BONUS: "The Sympathetic Spiral of Doom!” – The Fastest Way To Reset Your Nervous System & End Burnout with Dr. Scott Sherr | Menopause, Perimenopause & Mental Health

Welcome to Everyday Wellness Podcast. I'm your host, nurse practitioner, Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives. today i had the honor of reconnecting with dr scott share this is one of my highly vetted podcast interviews focused on dr scott shares company called troscriptions as i've stated earlier this is our third discussion he is a board certified internal medicine physician with an additional certification, hyperbaric oxygen medicine. He is the CEO of Troscriptions, which is a line of physician-formulated, pharmaceutical-grade and precision-dosed, buckled trochies containing novel ingredients like methylene blue, arrogant, and others in formulas for energy, focus, sleep, stress, immune support, and more. Today, we spoke at length about the sympathetic spiral of doom and how mitochondrial dysfunction fuels chronic stress, disrupts GABA signaling and what we can do about it, the capacity of energetics and mitochondrial health, the role of detox and methylene blue, GABA stress in the midlife brain, the importance of the vagus nerve and parasympathetic tone, how taking oral GABA and having it be effective can be a sign of leaky brain, the impact of sleep, and my personal favorite, rapid fire questions. This is one of these invaluable conversations that you will likely listen to more than once. Dr. Scott Sher, such a pleasure to have you back on the podcast. Cynthia, good to see you. And thank you for having me again. We have so much simpatico about where we grew up and where we trained. And before we started recording, we were talking about some terminology that you have framed that I think is particularly relevant to my community, especially to middle-aged women. Talk to me about the sympathetic spiral of doom. What is this? And like, what is the reframe that we can take from this in this kind of crucial time in our lives where there is so much flux between the health of our mitochondria and hormones and neurotransmitters and how we navigate this stage of our lives into subsequent decades? So there's two ways to describe what you've just described. And I don't want to get everybody, you know, scared, but it's important to sometimes understand what's happening from a holistic way, a holistic picture, and then from there be able to kind of break it down. So the sympathetic spiral of doom is sort of like the dun-dun-dun of the whole thing. But the other way to talk about this is what I also say is sort of on the positive, which is called the parasympathetic edge. And so what I mean by that is that when your nervous system is more relaxed in general, you have more capacity. Now, so that's the whole framing as we talk about this. But it's important to kind of define terms, right? So sympathetic spiral of doom. The spiral of doom, people can pretty much understand what that means. Like you're in a spiral. Things aren't going well. and you don't really know how to get out of it. You may not even know you're in it to some degree, which is actually the hard part, but it's happening. And you know things aren't going as well as they used to. You don't recover as well from the things you used to recover easily from. You can't stay up a little bit later. In the morning, you're groggier. You work out, you don't exercise as easily. You injure yourself more. You just can't keep kind of going on. Like every time you go to the gym, you hurt something else. Or you get off an airplane and you're like, you're feeling terrible for three days where it wasn't usually an issue. You have a drink of alcohol and you're trashed for the entire next day. You have more mood instability where you don't have the capacity to maintain your mood as you used to. Like you'll just suddenly be, and this is not just related to your menstrual period. These are just unusual things that are happening. So what I'm describing to you is some of the symptoms of what this is, right? And then this spiral is sort of at its main core related to two different things, okay? which is your sympathetic nervous system and the part of your cell called your mitochondria, okay? And the sympathetic nervous system is your fight-or-flight nervous system. It's a nervous system that's supposed to be active when you are preferably running away from the saber-toothed tiger. This is like the strange medical analogy that we always give, but in general, sympathetic nervous system is supposed to be activated when we need to do something very fast, very strenuous, very quickly to get away from something that's chasing us, for example. Okay. However, in modern world, we don't have those kinds of stimuli. We're not running away from tigers for the most part, but we are running away from our kids, our parents, our relationships, our job, or running towards them or having a lot of stress related to them that's activating the sympathetic nervous system. And it's giving you this, oh shit, feeling more of the time. Okay. And so most of us are running around with a sympathetic nervous system that's always on this fight or flight when what we should be doing is more on the other side of our nervous system, which is called our parasympathetic nervous system, which is our rest, digest, detoxify, and heal nervous system. This is where we do all of the, you know, this is where we actually do a lot of our healing and detoxifying. But a lot of us aren't spending a lot of time in there, okay? And so when that sympathetic nervous system is really elevated for long periods of time, what happens is you get all these hormones that get released, things like cortisol, you get neurotransmitters like norepinephrine and epinephrine that stimulate the system to start working harder because the system, your body, your mind always thinks you need to be on, on, on. This has a huge effect on the mitochondria, the part of the cell that makes energy. And that part of the cell tries to keep up. It tries to keep up with all the energy that you need, that you're asking it to make, cortisol is getting dumped into the system. It's like your hormone that helps actually in the short term breaks down fat and carbohydrates to give you energy. But then all that energy is being trying to be made by your mitochondria and your mitochondria start going into the shock mode. They can't keep up anymore. And it's something called the cell danger response. And so you have this period where you're trying to make more energy, but you can't. And then what happens is that as a result of not making enough energy because your mitochondria can't keep up. You get into this reactive sympathetic activation even more because you're trying to make more energy, trying to do more than your body really can, and you sort of throw yourself into this loop. So now you have sympathetic activation, mitochondrial dysfunction that kind of goes rolls and rolls and rolls into this spiral. and it can happen either from sympathetic stress things that are happening outside the body or it could happen because the body actually itself is being significantly changed during certain periods of your life for example where you were able to tolerate certain amounts of stress until you couldn't and so now you're in this place where you're in fight or flight more than most of the time your mitochondria aren't working very well your immune system isn't working very well and well, what do you do, right? And now you're going to your doctor saying, I feel like crap, and I don't know why. And I think on a lot of different levels, this is the point at which I see most of my patient population because they're cruising through their teens, 20s, 30s. A lot of these personality traits that contribute to being sympathetic dominant are what allow them to achieve and what allow them to succeed. And then suddenly, as we have alterations in hormones and neurotransmitters, suddenly we don't cope quite as well. And I was transparently sharing before we started recording, I suspect this is one of many reasons why I hit the wall of perimenopause without really having a firm understanding of what was happening. And I think for a lot of listeners, this is something they relate to, that what has allowed them to achieve and be so successful suddenly starts to kind of backfire. And I see a lot of the thyroid health experts talking about the cell danger response specific to thyroid hormone and how this is actually what's at play. It's less about the autoimmune piece. It might be more likely related to the cell danger response that's driving some overt, I don't dare I say epidemic of women having hypothyroidism in perimenopause and menopause. Do you see that within your own patient population as well that that could be what's contributing to the constellation of or incidence and prevalence of hypothyroidism that we're seeing in perimenopause in particular? I mean, I think what you're seeing is that at its base, Cynthia, everything sort of goes down to how well you can make energy or not. And if you can't make energy effectively, the system starts breaking down. And what is highly metabolic? One of the, your master regulator of metabolism is your thyroid, right? And so you're going to see manifestations of this in a lot of different ways, depending on the person, but also depending on the type of stress that the body's on under for long periods of time. And so what it comes down to is your mitochondria are making energy at all times. Like they make 150 pounds of ATP, of our energy currency every single day. That's how much you make. And so if you can't meet your energy demands and the system starts breaking down, and then what you're going to see it break down most commonly is in the places that have the most metabolic demands. so the thyroid is a big part of that the brain is a big part of this right and then you're also looking at even so your sexual organs ovaries sperm so fertility rates for example you know if are going down dramatically right because there's so many mitochondria per cell so the way i always think about this is like well in at its base we have mitochondrial dysfunction and whether it happens because you have direct impact on the mitochondria itself or it's because of the stress response that's going and going and going, right? The direct impact on the mitochondria is interesting, right? Because if you don't necessarily have to have sympathetic activation initially, right? What could happen is that you have a stress to your mitochondria directly. So a good example of this is, well, where did my hormones just go, right? And so where's the estrogen that was optimizing my mitochondrial function? It's not there anymore, not as much as it used to, or that it's going up and down like crazy, right? Where's the progesterone that was out there that was helping regulate my GABA system, that's also regulating my nervous system and helping me sleep. And then if I can't sleep, then my sympathetic nervous system and my mitochondria can be a significant activation there too. So the hormones play a big, big role here on regulating mitochondrial function, but also toxins on our environment, infections, medications that we're taking regularly, insulin resistance. So these are all things that have a significant effect on the mitochondria itself. And then as a result of having a detrimental effect on our ability to make energy. We don't have the capacity, but we need that capacity. We feel like we need it because we're doing all the things that we're trying to do. And then that's when this sympathetic loop really starts ramping up dramatically. What I always, it's interesting because when you work with somebody that has this sympathetic loop that's going on, you think, well, let me just give them some supplementation. Let me just give them HRT. That's going to work. Right. And HRT can be helpful, right? It can definitely be helpful, but it's usually not the only thing that needs to happen, right? Because you're in this sympathetic loop. So you need to look at it, not only from the giving HRT, for example, I had a practitioner of mine just a couple of days ago. I was just like, I had my patients on HRT, you know, everything looked good from a hormone perspective, but she still felt terrible. And then, well, well, what did you need to do here, right? You actually needed to think about things in a little bit more holistic way and actually work on the mitochondria itself. And if you looked at the mitochondria and we actually started some methylene blue on this particular patient, she did, my colleague, she's like, within a couple of days, they were back to completely feeling almost back to normal, right because the hrt helped but it wasn't the whole story right and i think that's what you're going to find with a lot of women in your network and in your group is like well i did hrt but i still feel like terrible or hrt made me feel better but i still feel xyz right because you still have this loop that's ongoing because you really have to think about this on both ends that's the deal right if you just look at like hrt on its own it can be very very helpful but you have to think about the mitochondria like how are they working how are they functioning and how can we look at that sympathetic side of things at the same time and see where we can kind of balance people? I think this is such a good point because as much attention as, and focus is on perimenopause and menopause right now, which I think is fantastic. And the discussion about hormone replacement therapy and peptides and supplements and lifestyle, all critically important. But I was saying to someone the other day, if you think just slapping on an estrogen patch is gonna fix all your problems, you're incredibly mistaken. And that is really what you're speaking to is that, yes, replenishing hormones is important, but there is a bigger picture, a bigger discussion that needs to be had. And when we're talking about down to a cellular level, it's helping everyone listening understand that all of these things ultimately impact whether or not our body can actually generate energy. And if we can't generate energy, putting on an estrogen patch or taking oral progesterone or using, you know, a tenth of a packet of androgel is not going to fix all these energy pieces. And so I love that you mentioned methylene blue. And I know that we've talked about this on previous podcasts, but for anyone who perhaps missed that second conversation that we had, what does methylene do specifically at the mitochondrial level that's so beneficial? And let me be very clear. One of the things I like, know, and respect about your work is that you are a practicing physician. And so all of your products are formulated specifically by physicians. We're not talking about just don't go buy liquid methylene blue online. And that's not what we're speaking to. We're looking therapeutic doses, appropriate doses that are used for mitochondrial health. So this is really an important question and an important topic here, Cynthia. And I think what my lead in here is that we're talking, and this is really important for those that are listening, we're talking about the capacity to make energy. But that's not the whole story. Okay. Not only the capacity to make energy, but also the capacity to harness that energy for the things that we need. And also then detox from the energy that we make. our cells are like gasoline powered cars we are not clean like your electric car machine like okay like we have we can have different arguments about electric cars are they clean and things like that but in general there's no exhaust from an electric car gasoline power cars have a gut have exhaust so we make atp our energy currency we make again a huge amount of this right as i mentioned a huge amount 150 pounds a day but we also make waste products in quotes we make carbon dioxide which we breathe off, right? So we need oxygen to help make energy. And we breathe off carbon dioxide. The plants take the carbon dioxide. They make oxygen. It's the beautiful cycle, right? That's how it's supposed to work. Then we also make water. Okay. No problem. This is structured water, interestingly, of course, and deuterium depleted if anybody cares. And then the next one, and we also make reactive oxygen species. These are called ROS free radicals. There's a number of other names for them, but free radicals, people pretty much understand. And these small reactive oxygen species, these free radicals, they're signaling molecules. They tell the mitochondria, do we make more energy? Do we make less energy? So for example, if you're just getting pummeled by sympathetic hormones with cortisol, epinephrine, norepinephrine, your cells are making all this energy, right? Trying to make all this energy. But they're also making all these waste products, these, in quotes, these reactive oxygen species. And what happens is that these ROS are building up. what you need are antioxidants in the body, specifically in the mitochondria in the cell that can help neutralize the stress of making energy. This is all well and good in your 20s, even sometimes in your 30s, if you're relatively healthy, right? Because you have enough capacity, but as you get older, your capacity is going to go down. Your antioxidant capacity is going to go down. So you're making all this energy and then you're trying to make all the, you're making all these waste products and you don't have enough capacity. So it happens on both ends, which is so, so important for people to hear is that as we get older, our capacity to make energy goes down. And this is because of the things I mentioned, insulin resistance, toxins, medications, you know, infections, that's all affecting your capacity to make the energy itself. And then on the other side of it, those things that I just mentioned are also causing an effect on your capacity to detoxify as well. And so in my world, the long game here, we have a nonprofit organization. It's called Health Optimization Medicine. We train practitioners like me, I'm trained in this, to optimize the health of my patients and clients that look at vitamins, minerals, nutrients, and cofactors that optimize the sympathetic nervous system and do this. But it takes a long time to get there It not like tomorrow somebody is going to feel better if they been feeling they 40 years old and they want to feel better tomorrow There are ways to give them things along the way, but it's going to take a longer time to truly optimize their health. And so Transcriptions was developed a company to help people right now along that path. And one of the main ways that we really saw very quickly as we've been talking about this whole podcast is that we have to work on energy production. We also have to work on energy detoxification. And the very cool thing about methylene blue specifically is that it can help somebody right now like an electric powered car, not like a gasoline powered car because it helps with the energy production side, but it also helps the detoxification at the same time. And this is so, so key. So for those that are listening that are like, oh, I just need to calm down my nervous system and everything's going to be okay. Number one, I will never tell my wife to calm down. That's never a good idea. Okay. I know very much from history, although I tend to repeat this, even though I know my history with my wife. Like if you tell somebody that you love, like a partner to calm down, that ain't going to work. Number one. But number two is that if you just look at calming down the nervous system, like so you're on, on, on all the time and you're clamped down. If you just try to calm down the nervous system without having some mitochondrial support, you're often going to feel terrible along the way. And I've seen this, like I was just talking to somebody recently. She's like, yeah, my doctor gave me some L-theanine and some other things to calm down my nervous system, but it made me feel so much worse because what happens is that your nervous system is trying to relax, but you have no energetic capacity to make energy or detox from the energy still. and so you're going to take off the gas pedal, but you're still, you're going to feel terrible along the way. And so the key with the process is when you're in this sympathetic spiral is to work on the mitochondria first. And by doing this, we're not talking about, you know, trying to make it perfect. It's not going to happen right away. It's going to take time. Vitamins, minerals, nutrients, optimizing your gut neurotransmitters hormones, that takes time. But what methylene blue can do is be that initial support while you're looking to see how you can break this pattern. And by methylene blue coming in as an electric power car, it helps with the energy side of things, helps you make energy. But it also helps exactly like something like an antioxidant, like vitamin C or alpha lipoic acid or a glutathione. It can work directly like that. And when you have that combination, that's a great way to start getting somebody to feel a little bit better. So they start getting more motivated to do things to help optimize their health more. And then you can start down-regulating the nervous system in a very intentional way with support that is easily done when you have more mitochondrial support there. Because if you just do it without mitochondrial support, you get in a lot of trouble. If you're a woman in midlife or beyond, you'll probably notice those changes in energy, strength, and recovery just don't feel like they used to. And what's frustrating is that for many women, this happens even when you're eating well, lifting weights, prioritizing protein, and doing all the right things. You're not lazy, you're not unmotivated, and you're not doing anything wrong. A big part of what's changing actually starts inside your cells. As we age, our mitochondria, the energy-producing structures inside our cells become less efficient, and when mitochondrial function declines, it can show up as lower energy, slower recovery, reduced muscle strength, and feeling less resilient overall. This is a normal part of aging physiology, and it's one of the reasons midlife can feel so different. And that's why I've added MitoPure gummies from Timeline Nutrition into my daily routine. MitoPure is the only clinically proven form of urolithin A, a compound shown in human clinical trials to support mitochondrial renewal. In simple terms, it helps your cells do a better job of making energy. And when your cells have more energy, your body is able to support strength, endurance, and recovery as you age. What I appreciate most about Mitopure is that it's foundational, not flashy. This isn't a stimulant or a quick fix. It's a daily habit that supports how your body actually works at the cellular level. And the gummies make it easy. They're just two sugar-free gummies per day. They're vegan and cleanly formulated. They're independently tested and certified for quality. And if supporting your energy, muscle health, and overall resilience as you move through perimenopause and menopause is important to you, MitoPure is worth considering. You want to go to TimelineNutrition.com slash Cynthia and use code Cynthia Thurlow for 20% off your order. Again, that's Timeline.com slash Cynthia and use code Cynthia Thurlow for 20% off your MitoPure gummies. I'm excited to tell you about a foundational health supplement that is backed by some incredible science. 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And then as soon as they started to get more aggressive with these protocols, they're like, okay, well, we're going to take ashwagandha and we're going to take these tonifying adaptogens, maybe some myo-inositol. And I was doing okay for a week or two, and then the wheels fall off the bus. And so I think there are many people listening that probably, you know, unknowingly weren't thinking about that mitochondrial support that I think is so important. And I think that it also lends itself to understanding that the body is incredibly complex. I think if we try to simplify things, it might say simplify not in a demeaning way, but if we oversimplify things and think that it's just this one supplement or just this one hormone that's going to fix everything, there's so much more to it. When you're working in particular with your middle-aged women, I'm sure that you have plenty of them in Colorado that you're working with. When they talk to you about progesterone and you are talking to them about the physiology of progesterone and upregulation of allopregnenolone and the GABA system, what are some of the uncommon aspects to GABA and the stress response that you think most people are probably not aware of? I think the main thing to talk about as a good segue from the mitochondrial side is that a lot of our conventional colleagues, Cynthia, you and I, if a patient goes to one of our colleagues and says, I would like to take some supplements because I heard that they're good for me or that I heard they can help, most of our colleagues would say, stop spending your money making expensive urine. Right. And what's interesting about that statement is that the more I've worked with people over the years that are in this sympathetic dominance, this sympathetic overload, they're not that far away from the truth. Because no matter, I mean, I've seen people like this and, you know, and everybody's heard or has been in this, maybe hopefully not in this place, but sometimes it happens where you've seen multiple doctors, you're not getting any better. You feel like, you know, nobody can help you. Like everything you tried, it doesn't work. Every time you try something, you react to it. And like, no matter how little it is of, of something like you have a sensitivity to it, you have a smell issue, you have a detox issue. Like this is almost always related to this sympathetic loop where you can't tolerate anything because you're in this sympathetic spiral. Okay. And so the most important thing is to look at this spiral in its, you know, at its meta level and saying, okay, this is what's happening now. How can I really address it? And so what I try to do initially, as I mentioned, is work on mitochondria just a little bit, not a lot, not trying to overdrive them. And what the problem is, if you give them a lot of vitamins, a lot of minerals, a lot of supplements all the time, they're not gonna tolerate this stuff, right? And what I found to be transformative here is that if you just use a little bit of methylene blue, I'm talking like four, eight, 12 and a half milligrams, just a tiny little bit. I don't even want them to feel that much. I just want them to have something there so that when we start looking at that sympathetic side, the GABA side on the progesterone side, which I'll talk about here, then they have the capacity to be able to downregulate without feeling like they're going to die, right? Or they're going to have like significant issues, right? Because what happens when that nervous system starts unclamping itself, people can get this reactive anxiety, this reactive feeling of doom, right? Because they've been sort of clamped down and working at this level. But what I found over the years is that if you just work on the vitamins, minerals, nutrients, and cofactors, et cetera, on somebody that's in the sympathetic loop, they're not gonna get better. Even if you put them on HRT, they're not gonna get better, right? Because you haven't worked on that sympathetic side. And that's where the GABA system comes along. That was a long preamble to your question. But I wanted to give like this framework the way I think about it because the GABA system is so essential. But as clinicians, you and I, Cynthia, we know like if a patient goes into their doctor complaining of anxiety, complaining of depression, complaining of insomnia, the first thing that they're going to get from their doctor is an SSRI, right? is going to get something that works on a system that we know has nothing to do with depression, really, right? We used to think that depression was a serotonin issue, but we now have very clear evidence that it's not, that it's much more correlated to GABA. And GABA is our primary brakes. It's the brake pedal of our brain. It's the inhibitory signal that tells the brain and the body to calm down. And when you're chronically stressed, chronically in sympathetic overdrive, you are depleting daba pretty dramatically and then as a result of that you have this reactive anxiety depression your mind is racing like on average we have about 70 000 thoughts every single day on average which is you know crazy to think about but if you're daba deficient you're 120 000 thoughts or more and you're having you know depression we're not talking about unique thoughts we're talking about in total so if you're depressed you could be thinking about the same thought 120,000 times that day. If you're anxious, it's the same kind of deal. What did I say? If you're living in the past, you're depressed. If you're living in the future, you're anxious, you're living in the moment, like it's probably the best place to be. But in the end, we certainly believe we should not believe a lot what our brain is thinking about on a regular basis. And I have this conversation with my kids all the time, my eight-year-old especially, who's like going, you know, he's now his brain is much more like, you know, it's like a bigger kid, not as fantastical. but like we used to watch movies together and he wouldn't be able to get the idea out that there couldn't be spiders coming from the ceilings and going to going to you know engulf him right and we were watching like a star wars or something and like your mind can make up amazing things and so his debate the way we outdid his mind was to have hamburgers eat french fries that was what he needed to do in his mind to be able to realize oh that's really silly i'm like yeah just like the spiders he's like oh yeah just like the spiders and you know so but we're not that far away from that same kind of mind game that's going on all the time. And so, yes, progesterone is fantastic for the GABA system, right? Because it regulates your GABA system in a very, very holistic way. So it gives you GABA, especially during certain parts of your cycle. But what goes down very dramatically during menopause, of course, or perimenopause is going to be your progesterone level and how it modulates over the course of your 25 or whatever day cycle that you have, right? And so in my practice, what we're always talking about is that, well, we want to get you back on some base level support if we can, but that's not the only question. The question is, well, what other things that are in your world right now that are causing a significant amount of stress that are compounding the issue? Is it a snoring partner next to you in bed? Is it a difficult relationship with your parents that you have to take care of now, right? Or that you're having a lot more support for, or is it, you know, your, is it your kids? Is it your job? And so it's not just like, here's progesterone and call me in the morning for most people. And the deal is that as you down-regulate the nervous system in a very intentional way, so people feel supported, so they have the progesterone on board, they have some mitochondrial support on board, then at least they can get the feeling of what it feels like to be back into that parasympathetic mode, that rest, digest, detoxify mode. Because that's where you have your biggest edge, ladies and gentlemen, right? Is when you're in that parasympathetic mode, you're calmer, your brain works better. You actually can think more clearly. You have more blood flow going to the brain actually is what it comes down to. And so learning how to be there and then maintain in that level, that takes time, but learning how it feels to be in there, that's the key. And then we can teach people over the long term how to stay there over for longer periods of time. Well, I think that most of us never learned techniques for activating the parasympathetic nervous system. I mean, I think right now there's a lot of discussion around vagal nerve training, the vagus nerve, how critically important it is. I kind of cringe because I worked at a cardiology-focused hospital for many years, and occasionally sometimes someone would have bypass surgery and they would accidentally sever the vagus nerve. And so we didn't think it was such a big deal, but I reflect on that now 20, 25 years later, and it makes me cringe because I'm like, it is a very important nerve. Talk to me about the role of the vagus nerve and how important it is for the autonomic nervous system, specifically the parasympathetic. Your vagus nerve is a winding nerve that comes out of the back of your brain that regulates what's called your parasympathetic tone. So again, we talked about sympathetic fight or flight. What I really would love to, and I always try to bring to the table with my patients is let's give you what I call the parasympathetic edge. Let's talk to how you can be calm, collected, and get your shit done much easier than you think that you just need to steamroll through everything. And look, I'm talking from experience. I'm type A myself. I know, Cynthia, you are too. We are the type of people that will just put on the blinders and just go, right and just you know grind and what i've always have to remind myself and also you know my patients is that we only have a certain amount of capacity right to be able to do that we can do that in our 20s and 30s to some degree but as we get older we just don't have that capacity anymore even with the best you know hormone replacement therapy even the best mitochondrial support like we just don't have that capacity and then we realize that if we had learned this earlier that we wouldn't actually have thought we needed to grind everything out. And a good example of this in a very different context, I have a friend, his name's Jeremy Bloom. Jeremy is a very cool guy. He's the only guy that was ever a Olympic skier and also a professional NFL player at the same time. So he played, he was a running back for the Eagles. So sorry if people don't like the Eagles, but running back for the Eagles and he was a Olympic skier. And so I talked to Jeremy, I actually, we had an interview once, I had him on our podcast and his, and I was like, we were talking about his pre-workout or his pre training routine, right? When he was younger, he listened to Metallica and like, you know, a high, heavy, heavy hitting kinds of things. But once he got to the top level of his sports, he was listening to Mozart and Beethoven, right? And before he was getting on a mountain or getting on the field and playing. Why? Right. Because we know that we're always sort of in this grinding, you know, pushing mode, we actually lose capacity up there over time. The more skilled we get at something the less we need to be up and the more we need to be you know dropping in And this is where the parasympathetic mode and the vagus nerve come in And so if you can learn how to train your parasympathetic nervous system and you can use vagal nerve stimulators there's a number of them out there now. There's handheld devices that go on your neck. There's some that go into your ears. If you have a sensitive neck and you might, you know, there's people have like the carotid arteries here in your neck and you actually stimulate that or the nerve right next to it, which is the vagus nerve. And, but if you're very sensitive on your carotid, you may not want to do that. And if you have low blood pressure, This has happened to me, you know, fun fact. So it'd be as if you press your carotid, you know, Cynthia will know what happens when you do that. You stimulate your vagus nerve and then your heart rate drops dramatically and your blood pressure can drop. And well, you know, if you have low blood pressure already, welcome to the floor, you know, so be careful. But anyway, it's not usually that big a deal for most people. The carotid in that area is a place you can stimulate. You can stimulate the ears in the auricular area. There's a branch of the vagus nerve. And the vagus nerve is really, really interesting, right? Because it goes to most of your organs. and regulates the capacity for them to know if you're in the rest digest mode, right? Or if you're in the sympathetic mode. Because by the way, if you're in sympathetic, you're not gonna digest your food very well because blood is not gonna go there at all. And so you have digestive issues, you have SIBO, you have leaky gut, all these things. And yeah, I can give you GI supplements, but they're not gonna do jack if you're in that sympathetic nervous system overload. And so this is where it becomes an interesting conversation for my patients. It's like, well, I have gut issues. I'm like, yeah, you do, sure. but let's work on your nervous system first and with a little bit of mitochondrial support and then like well i have stress and i have i can think of like i have chronic pain i have chronic inflammation whatever it is yeah we need to work on that but let's work on your stress on your nervous system regulation as we're doing this right it becomes this like larger conversation so just to give you a sense of how i think about this and from like a totality perspective we want to give people an understanding of what the vagus nerve is and i give people exercises they can go So singing is great. Humming is great because that also stimulates the vagus nerve. And there's also different types of breathing exercises that you can do that'll stimulate the vagus nerve as well. It's a very cool nerve. It's run by a neurotransmitter called acetylcholine. And so you also have to have good sources of acetylcholine in your diet if you want to optimize your acetylcholine system. Actually, one compound that I use that's kind of interesting here to do this is nicotine. Nicotine actually stimulates the vagus nerve. It gives you more cognitive capacity and stimulation, but it also stimulates the vagus nerve at the same time. And that's a very interesting combination. That's why you see smokers smoking and feeling relaxed because it's actually relaxing the vagus nerve. So I don't recommend smoking or vaping or anything like that. Nicotine in small doses could be very helpful, but just an instructive way of thinking about the vagus nerve, I think. That's so fascinating. And it's interesting. I just reported a podcast with Dave Asprey when I was in Austin. And Dave really likes using nicotine spray while he's recording. And I was told before I came on set, do not let Dave give you nicotine spray because your head will like explode. And so he kept trying and I was like, no, no, I really appreciate that. I don't think I need it. But he was like, this is how I'm able to do seven podcasts back to back. And I was like, yes, clarity, focus. I get it. But I think it's really interesting that when you're working with patients, you're helping overemphasize the fact that they have to be thinking about being in the parasympathetic if they have gut health issues. So, you know, big pearl to listeners is if your treatment program for your gut does not include parasympathetic work, you're probably not going to get the same results as someone who is focused on that as a primary kind of objective. And, you know, I keep reflecting back on like traditional allopathic medicine. Of course, we all learned about the vagus nerve. But I think now like this evolution of understanding the vagus nerve is far more than just being this wandering long nerve in our bodies. And to your point about the vagus nerve and being in close proximity with the carotid artery in the back of my head, as you were talking about that, I was like, oh, you know, we used to be very conscientious about carotid stimulation, you know, palping a carotid artery. because if you have someone who's like 85 years old, little old grandma, grandpa, they might have some plaque there. So it's like, you know, don't be, it's like be very gentle with your carotid artery. If you're deciding to go, you know, with your fingers, try to figure out where these are anatomically, depending on who you are as an individual, be careful about that. Yeah, one thing I just want to reflect. So two things, one funny story is I remember my wife, we must've been like just married or like, you know, just maybe dating. And she was like giving me a massage, right? And she rubbed both of my carotids at the same time. And I saw stars. I went to the ground. I did the whole thing. And thankfully, I didn't pass out. So you have to be careful there for sure. But I love something you said earlier, just a minute ago, Cynthia, is like, if your treatment program does not include parasympathetic focus for anything that you're doing, it's not going to be as beneficial. And that's the thing. Even if you're in perimenopause and you want to get on HRT, great. I think that could be very, very important. But if it's not focused on the parasympathetic edge that we're talking about here, it's not going to be as impactful as you think it is. If you're looking at optimizing your pain, your inflammation, your brain fog, and you're looking for stimulants or you're looking for other types of treatment to help you and you're working with a provider and they're giving you supplements and a dietary change, that's all great. And I agree with all that. But if you're not working on that parasympathetic edge at that same time, you're not going to see the benefits to the level that you're hoping for most of the time. Because again, if you're in this sympathetic dominance, cortisol is through the roof. You're breaking down your mitochondria over time and you're trying to like use supplements and use the diet. And it could be, it could be almost feeling self-defeating sometimes, right? And, and I've had a number, like, like I mentioned, the colleague come up just a couple of days ago and reach out to me and say, just a little bit of methylene blue, what a huge way, because now we have some mitochondrial support. That's good, right? And then just a little bit of GABA support, looking at calming down the nervous system, went a huge way. And now we can actually see this gut is starting to heal. Instead of, you know, rechecking the gut every three months and seeing no improvements, all of a sudden, now they actually don't have a leaky gut anymore. Their inflammation levels are down. And so I think what we get so stuck in, in medicine is looking for that one thing that's going to work, right? And I think, and what I've found over the years is that it's almost never going to be that way. You may feel better for a short period of time doing one thing. Like if you go vegan tomorrow, if you're on a standard American diet, you're going to feel better for the next three or four months until you don't, right? Or if you go carnivore, typically the same kind of thing. Because as we say, wherever you go, there you are on some level, right? Because in the end, your physiology is going to catch up to you. You can do certain things that can be helpful, but in the end, if you don't change that physiologic response to be more balanced and more weighted towards your parasympathetic nervous system, you're not going to see the benefits long-term. And this even goes to exercise, ladies and gentlemen, right? We're not even just talking about, you know, we're not talking about your gut or inflammation. We're talking about if you want to exercise most effectively, if you're going into your workout super stressed, like how much reserve do you have to bring it up another notch to make any gains in the gym, right? And if you're at the end of your workout, if you're going directly to work to your meetings and to your job and or going into your cold plunge and, you know, whatever, and continuing to stress your system without going down into parasympathetic, you're not going to make the gains at the gym that you think you're going to make or that you should make or maybe you would have made when you were younger because you need to be in parasympathetic mode to heal and to recover and to build muscle. You don't build muscle in the gym. You build it after the gym. So this is so key for everybody. I'm just trying to find different ways in for people that are listening. Like, yeah, okay. Yeah. I'm, you know, I don't really understand that, but yes, I don't work out as easily as I could. I, I'm not making the biggest gains as I used to. Now I'm getting injured when I, when I exercise. Well, why? Right. Because if you're under so much tension already, when you go and work out, there's not so much more attention you're going to be able to provide, you know? And then what's going to happen is you're going to flip yourself over and not recover for another three days if you really try to go hard with that another HIIT class that you didn't need, you know? And so if you don't take it from the place of, of like, there's two different angles here, which is that, you know, I'm stressed, I'm wired and tired. I don't know what to do with myself and I'm really having a hard time. Or it's like, I just want to perform better, you know, at the gym. If you want to perform better, you know, at life in general, being more parasympathetic is going to help you. And that GABA system is a window in either way. So, you know, what I can do is I can give somebody a supplement, something that gives them a GABA experience. And then we can go from there and go, okay, this is where we can ride and understand where to go from here, you know. I think it's such an important message because we're, you know, in the health and wellness space, it's like we love extremes, right? We can't just take a cold shower. It has to be a cold plunge. We can't just do, you know, infrared sauna or sauna. We have to do hot yoga all the time. I mean, it's like all of these extremes. And what you're really speaking to is hormetic stress, the right amount of stress at the right time. But what I find is, and it's not unique to women, just in talking to different people, how much stress people like to put their bodies under. And I'm like, listen, to your point, if you're already super stressed out, doing that cold plunge is not doing your body any benefits. Same thing with, you know, you're going to do Ashtanga yoga at 110 degrees and you're going to go home and feel terrible. And so I think we're really speaking to a truth about our physiology that is not emphasized enough in most conversations. Maybe it's not sexy to talk about the parasympathetic, but if you're looking for an advantage, you know, whether it's a fair advantage, unfair advantage, you really need to master the parasympathetic. And, you know, it's not something that you can't start doing tomorrow. This is like an evolution. And I think for a lot of my patients, myself included, the value of creating boundaries in your life, the value of saying no, the value of going to bed earlier, the value of more recovery days, not less, the value of not drinking alcohol or insert whatever bad habit you have that you've eliminated. I think for a lot of people, we're really getting back to this foundational approach that is not bright, shiny objects, but is really emphasizing how important these basics are in order to be able to not just survive middle age, but actually thrive. And has that been your experience that the patients that are able to access your recommendations about parasympathetic tone and edge are actually doing better healing faster than those that fervently are like really unable to change their habits? And we have patients like this. I know we all do. Yeah, of course. I mean, it's not a subtle difference between somebody that has a lot of reserve and resilience with somebody that does not have a lot of reserve and resilience. And with the reserve piece, I mean that what's called your, I call it your sympathetic reserve, which is your capacity to stress your body when needed to, like a hormetic stress, and then be able to come back from that stress easily, right? And then what is the delta? What is the change in the sense of the further you have to go? So the lower your nervous system tone is, the more relaxed it is. And the more you can bring it up, the more capacity you will have. and then that's also that's anything from you know your exercise you know to your work meetings to any other stress that's going to happen is if you have more capacity more of that delta more of that change that's where we have a lot more ability to actually enjoy our life and actually feel like we're present in it and actually have much more capacity and then the resilience piece of it is what i was mentioning that on other acts which is that you can come back down and that nervous system doesn't stay all the way up it comes back down to that parasympathetic side and that's resilience because you can go back up and down back and forth this is what i call a dynamic oscillation we should be able to you know be up when we need to be up and come down when we need to come down and know that most of us need to be down more than we're down more than we're up but i don't mean down by like you know lazy and relaxed and like not being able to do anything i mean having a conversation like this and keeping your nervous system down and relaxed or having a conversation at work or doing a presentation there or you know a lot of these other things where if you can drop down just a little bit, you know, you can see a massive difference because that sympathetic nervous system decreases blood flow to the front of your brain. So where you, where your executive function is, your ability to keep things in your mind, recall things from long-term memory, your short-term memory and capacity maintain as you're having a conversation or whatever, that goes down dramatically if your brain's not getting enough blood flow. And so for me, what I love to be able to do is give people the experience, as I mentioned, of getting their nervous system to calm down, feeling what it feels like to bring it down just even a little bit, take off that edge. And then they realize that when they're calm, cool, and collected, their mind works so much better. Their body will work much better in the gym and they'll have much more capacity to maintain their safety as well. Just in general in the gym, for example, and working out, if you're too stressed and you have a higher risk of hurting yourself, like I said. So I love the experience of people and watch it happen and the experience because I can, you can see it. Like once they can have the experience of bringing down the nervous system, like I said, I'm not saying, you know, go find ways to calm down. I'm like, let's give you something now that can help you and you can experience this. And then from there realize, okay, the world's not going to be over if you're not always clamped down and stressed, it's going to be okay. And then from there, maybe it's sleeping in a different room than your partner if they're snoring. Maybe it's changing jobs. Maybe it's changing cities. Maybe it's getting, having a better boundaries with your spouse or with your parents or whatever, right? But these things take longer, right? But once you have more capacity because you have more sympathetic reserve, that delta that you have capacity to increase is higher, then almost anything is gonna be possible, right? The things you couldn't do because you didn't have enough capacity, then now you can do, which is really, really transformative for people. 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Obviously, now we're looking back, you know, 15, 20 plus years, you know, individuals that are in a different, you know, urban, indigent, poor kind of population that you're working with. And we're wondering why we're not getting the results, even though they're committed to the results. But it's the understanding that they're probably in this high sympathetic tone all the time, which, you know, is catabolizing muscle and contributing to a constellation of other health issues that, you know, maybe at the time, certainly me 20 years ago, I wasn't thinking like that. But retrospectively, I think what you and I are both saying is that this isn't easy. You know, we're not saying that it's easy to figure out the long term ways to unwind this spiral. Right. Because if you have a really difficult living situation, if you have a difficult time getting money for your family, like I totally I have not been in that position, but I can very much understand how that could be very difficult. Right. And so for me, what I think is important though, is that we do have certain things that we have capacity to, no matter how much money we have, we can learn how to breathe, right? We can learn how to breathe more effectively to calm down our nervous system, right? We can learn how to do like a little bit of yoga or like a little bit of mindfulness training. These don't take a huge amount of time, right? And so there are certain things that almost anybody can do to start coming down on that nervous system tone, even if you're in a really tough spot. Because, you know, what we, I was just thinking of this example of like, with, of course, it comes back, you know, I have four kids. It's like, if somebody is upset about something, well, something happens, right? Something happens that makes you upset. Does it typically help to be upset about it? No, right? It doesn't help you to be upset about it. It typically helps to take a step back and have the, you know, sort of the meta-awareness to go, okay, this is happening. Now, what can we do about it? right? So this is something that almost anybody can benefit from no matter where you are in life. And certainly the more comfortable you are, the easier it is to make more, you know, go do your cold plunge and like your sauna. And like, and I totally get that, but it doesn't require a lot of that in really what it comes down to it. Those are nice, but they're not always needed. If you can learn various ways to do this. And so, you know, we have, you know, we have products that prescriptions, right, that I use in my patients that give them the sense of calming down their nervous system. So I think that's the most important initial piece, which is like, what does it feel like to be there again? You know, because so many of us have been stuck in this fight or flight for such a long time, we don't even know what it feels like to be back down there. And so that's the only thing where I'm like, well, I think supplementation just in the short term, but the thing about it, and I should mention this, I think we've talked about it before, but GABA, you can take as a supplement, but it shouldn't work for you. If you take GABA as a supplement and it works for you, it means that your blood-brain barrier, which is supposed to keep things out, is letting things in that it shouldn't. And that's called a leaky brain. And this is unfortunately very, very common, especially if you have a leaky gut. So if you take a GABA supplement and it works for you, it's often because of this case. And it's almost diagnostic. And I've had patients myself where they were taking GABA, it was working for them, and then we sealed up their gut and the GABA supplement stopped working. So you can take it if it's working for you, but know that it's, there's something else that needs to be addressed because if you have a leaky gut and a leaky brain, that's a lot of inflammation in the body at all times, causing your sympathetic nervous system to go up by the way, right? And causing mitochondrial dysfunction and all the things that we talked about that spiral, that's all happening. And again, chicken before the egg, did it start off because the stress that it started off because of the mitochondria in the end, it doesn't matter per se, in the sense that you have to, you have to address them both, but addressing that leaky gut and leaky brain can go a long way. So we use compounds like kava and cbd and cbg and something called b3 gaba and a product called trocom that really work well to down regulate the nervous system without making you feel tired and then this particular nicotinol gaba gets across into the brain no problem and then the biggest lever that we haven't talked about cynthia that's very important for people is sleep right if everything is dysregulated if you're wired and tired the first thing that i love to do is support mitochondrial function if I can. And again, methylene blue is just one of the ways that I found to be really, really helpful here. In addition, sleep. We need to get everybody to sleep, right? If you can get somebody to sleep, almost anything's going to make you feel better the next day. You're going to be a better person, right? And so what I think about here is other compounds that can enhance the GABA system as well. We have one that we use called agarin, for example, which is from a psychedelic mushroom. It's not psychedelic. It's from the amanita mushroom. And it's an artrosy. And it's combined with something called honokai or honokial from magnolia bark. But not only that, we also have 5-HTP and melatonin in there. We have adenosine, which works on another neurotransmitter system in the brain. We have cordycepin, which works on the adenosine system. So the reason why I just mentioned all this is that sleep is a very complicated thing. It's not like we're just, you know, we're not just passed out. Like we've had anesthesia. We have a lot of metabolic processes that are happening, a lot of sick molecules. It's not just melatonin. If you're taking just melatonin, probably not going to solve the issue. And so, but working on dialing in sleep is so key. And so we have these GABA compounds that do it. That can be very, very helpful. But in combination with this more, this sort of this comprehensive sleep formula has been transformative to my patients. So that if I can get them to sleep and I can give them a little bit of mitochondrial support, then it's like the world is our ocean. Like everything is possible, right? But a little, you know, incrementally, it's not like tomorrow they're going to be running marathons, if that's even a good thing. But that's a different story. But the idea would be sleep and mitochondrial support can go such a long way to helping our patients feel better and helping you feel better if you're listening. But again, if you're looking at sleep support, GABA is really key there. If you're just taking melatonin or 5-HTP, it's not going to be enough. And then cannabinoids sometimes can be helpful, the non-psychoactive ones like CBD, CBN, but THC screws up your deep sleep. So I don't recommend it unless you absolutely have to in the short term. And then your benzos and your alcohols of the world that support the gap that that work on the GABA system, not support it, that work in the GABA system. They're also going to screw up your GABA system over the long term and screw up your sleep too. And I bring up so many good points. And I always say that sleep is foundational to our health. And more often than not, if someone's not sleeping through the night, that is the very first thing we have to work on. I have a couple of rapid fire questions to kind of round out our conversation. Nice. Most overlooked cause of anxiety? You, the person that's listening right now. Most of us think that anxiety is coming from the outside. And I don't disagree with that. There's a lot of stuff that's happening. But most of it is you, right? The common thing is, and the most classic example that I can think of, is that your daughter comes into the room, asks you a question. Maybe it's something that's a little bit inappropriate. Maybe you're doing something that you're a little bit busy and you yell at your daughter, you yell at your son, whatever, right? Does that have anything to do with them? No, no, no, no, it doesn't, right? It has everything to do with you, right? And your response to it. So I think the most overlooked cause of anxiety is, you know, it's an inside job. Absolutely. Most underrated nervous system habit. Underrated nervous system habit. Let's see here. Closing your eyes. This is something that I find to be very, very helpful. even if you can just close your eyes for 30 seconds and just stop looking at a screen that's going to help you this is kind of correlated to most of us are spending most of our time every day on screens right and so i did a i had a cool podcast interview with with an eye specialist and he talked about just making sure you look further away from the screen all the time not just at the screen and i think that's great and important but closing your eyes can help you know calm down your nervous system right just even for five or ten seconds can go a long way there's a lot of other ones that I was thinking about. A meditation, I don't think is that underrated anymore. But I was trying to figure out one that people wouldn't necessarily be thinking of, but close your eyes. Every now and then I get a little bit, sorry, I'm not going to sing for you. Best daily practice for parasympathetic activation. So for me, this may be a little bit different for everybody. I think that, I think for me, it is meditation. It is just letting the mind, you know, get crazy for the first five minutes or so when you close your eyes and do your meditation, but then you really do drop down your nervous system and you really can feel it. So for me, meditation, I think another one really, really helpful is breath work. So learning how to do prolonged exhales and your breathing doesn't have to be crazy. It could be three seconds in, five seconds out for two to five minutes at a time. Like it's simple. It doesn't take a long time. There's the sigh breathing that people talk about that can be really good. So you make a noise when you take like a deep breath in, you take another one and you take a sigh as you go out. that because what is that doing? That's vagus nerve, right? So humming, gargling, like singing, these can also be really good for your vagus nerve. So those are some of my favorites. I mean, I also have, you know, I also sometimes I'll just take one of our trocoms if needed, just to calm down my nervous system. If it's one of those days, you know, then I'm like, well, you know, I'll just take one of these, you know, and that's okay too. Like sometimes you take something that just calms down your nervous system, like that can be really helpful as well. Absolutely. One supplement that supports mitochondrial resilience that isn't methylene blue. The other one that I've been really interested in recently, other than methylene blue, is molecular hydrogen, interestingly enough. I was very, very much a skeptic for a long time. And then I was doing more research on it. And it's one of the only other compounds other than methylene blue out there that has the capacity both to energy enhance and detoxify at the same time. In fact, I don't know of any other compounds that do this. And hydrogen is, you know, I don't know how it works. I don't know how you can drink it and it goes into your cells. I don't know how you can inhale it exactly. And it does this because nobody really knows, but I will travel with it now. It's one of my things that I use as an immune stack, as an antioxidant stack. So that's the other one that I'm most intrigued. So a lot of my patients will, you know, also be taking this. The other one, I guess, if you're talking like a prescription would be LDN, like low dose naltrexone. I've been using a lot of that over the last several years with muscle activation. I use it like my big, one of my biggest stacks is methylene blue with LDN. So you take the methylene blue in the morning, somewhere between four and 25 milligrams or something like that. You know, from a good source, you know, you got to be careful. We talked a little bit earlier, you don't want to get like a liquid off of Amazon. That's not going to be potent. It's going to be, you know, it's got a lot of heavy metals. You know, at our company, we really do care about quality much more than anybody else. We're the only physicians that run a methylene blue, a company that makes methylene blue products. so methylene blue and ldn i guess i would sort of like there's another one that i also use as well i can't use just one here is cordycepin so cordycepin is from the cordyceps mushroom and it's the most potent component of the mushroom about 100 times more potent than the mushroom as an antioxidant anti-inflammatory anti-inflammatory antiviral and it also increases deep sleep so like the my triple combo for a lot of my patients is methylene blue in the morning usually are just blue from from transcriptions and then our so cordycepin is in our tromune our tromune product which is fantastic for travel fantastic to abort a virus or like a cold or you know or as a prophylactic to make sure you don't get sick so and but also for people patients have like long-term anti-inflammatory needs as well or autoimmune related issues as well and then the ldn is a great one if i can if i can get that on patients as well so i gave you two others other than methylene blue. But cordycephrine is like my favorite other mitochondrial support now other than methylene blue, because you can use it at night and it's got fantastic capacity to support it. No, I've definitely been using that product with all the travel that I have. The last question, one habit that damages mitochondria the most? You're like, I can think of 20. There are many habits that damage the mitochondria the most, but I think the main one that we've been talking about throughout this podcast really does hit home. You know, for me personally, something that I'm always working on, and also for many of you listening and many of my patients, is that this sympathetic spiral of doom is legit, and it's happening without us knowing it. And it's not like most of us have fallen off a cliff. It's just, I mentioned in the beginning, we don't recover as well. Our mood is all over the place. We can't travel as easily. We just don't sleep as well as we used to before. Like, why? like we're tired but wired this is the sympathetic nervous system that is stressing our mitochondria it is causing all those you know it's cortisol release norepinephrine and epinephrine we can't make enough energy effectively we can't detox from the energy that we make we throw ourselves into that cell danger response and then we're trying to make more energy we can't do it right and so the main thing that i think most of us can do is just unclamp that nervous system and relax a little bit more. And again, I'm not telling you to calm down. I'm telling you to find ways to learn how to down-regulate your nervous system and find ways to create that parasympathetic edge, which is that edge where you're not as stressed and you have more capacity, you have more reserve, and you have more resilience. And that's, I think, all what we want, right? And that's how we can live a life where we feel content, right? That we have capacity and reserve, right? And that's really what downregulating your nervous system can do with good support, as we've been describing throughout this conversation. Well, Scott, I so love this conversation, as I always do. Please let listeners know how to connect with you outside the podcast. Obviously, your company has given my listeners a very generous discount. We'll include that in the show notes. And transparently to say that myself, my husband, and my youngest son, who just got off three months of antibiotics for Lyme, but has been exposed to mold, mycotoxins, a whole slew of crazy things. We've all been sampling the products. And for me, I feel like one of the things as myself as a nurse practitioner, I've been a little hesitant about methylene blue, but feel very comfortable taking your products and knowing that it does so many beneficial things to our mitochondria and really emphasizing for people, we ultimately have to do the work to support our parasympathetic nervous system. There's no trick. You just actually have to make that investment in yourself. But please let listeners know how to connect to the outside of the podcast. Well, thanks for having me again, Cynthia. Yeah, there's ways to help you now along that path, but the path is yours, you know, to travel and to get to the end. You know, we don't want that, right? It's a path, right? The end is when we're no longer here. You know, it's always going to be a path. We're always going to have things to work on. So always know it's a path and it's a process, right? My dad always liked to tell me that when I was in college in medical school, like it's a process. Enjoy the process. I'm like, can I really enjoy this? Is it really possible? Yeah. But, you know, but really in the end, that's all it is, right? So it's a process. And thanks for listening, everybody. So again, if you're listening and you're interested in some of our products, you can check them out at Troscriptions. It's at troscriptions.com and you can use Cynthia's discount, of course. And we have a number of them we talked about during the podcast today. Just Blue is our pure methylene blue. We have something called blue canatine, which has a little bit of nicotine and caffeine for the stimulation side of things. very low doses very very well tolerated and very very well loved and then we have our trocom and our troz for the gaba support the breaks of the brain both daytime support the calm and then the troz in the evening if you're a practitioner listening we also have a practitioner side of our business where we have different products we have high potency products higher potency available you can check it out also on our website and sign out to be a practitioner there with discounts and webinars and you know lots of good data lots of good education there as well For me personally, you can check me out at, my website is drscottsherr.com, my name, D-R-S-C-O-T-T-S-H-E-R-R.com. You can find my consulting for my own clinical practice. I work in hyperbaric medicine, our transcriptions company, our nonprofit as well that supports transcriptions and vice versa called Health Optimization Medicine where we do training. That's what I'm trained in and that's what I do long-term on the path to optimization with my patients as well. And I have a hyperbaric company called OneBase Health as well. You can check that out if anybody's interested. Thanks so much, Scott.