: Seafood, Lipstick, and Eyeliners Integrative Detox Protocols for Obesogens Binding and Eliminating Obesogens: Activated Charcoal and Fiber Supporting Liver Detoxification: Glutathione, Milk Thistle, and Sulforaphane Dandelion Root and Sweating it Out Restoring Gut Health and Hormonal Balance The Missing Piece to Weight Loss: Detoxing Obesogens Emotional Repression and Weight Gain Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/

In this episode, Dr. G and Naz Perez engage in a candid and wide-ranging conversation, exploring topics from hormonal health and gut issues to the emotional impact of community and movement therapy. They dive into the intersection of anxiety, the vagus nerve, and holistic well-being while also discussing the evolving entertainment industry, the role of AI, and personal experiences as a Latina in media. The conversation takes a metaphysical turn with discussions on alien activity, human evolution, and consciousness. Throughout, Dr. G and Naz share insights, personal growth stories, and thought-provoking perspectives, making for an enlightening and dynamic discussion. #wellness #spirtuality #podcast Naz Perez Instagram @NAZPEREZ === Thanks To Our Sponsors! Timeline Visit https://timelinenutrition.com/drg and use code DRG to get 10% off OurPlace Visit https://fromourplace.com and use code DRG to receive 10% off. Birch Click here https://birchliving.com/healthyself to get 20% off your Birch mattress plus two free pillows. === Show Notes: Discussion of hormone imbalances and estrogen dominance Exploration of gut health issues including SIBO and IMO The connection between anxiety, gut health, and the vagus nerve Importance of testing hormone levels in conventional medicine Using movement and dance as therapy Processing emotions through music (classical music for sadness, Tchaikovsky for anger) Impact of community on personal health and wellness Discussion of emotional repression (anger in women, sadness in men) Changes in the industry due to social media and AI Future of creative work and authenticity Movie recommendations Personal experiences as a Latina in entertainment Alien Activity in New Jersey The Cassiopean Experiment Human evolution speculation Discussion of consciousness and personal agency Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/

In this episode, Dr. G and Naz Perez engage in a candid and wide-ranging conversation, exploring topics from hormonal health and gut issues to the emotional impact of community and movement therapy. They dive into the intersection of anxiety, the vagus nerve, and holistic well-being while also discussing the evolving entertainment industry, the role of AI, and personal experiences as a Latina in media. The conversation takes a metaphysical turn with discussions on alien activity, human evolution, and consciousness. Throughout, Dr. G and Naz share insights, personal growth stories, and thought-provoking perspectives, making for an enlightening and dynamic discussion. #wellness #spirtuality #podcast Naz Perez Instagram @NAZPEREZ === Thanks To Our Sponsors! Timeline Visit https://timelinenutrition.com/drg and use code DRG to get 10% off OurPlace Visit https://fromourplace.com and use code DRG to receive 10% off. Birch Click here https://birchliving.com/healthyself to get 20% off your Birch mattress plus two free pillows. === Show Notes: Discussion of hormone imbalances and estrogen dominance Exploration of gut health issues including SIBO and IMO The connection between anxiety, gut health, and the vagus nerve Importance of testing hormone levels in conventional medicine Using movement and dance as therapy Processing emotions through music (classical music for sadness, Tchaikovsky for anger) Impact of community on personal health and wellness Discussion of emotional repression (anger in women, sadness in men) Changes in the industry due to social media and AI Future of creative work and authenticity Movie recommendations Personal experiences as a Latina in entertainment Alien Activity in New Jersey The Cassiopean Experiment Human evolution speculation Discussion of consciousness and personal agency Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/

Dr. G explores the science of human connection, breaking down how social bonds impact health, why loneliness is a hidden epidemic, and how to build meaningful relationships. Learn how connection shapes well-being and discover practical steps to create a healthier, more fulfilling life. #community #wellness #lonliness ==== Thank You To Our Sponsors! SuppCo Get 100% free access today at supp.co/DRG Jaspr Go to jaspr.co/DRG and use code DRG for $300 off for a limited time. ==== Timestamps: 00:00:00 - Importance of Community and Social Connection 00:00:59 - Practical Steps to Rekindle Relationships 00:01:42 - Evolutionary Roots of Social Bonds 00:02:37 - Importance of Knowledge Transfer in Communities 00:03:34 - Biological Imperative of Social Bonds 00:04:12 - Role of Oxytocin in Social Connections 00:04:59 - Managing Stress Through Social Connections 00:08:06 - Shift from Close-Knit Communities to Individualism 00:09:04 - Importance of Face-to-Face Interactions 00:09:58 - Health Risks Associated with Social Isolation 00:11:12 - The Connection Between Nervous, Hormonal, and Immune Systems 00:12:26 - Building Community for Better Health 00:13:52 - Leveraging Technology for Relationships 00:14:29 - Understanding the Loneliness Epidemic 00:15:15 - You Deserve Community and Connection Be sure to like and subscribe to #HealThySelf Hosted by Doctor Christian Gonzalez N.D. Follow Doctor G on Instagram @doctor.gonzalez https://www.instagram.com/doctor.gonzalez/