The Science of Burnout: Interview with Dr. Sangeeta PatiJan 22, 2020
Betsy: Good afternoon. I am Betsy Jordyn and I am so excited to have Dr. Sangeeta Pati here. She is an integrative health doctor who completely was instrumental in helping my overcome my burnout. Thank you, thank you, thank you Dr. Pati for coming to talk to us today. I'm so excited you're here.
Dr. Pati: I'm excited to be here. You're in inspiration.
Betsy: Before we get started I'd love for everybody here who is listening in or watching to know a little bit more about you and your background, and how you're connected to this project that we're talking about related to the Science of Burnout.
Dr. Pati: Okay. Well I was born in the United States and traveled and got exposed to a lot of schooling abroad, which obviously ultimately has influenced where I have gone in medicine. I've practiced as an OBGYN in private practice in the D.C. area. And I then joined a safe motherhood project which was a non-profit project funded by Bill Gates to reduce maternal mortality around the world. What I realized when I started traveling around the world and working with midwives and traditional birth attendants is that the tools that I had learned at Georgetown where I trained, which were mostly centered around pharmacy and surgery, were limited. There's many more tools than pharmacy and surgery.
I became very aware of it when I was in the field with people who had other tools; and then as I came back to the United States and went from the non-profit to the sector that I'm in right now practicing restorative medicine, I started adding tools to my tool box. The very first was hormones. I am an OBGYN, I'm board certified in that field, and it was a pretty natural jump going from prescribing hormones that are not natural to the body to learning about hormones that are. And that transition actually occurred because people were walking through our office door with Suzanne Somers' book saying what do you know about Bioidentical Hormones. I'm like Suzanne Somers is teaching people about hormones?
Well women are determined. So you either learn about what they want to know about or they leave your practice. So out of the five women in my practice I ended up starting to read her thing. I took a year and a half really to research the details behind hormonal therapies and Bioidentical Hormone therapies, and realizing that they reverse disease if we maintain levels with natural hormones. So that was an easy segue starting to practice hormonal therapies that are natural and bioidentical, which started in 2003. It became really evident that there were other tools. So if you didn't have nutrition that was activating your hormones you wouldn't be able to really have full activation. And then you have to deal with the toxins, and then the mind, and then the body.
So where we are now thirteen years later is in a spot of basic common sense; which is – the common sense is your body is a miraculous thing. It's capable of keeping you healthy, happy and energetic as long as it has a fuel tank that has enough hormones and nutrition in it, and that you have a filter where toxins are removed. And we are mentally – that's subconscious, conscious and physically – in a sound place.
Using that model we've been able to reverse lots of diseases: diabetes, cholesterol, fatigue, chronic fatigue, fibromyalgia; all kinds of diseases and symptoms. And also we've had the benefit that because we have this integrated, five-point model which is in action; we have been the site of training for many physicians who are learning to integrate other tools.
I'm really happy that I'm able to present to a patient, okay, you have diabetes; these medications are an option; so are these other tools. Options are important, and I think it became really starkly clear to me as I started taking care of myself, where usually of these things really start, and started taking care of my family. Because who wants to have a pharmaceutical drug that has a bunch of side effects unless you have to?
It's a natural instinct as a human to always look for reversal and restoration of body function. It's a natural instinct in the animal world; it's a natural instinct of ours. So I'm really happy I'm able to practice that way. And we've been really happy with the results, and just every day I find out that the more I learn the more I need to learn.
Betsy: I have so many questions I'd love to ask you about your background. Every time we talk I'm fascinated by different aspects, but I think for those who are new to you and knew some of the phrases that you said. You talked about now that you're in restorative medicine, and where you talk about reversing disease. That sounds really different than the typical doctor that we go in to. So can you just quickly describe the difference between restorative medicine and reversing disease versus what we might be used to?
Dr. Pati: Yes. If you think about how we've been trained in medicine, most of our emphasis has been on managing disease once we identify it. So for example, we could have a fasting blood sugar of 60 – 90, which would be a normal range; or 99. And we could start at 60 and go to 70, then 80, then 90, and be told that we're in the normal range; until we hit 99 and then we have a diagnosis which is pre-diabetes. And or course in the standard of care we do lifestyle modification, and then after that we give you usually some medication to start managing the sugars. It's disease management.
If you wanted to have a restorative approach to that you would start to look at underlying causes for why; and the why shouldn't come when it gets to 99. The why should come when my baseline went from 60 to 70. And what they're actually showing – even if you look, for example, at blood pressure. The diastolic blood pressure from 60 – 90 is normal; at 90 we call it high blood pressure. It's now proven that that transition between 60 and 90, which basically occurs in everybody because we start to lose the elasticity of the cell; so that transition occurs over fifteen years. And the cardiac literature is really saying by the time we get to the 90 and we're providing a medication to lower the blood pressure, we've already gone through about fifteen years of damage to the lining of the blood vessel. In a restorative approach we would actually look for those causes; which would be stress, nutritional, anti-oxidants, what's the vascular system doing, how much water intake do you have, what kind of exercise do you do. So we would be prompted to start doing something when you went from 60 to 70.
Betsy: Wow. So it sounds like what you do with your clients or what I do with my clients and organizations; but that's a different subject for a different day. So I’m dying to hear how this relates to the experience of burnout, which is the topic for today.
But before we get into the Science of Burnout, I'd love to get your perspective on how significant is burnout as an issue today? I'm starting to feel that a lot of the high achieving women that I partner with and who are my colleagues, we're all dealing with it on some level. And I believe that it must be the cause for the leaky pipeline and women not achieving those sweet roles. Because burnout seems to me a big issue, but I would love to know am I right? Is this a big issue today? And why do you think it's a big issue?
Dr. Pati: Yeah, I think you're absolutely right. It is a big issue today. I really am inspired by the fact that you put it on the table and are talking about it because I don't think people really recognize it as a medical condition. It almost sounds like a psychiatric condition. And actually most women who start reporting these symptoms end up on either anti-depressants or anti-anxiety medications, and sleep medications and all kinds of solutions for symptoms of burnout.
When I started practicing medicine in this way in 2003, which was thirteen years ago, I would see an occasional woman coming in with this kind of patter. And the way we tell is clinical history, but also it is very evident in the labs. You can see that you’re depleted when you look at the labs. At this point I really rarely go through lab work with women and can tell them that they don't have any level of burnout. So basically it's something that's ubiquitous; we're finding it pervasive all throughout. It isn't really talked about much, that's why I'm so happy that you're bringing it to the table.
And the great news about his is that we have the best of our life in front of us, and it is completely possible to tweak things that are underlying causes for this and have our best life ever, which is in front of us.
Betsy: So this is great news then.
Dr. Pati: It's great news.
Betsy: It's a big problem, but what I'm hearing you say is that it's not a psychiatric problem that is requiring anti-depressants or anti-anxiety medication or sleep medication. There's a medical underlying cause and that there is legitimate solutions to it. So that's great news.
Dr. Pati: Right. I mean nobody is Zoloft deficient. Nobody is Ambien deficient, or Lipitor deficient. They may be progesterone and thyroid deficient; they may be magnesium deficient, right? But I think it starts with us recognizing – and if you can share the screen to that first photograph I have. It really starts with each one of us – and I really love this picture because this really is a depiction of what each one of us should be feeling like. We should be feeling free, radiant, vibrant, balanced.
I always imagine this when I'm trying to manifest what I'm working towards with myself, and also with all of my patients. So with that aim and realizing that it's very straightforward; I am not going to use the word easy, but straightforward to identify the things that are imbalanced and then correct them with the vision of having our best life in front of us.
To understand what some of the causes are – and you asked me why it is so prevalent – I think it's important to go to the next slide which I want to share with you. So this is the five point model that I talked about a little bit. I think it makes it a little easier to understand the causes of burnout if I can explain it on this model.
So basically the common sense idea is that your body is a miraculous thing, and it can keep you healthy, happy, energetic; no anxiety, no depression, no weight gain, no cancer, Alzheimer's, arthritis; if indeed it has a fuel tank that has hormones and nutrients in it, and at the 75th percentile, not at the 25th percentile. In other words, your gas tank should be 3/4 full.
The other thing is we want to make sure that we're able to clear out toxins which inhibit the production of hormones and nutrients and their function. And the best way to clear toxins out is to drink 100 ounces of lemon and salt water every day. And then to be clear that we are mentally and physically in a good place. This is probably the absolute key to what goes on with the rest of it.
I used to have people coming in saying, well, I want some hormonal therapy because I'm tired and I'm anxious and I think it's my hormones. I started out giving hormonal therapy and giving nutritional therapy, and filling up the gas tank if you will, or filling up the bucket with some of the things that were depleted.
As time went on – and this has a lot to do with basically what happened in my own life, because this is how you learn these things. They happen in your own life and then you have to figure out how to make things more effective. So if we have a lot of mental stressors; and 90% of our health is controlled at the subconscious level, 10% is controlled at the conscious level. If we end up having a lot of stressors, and if we have physical stressors from the body like pain or excessive physical activity, we end up depleting that fuel tank.
So as we fill hormones and nutrition into the fuel tank, if we're not simultaneously working on how to balance our life and how to handle the external stressors the world is dealing to us and bring them down to not affecting our internal organs; once we learn those things we're able to preserve the tank. So life balance becomes a really important thing.
When you asked me why is this so prevalent; the reason why it's more prevalent now is because there are more environmental stressors, which is just the general universe in chaos as we know. And what happens is that in addition to having that, we are also not well versed at how to bring our nervous system to a place of calm subconsciously and consciously so that we're not running out the fuel tank.
So those are the tools that we need to learn. And one of the things that happens in women who especially grow up culturally in families where we're taught that women can achieve anything and should do everything, and should be able to take care of everything; we're in a bit of a denial. And I'll find many times when I look at hormonal and nutritional levels that the fuel tank, if you will, is down under the 10th percentile and the person is still reporting great energy and functioning with a five day a week workout and taking care of five dogs like I do and a couple of children, who knows?
So a lot of it is just our expectations, and also knowing that mind is always over matter. So if I get up in the morning and I don't have much in my fuel tank but I have stuff to do, then I'm going to go through my checklist and do it.
Betsy: So we have to get some more questions on the hormones. I had heard through – I read the book called The Female Brain and about the impact of testosterone on a woman. And I was wondering if you could explain a little bit more around women's hormone level around testosterone. Like what's the role of testosterone and accountability, and what's the impact if women don't have as much? Like what's the role of hormones in our ability as it were?
Dr. Pati: Okay. I think – first of all I was mentioning that there is more chaos in the world and there is more stress in the world, and that's one of the reasons why we seem to be getting more run down in our hormone and nutritional categories even more so than before.
What happens is that these stressors start to first affect the cortisol pathway. And the cortisol pathway, which normally is what responds to stress, starts to become weak and cannot produce the same response. So what starts to happen is it starts to draw from all the hormones that can make and be shunted to cortisol. So those hormones include pregnenolone, progesterone, DHEA, testosterone and estrogen. Every one of those hormones is capable of supporting the cortisol pathway, and when we have a lot of stressors it does support the cortisol pathway; which means all of those hormones decline.
What is the consequence of them? And you asked specifically about testosterone. The consequence as the testosterone levels drop is not only that you might notice a change in sexual function and sex drive. But more importantly, testosterone is one of the hormone's that's responsible for muscle mass, blood flow to the frontal lobes of the brain, anxiety, depression, energy, stamina, immune system; the list goes on. Because testosterone receptors are present in all our brain cells, in all of our body cells, our muscle cells. So basically as those levels fall we start to see symptoms that correlate with low testosterone. And we also see diseases over time that correlate with lack of maintenance of those organs; namely brain, bone, heart, skin. Does that answer your question?
Betsy: Yeah. One thing I loved that was super helpful to me when I went to see you for my burnout is after I got my ten vials of blood in order to give you all you needed for your blood work, you explained this interesting dynamic between the cortisol. And you were telling – and I don't remember exactly what it was because you explained to me what was going on in my body. You said something along the lines of like this being low, it was borrowing from this. So like the progesterone was low so it was stealing from the testosterone; and you explained this whole dynamic. I thought it was really helpful for me because it made me feel like I wasn't crazy or lazy; I just had a medical condition going on. If you could just.
Dr. Pati: It is a medical condition. It is a medical condition. In our society it might be called crazy or lazy, but it is actually a medical condition. Because just as you said, if we are using a lot of cortisol and a lot of magnesium and B12 that's coming from the stress, we're simultaneously dropping the rest of the hormones. The top of the pathway is going to be progesterone, that's the very first one that goes. And lo and behold, what are the symptoms? The first symptoms are lighter sleep, sometimes no sleep; more anxiety, more irritability, mood swings up and down, mid-abdominal weight gain, tiredness. Some people have panic attacks, some people just feel overwhelmed, can't focus. And then other symptoms like fibroids, breast cysts, ovarian cysts and bleeding. So those are all symptoms of just the progesterone coming down.
The other connection that's important to realize is that any time we're under stress, that pathway automatically suppresses the thyroid system and thyroid function. So whereas you might very well be in a normal range for thyroid, you do not have optimal function. So any time we have stress they thyroid function starts to drop. And the symptoms of that are going to be lower energy, lower mental clarity, memory, focus, concentration, depression, sometimes unexplained weight gain.
And then there's a whole lot of other symptoms which can occur in some people; which are things like dryer hair, dryer skin, colder hands, colder feet, hair loss, lack of motivation, blah feeling, what am I doing here, what's my purpose, what am I really here for, is this what life is about. And the interesting thing is that this basically happens in everybody to some extent. It accelerates when we're under stress.
Betsy: So if I hear you right then, we're supposed to have a certain amount of cortisol that matches the normal stresses in our life. So when the stresses increase the cortisol goes down, and when the cortisol is shunted all of these other hormones are all jacked up if you will and depleted in certain ways, and they all get kind of.
Dr. Pati: Exactly.
Betsy: So maybe that's what you were talking about with the mind part is the mind and the body to provide some sort of barrier against the stress so that the cortisol as a chance to replenish itself, and then you work on it on the back end with getting some of the hormones at their 75% level.
Dr. Pati: Yes. And the nutrition, because obviously the cortisol system requires magnesium and B12. I have not seen a single person that is not deficient in magnesium and B12, because we actually measure those levels. The thyroid requires zinc, selenium and iodine. So if we have – I'll give you an example. Your phone rings, you have to be at a meeting, your kids forgot their lunch at school, your dog has pooped on the rug, you got into traffic, you have to be in your doctor's office at a certain time. It doesn't matter what it is; you got on the treadmill and worked out for an hour. Your nervous system has to fire, that's the common denominator. Nervous system fires, it starts using cortisol, magnesium, thyroid, B12; it starts using your fuel. And that's why preserving our reserve is the key to keeping ourselves well. Even turning off our phone, because if we realize that when our phone is on and it buzzes, the nervous system fires and you start depleting your cortisol and thyroid system.
Betsy: If you have a reserve?
Dr. Pati: No problem. If you're feeling tired, turn it off and take a nap.
Betsy: So before I ask – because I want to know what are things that people can do that would be like the prescription for everybody. But I am curious about – because I am finding more women, especially the high achieving women are burning out more frequently, at least in my observation. And I'm curious about why women are burning out more when that issue of the stress and the cortisol and all of that would affect men; but it doesn't seem to affect men at such a fundamental level that it seems to be affecting the women that I'm observing.
Dr. Pati: Yeah. You are exactly right. This is exactly what I've noticed. The way that I like to think about this is the following: if you look at all of the steroid hormones the body normally makes, among them are progesterone, testosterone, estrogen, DHEA, pregnenolone; all of those. It turns out that as women hit the 40s, some of those hormones actually drop to zero. Testosterone can drop to zero, which means there is no backup. If you're a woman who's under a lot of stress, you're using your ovarian hormones to support your cortisol pathway. So your testosterone is backing it up, and when the ovaries' function falls down to zero you don't have any backup. So it could be like falling off a cliff. That is exactly why when people come in and ask me, well, my grandmother didn't need anything and my mother didn't need anything. And it all depends upon how much stress they had and whether they were supplementing their cortisol system with hormones from the ovary.
With men, they start off with a testosterone level in the 800 to 1000 range. So even in their most stressed point they generally are not dropping below 200 to 300. And although that's not ideal for a man, it certainly is high enough to support the rest of the system.
Betsy: A woman could drop to zero and a man could only drop to 200, but a woman could drop to zero in the testosterone?
Dr. Pati: One hundred percent. The thing is that I am seeing more burnout in men now than I have seen before. And the fact is that you have to go a little beyond the depletion being just physiological. What I mean by that is that it's very simple for me to explain that, well, your hormones and nutrition are down in the 1/4 tank range; let's bring them up to 3/4 of a tank. Physiologically you'll have what you need to run your engine.
There's another piece to that though, and that piece is emotional. And the fact is that we allow ourselves also to become emotionally depleted, where life becomes a big checklist of things to do, and joy is not part of that. And living in the moment and doing the things that you want to do in the moment; some of us don't even know if you gave a choice of what to do in the moment what you would do. I mean I do this exercise asking people to think about something they really love to do, and sometimes they're not even able to go there because it's so much in the distant past.
So filling our hearts with love and joy, and especially self-love, is part of this picture also.
Betsy: So why is it so hard to come by then for so many women to experience that what makes us have joy? How do we experience that? Why is that so hard to come by for us?
Dr. Pati: Well there's a bit of a subconscious program that we're inadequate, and that happens to vary depending upon what culture and what kind of upbringing we've had. But this idea of having to look a certain way or act a certain way or achieve certain things or be a certain somebody, those are held close to the heart, especially in the subconscious in many people. And subconscious controls a lot of this. So using mechanisms to re-program the subconscious tune is important.
The example – if you look at Hopkins, they're basically saying that the majority of our health is controlled outside of what we are aware of, out of our conscious mind. The subconscious plays sort of like a software program, and it's either playing "I have my best life in front of me, I will cure this cancer, I will get over this burnout, I will have joy and have a high vibration in my life". And all of those thought processes produce one set of neurotransmitters. And those neurotransmitters are chemicals that affect the body positively.
The other though process, which is "maybe my best of my life is behind me, maybe I can't get over this, maybe this is what life is like"; it has a totally different set of neurotransmitters. And they affect the body a totally different way.
So the conscious part most people understand when I explain it to them. Like most of you probably could relate to the fact that your conscious thoughts can change the outcome. The part that people have not fully accepted in a large way is how powerful the subconscious is; how powerful is what we feed our children when they're growing up or our daughters. You know, like you're great just as you are. You're perfect just as you are. All the things that you did right. And some of that is different between women and men, even in bringing up.
So I'm giving you a little bit of theory here, but I've seen it enough and we work with subconscious enough that when we get there these are the things we find. And as we start to correct them – and some if is self-talk, and some of it is affirmations and some of it is working with sighted imagery and so on. But as that starts to correct and we are – you know the most unselfish thing we can ever do is to put ourselves at the top of the golden pyramid and keep ourselves fit. Because that's how we are going to do out duty and take care of the people who depend on us.
So it's totally fair to say I'm spending some time – and I usually recommend three months for people – devoted only to myself. And when I feel great and I'm in great vibration and great joy, that's what I'm going to be putting out to the rest of you.
Betsy: I remember the first time I traveled with my kids together. And we were on the airplane and the stewardess was talking about that whole thing like put your oxygen masks on. And I looked over at my two little girls there, and I'm like are you kidding me? Are you crazy? There's not a chance in the world; like you're asking me to go against what feels like my instinctive wiring to put my oxygen.
Dr. Pati: Exactly.
Betsy: So it seems interest that it kind of reinforces what you’re saying is that most of this stuff – when I heard you say with the mind is that 90% of it is unconscious and a lot of these other things are underneath it. So it's not just like hey, put something that you like to do on the calendar and just protect it. Or go look in the mirror and do some self-affirmation. That's not going to work because that's only what's in your conscious mind. Rather than digging into what's in your unconscious mind that's really guiding the show.
Dr. Pati: Yeah. And the good thing is that it's rather easy. You don't have to dig up the past to go there. You just have to re-program the current and the future for what you want to see.
Betsy: So what's interesting is – this is far more complicated, but to me the good news is that for me as a woman. Again, I'm not crazy, I'm not lazy; I'm just burning out. And you did share at one point too; as we get older too that there is other impact. But you said this burnout is not necessarily even as pervasive in other cultures as it is here. Is that true? Did I hear you right on that?
Dr. Pati: We are more – the way the lifestyle is, we tend to expect to complete 36 hours of work in a 24 hour day. There's very little respect for life and the quality of life. A simple example would be that the human biological sleep cycle is diurnal. We are supposed to be sleeping twice in a 24 hour period. And if you look at most of the world, they respect that second dip. If you look at all the blue zones around the earth where people live quality of lives, for long lives, and they also live the longest. There are seven blue zones on the earth; they always take a nap between 1:00 and 3:00 in the afternoon because it's rejuvenation and a restoration of the body.
In fact, Harvard published a study about nine years ago where they looked at the effect of the sleep cycle and napping, and found that it increased performance, productivity, memory, health. And a lot of Fortune 500 companies around the country went ahead and added nap rooms. Ten percent of Fortune 500 companies still have nap rooms. This is respecting our lives. You know, we could be eating while we're standing and doing ten other things. This concept of multi-tasking is considered to be socially a skill. We talk about that as a skill that you can eat, you can tie your shoe, you can pet the dog and do the kids' homework at the same time. Right? And it also takes us away from a mind which is being mindful of what we're doing; mindful of what we're chewing and how we're chewing and what we're tasting. So we live life in this pace which is not a pace that's sustainable if we want to have healthy, quality lives.
Betsy: I can imagine somebody on this call would say you know what? I'm going to start an initiative in my company. We're going to have nap rooms. And they get the CEO and he says yay, nap rooms. I can see the business case for it. The nap rooms are put in and nobody uses them, because it's so kind of [inaudible].
Dr. Pati: It's anti-cultural.
Betsy: Why would we not do them? Because we know some of this stuff. We know that technically the policies don't say that you have to work this many hours, but we do. The policy says you get this much vacation, but I think the majority of vacation gets unused. Most people don't use up there vacation time, or if they're on vacation they feel like they need to stay connected to their office. So what's up with the US corporations that may have the policies that seem to support what you're saying; but the practice? People would be like I'm going to lose my job if I do any of this.
Dr. Pati: Yeah, our culture is that way. They've actually done some studies now to show that the 35-hour work week is more productive than the 45-hour work week. There's a lot of cultural things that we have that we're slowly starting to become aware of, and it's a slow process. It really is. I agree with you that people may not use it. I think as awareness goes up, as you do this show and it goes all over, and you start to educate people and get them more aware of things, I think that people start to realize that if we don't dial back we will get sick. And it's more than just burnout, because burnout is very much the first step to the rest of the diseases that come when we don't have enough fuel, if you will, to maintain the body.
Betsy: So I'm scared to ask: what's next?
Dr. Pati: Well what happens is as these systems fall, inflammation in the body goes up. And usually we don't see it in the first year or two, but after five to ten years the genes start to alter. Remember, we now have great data and great news about the fact that our genes do not control our destiny. We get to control our genes because promotor and suppressor regions of genes are turned on and off by factors like zinc, selenium, melatonin, what you're thinking, whether you have mercury in your body.
So the fact is that we alter our genes by our behaviors and our environment and our nutrition and our hormones; and those gene alterations can lead to degenerative diseases. And they do lead to degenerative diseases. So really this is how we protect – our lifestyle changes is really how we protect ourselves from illness. And that is proven in many ways over the last 100 years.
Even by study, if you look at Dean Ornish's initial study thirty years ago where he basically showed that you can completely reverse atherosclerosis using lifestyle medicine. So he did before and afters, and there really was – it was better than any stent could ever produce. It was complete reversal of atherosclerosis in the cardiac system utilizing a model where he basically put people on stress reduction daily, 30 minutes of exercise – moderate walking, intimacy and love and time for intimacy and love, and a balanced nutritional program with less than 10% fat in it. That was all he did to reverse this.
Thirty years later he asked this really interesting question. He goes well, if we're reversing disease I wonder what we're doing to the genes? So then he took 30 men who had prostate cancer and decided not to go through conventional therapy, and he put them through this same lifestyle program. And within 90 days, three months, 500 genes that control prostate cancer had either been turned on or off in the positive direction based upon the heat map technique that they had to measure it. So you can literally see before and after; there's 500 genes that have been altered in 90 days using just lifestyle modification.
Betsy: So basically burnout is a medical condition. If you work on your burnout, not only will you resolve those symptoms and the root causes of that, you will actually prevent yourself from getting significant diseases later on.
Dr. Pati: Yes. And in order to get through it though, especially for people in their 40s and 50s and above, you've got to fill the tank back up. You've got to get the hormones back up; you've got to get the nutrition back up, while you simultaneously work on your lifestyle so you reduce the demand.
Betsy: So I'd love to get your actionable tips in each one of these aspects of the five point model that would be relevant to every high achieving woman who feels that she's experiencing burnout. Like what would be a couple things that she could do in each one of these categories that would work for everybody?
Dr. Pati: Okay. It's rather easy to put together something that's basic. The first thing one would do hormonally is get your hormones measured. I usually measure them before 8:00 in the morning. Make sure that you go to somebody who's going to interpret them into the optimal range, not the normal range.
Betsy: So how do you find that person?
Dr. Pati: You need to be up above the 75th percentile, so people who practice function medicine or restorative medicine generally know that. So they're not waiting for your thyroid to get to zero before treating it. We're going to treat it when it's lower than it should be.
Betsy: So here in Orlando I know for sure I would highly recommend SaJune, which is your clinic that I love. I love just going there because it's beautiful over in Baldwin Park. And I think you're opening a second one too, is that correct?
Dr. Pati: Yeah, we have places that are opening around the country. There's a few on the horizon: New York and in the Maryland area, and L.A. There are a lot of doctors who practice like us also.
Betsy: What do you Google? What do you look for and how do you know it's a good one and not somebody who's – how do you know the difference? So two things. What should somebody Google for to look for somebody like you? And then how do they know who's a good one that you would recommend versus who you wouldn't – or you'd kind of feel like ehh?
Dr. Pati: That becomes a little bit challenging because there are a lot of people who are doing bioidentical hormone therapy. You can type that in and you'll find them. There are less people that are utilizing a comprehensive holistic model, where they are tying in the effect of the mental and the physical stressors and dealing with that in a primary fashion so that you really reverse disease. So you're looking for somebody who's doing kind of all of these things, and sometimes you end up having to ask a lot of questions to understand how they would do that.
We do see patients from all over the country. They have to come and see us in person once a year. So it turns out that even though I'm in Orlando, we actually have about 50% of our patients are coming from outside of Florida. And about 30% - 40% are coming from six hours away from Orlando. So they come once a year; it's not the most convenient thing. I can't wait for the day when I can actually have a list of doctors that I think are using the full model. Especially with the training programs we're doing; we're starting to see more and more cities with people using the full model. We have a place opening up in Naples as of the end of the month; Naples, Florida. So I think what they'll find is over time more and more people will be practicing this way. Initially it will be a little tough to find people like that.
Betsy: So the trick to hormones; you need to get them tested. Find somebody who's got more of the integrative approach. I'll tell you who to ask. I asked my OBGYN. What was ironic was when you and I were first talking I was walking out of the OBGYN and I was like oh, I feel so burnt out. And then I went back for a follow up appointment and I was like yeah, I found this and I'm working with this person. And he was oh, she can align your [inaudible 00:43:38] for you in this way? And I was like maybe.
But I don't know. You've got to be careful of the medical doctors because I think they're going to poo-poo this whole thing. Is that correct?
Dr. Pati: Yeah. I mean it turns out that there's plenty of data at this point on every part of this model. We know that it takes about 20 years for science to transform information into actual action that people have access to. So unfortunately there's quite a bit of legwork on the part of people who want to address these things. But I think it's going to become easier and easier, because most people are realizing that they don't want to be sick. And our medical management approach has no other way to go except for to give us one drug to take care of the side effect of the other drug, to take care of the side effect of the other drug, and so on and so forth. So therefore a lot of people do come to us. Any time somebody calls from afar and we know somebody in that area who can see them, we automatically tell them about who they can see local.
Nutrition wise, the things that everybody in the whole world agrees about nutrition are three things. And this is according to David Katz from Yale University, who heads the integrative medicine division in Yale. Because you know, it's easy to get confused about nutrition. And the three things are that you eat real food, eat less, and eat more plants.
Other than that, the actionable item for you would be that you measure your nutritional profile. There's a test called SpectraCell; it's covered by Medicare with a co-pay of $88. All other insurances the co-pay is $190. It's a very detailed test; tells you exactly what you need. So do I need B1, do I need B12, calcium, magnesium, CoQ10? What do I need? So once we get that result we're able to share with you what kind of food changes you could make, because food should be the primary mode of getting these nutritional values up. Sometimes we use supplements initially to try to boost them up a little more quickly, but at least they're directed at what your status is.
So measure your hormones, measure your nutrition, get them corrected to the 75th percentile.
Betsy: [Inaudible 00:46:10] magnesium and B12 are something that everybody is depleted in, is that – can I just go to – should I just go ahead and take it before I’m waiting for the SpectraCell assessment?
Dr. Pati: Some people I recommend it depending on what kind of symptoms they are. I find that most people are highly motivated by looking at their numbers, but there are some guesses that I make. A lot of people don't look at the numbers, and I can be fairly accurate if I see what the hormones are doing as to what they need. So sometimes we direct it.
But I think it's better to take nutrition directed by someone; that makes sense. If there was one nutrient, or two nutrients that I would say everybody is needing right now ubiquitously, it is magnesium and B12; those are the two big ones that I'm seeing.
Betsy: Does B12 come in a shot? I remember getting it.
Dr. Pati: B12, if you're above the age of 40–45 the absorption goes down so you end up having to use a sublingual or a shot. Toxin wise the most important thing there is to flush the body daily with 100 ounces, not 64 ounces of water with lemon and mineral salt. So pink salt. Why do we do that? It's because we're re-mineralizing the body. Under stress the body de-mineralizes automatically.
Beyond just drinking 100 ounces of water, the next level of stuff we do is look at your gut and your bowel, and look at the pH in the tissues. Because the pH and the bowel are the two things that help you eliminate toxins. And as you may know, there are more bugs in our body than there are human cells. So we have almost 40 trillion human cells and almost 40-plus trillion bugs; so we are sort of a bug farm. And it's very important to realize that these bugs, if you will; they're microorganisms, bacterial mostly, play a very important role in our neurotransmitters, our nutritional function, our communication between the gut and the brain which you guys may have been hearing about.
So the actionable item in toxins would be flush your body. Your body is over 80% water; flush your body. We all drink too little.
Betsy: So with the water; you said water, mineral salts and lemon.
Dr. Pati: Yes.
Betsy: Is there a proportion? I'm not a great cook so I don't.
Dr. Pati: I usually put – you know, I prepare it in the morning, 100 ounces of water; and then the salt is to taste. When the body needs more minerals you'll want more. And I usually put one lemon per day. You could make the argument for two, but I put one a day.
Betsy: So you just get 100 ounces, squeeze a whole lemon in it, and just salt it until you kind of taste it and then you're good?
Dr. Pati: Yes. And if you're an athlete and you want to turn it into something that would really help kick your energy levels and so on, you put a pinch of bicarb, you put a little bit of ribose, which is a sugar. Which is basically our muscle sugar and cardiac sugar. So that's kind of what I call adrenal aid; it's my stress buster aid. It's coming out in our newsletter actually this month.
But it's obviously relevant in the summer time when most of us do get dehydrated and don't realize that many of our symptoms, like even weight gain, can simply be because the body's pH is too low because we're not flushing it. I've seen people raise their water intake and drop weight just by doing that.
And then as far as mentally and physically, the main thing I ask people to do here is the simple things. Balance your life, say no to more things, engage in the things that raise your vibration and your joy, reduce all the others, do a workout that's consistent with your stamina and energy level, sleep, respect yourself, fill your life with joy. I usually suggest about twelve weeks that you dedicate to this. And actually since we're doing this at the beginning of the summer this would be great. July, August, September; it's all about me.
Betsy: That's a great way to think about the wrap up. It's like all of this is all about me, but right now dedicate the summer to be all about me? That's awesome.
You mentioned the mind and the stress reduction, and you mentioned some of the stress. Is there any stress reduction technique that you can do when you have that anxiety? Because sometimes I feel like it's hard to get all that higher vibrational stuff because the anxiety is getting to me. Like oh my gosh, I've got to get to this, my to-do list; that fight or flight thing seems to be building up. What do I do with that anxiety that keeps me from wanting [inaudible 00:51:16]. It's like yeah, yeah, yeah kids, I know you want to go swimming in the pool but Mommy's got to get these ten things done.
Dr. Pati: Well go back to the slide of the lady in the air and I will lead you through an exercise. This is one of the simplest exercises. It comes from a technique called heart focused breathing that was developed by the HeartMath Institute in California. And the power of this became clear when we realized of the last 10-15 years that it's actually the heart and the heart rate variability that control the brain; not the other way around. So whereas it could take you 60 minutes to get yourself into what's known as a calm brainwave using mind mechanisms, using a mechanism going through the heart, which I'm about to lead you through, you can achieve the same thing within anywhere from thirty seconds to five minutes. And I ask people to do this exercise twice a day; three to five minutes in the morning, three to five minutes in the evening, and thirty seconds anytime life is about to throw you a curve ball that you can see.
So what I'd like you to do is close your eyes for a second. And breathe consciously, a little deeper than normal. Inhale and exhale. Breathe into your heart and out of your heart. Imagine the air flowing into your heart and out of your heart.
I want you at this point to think about something that gives you joy, fills you with joy. It could be sitting on the beach, it could be dancing. For me it's this lady up in the air. And I want you to – as you breathe in and out of your heart, think about what that moment feels like. What does it sound like? What are the sounds in the air? Is there water, are there birds, is there a fan? What does it sound like? What does it smell like? Are you at the ocean; are you tasting the salty air? Continue to breathe, consciously, in and out of your heart.
As you do this exercise there's a certain coherence that happens between the heart and the brain. You can measure this by getting an app. We did about maybe 30-40 seconds, Betsy? You extend that to three to five minutes. That's the simplest mechanism; there's a lot of other mechanisms we use like guided imagery, audios. We give you an audio that's four minutes that's specifically for your situation, and we ask you to listen to it for twenty-one days in a row. Because it takes about twenty-one days to reprogram the subconscious.
So it could be something like, you know, somebody who’s trying to solve a sleep issue and we've done all the normal, physiological things; corrected the magnesium, corrected the progesterone. But there's a program where maybe the person will say hey, I've never slept; I've always had sleep issues. So what's happening is that belief system is very deeply ingrained. And to reverse that tune you do have to work with the subconscious, and the technique we would use is have you do this technique. We would give you an audio specifically for you that you would listen to for twenty-one days.
We use these techniques for people with cancers to help them revert the cells to normal, people who are anxious about their children to imagine their children healthy, happy and carefree. There's many ways to take this. But I would say that if you guys look up HearthMath.org you will see the incredible amount of literature that has developed over the last twenty years showing the effect of this heart focused breathing on the body.
But more importantly they've found that when you put your heart into a coherent sign wave you simultaneously affect the heart rate variability of everybody who's around you. Most of us know that if somebody walks into the room with a rumble that everybody's in a rumble. And if you walk into a room in a state of calm and your heart rate variability is in a sign wave – and the way they figure this out is by attaching the monitors to people and looking. I found out that even it affects your animals. I happen to have five dogs that used to fight with each other pretty frequently, and as I learnt the technique I started using it near them, especially when they were in a rumble, and there's no question that it totally reduced the little rivalry that they have sometimes between them.
So this is a very powerful mechanism. When people learn this, even if they do not teach it to their family members but they use it, it starts to affect the whole family. Most people come back and tell me; you know, the whole family is affected by this. So you can literally take this and expand it to your energy, anxiety; replace the anxiety or fear with something you're grateful for, or anger with something you're grateful for. And as you start projecting that, that's the projection for your future. And it's also changing your heart rate variability. So that's a simple example of one exercise.
Betsy: So if I were going to wrap up everything that we've talked about today, here's what I think I heard you say. And let me know if I missed anything really important. Thing one is that your burnout is – you're not crazy or lazy, there is a biological thing that's going on.
Dr. Pati: Yes.
Betsy: Thing two is it's much more complicated than we think it is. So unless you appreciate all the things that are underneath the iceberg; you don't want to deal with symptoms like anxiety, anti-anxiety medication or anti-depressant. You want to deal with the root; because the five points that should be working together optimally that are not. There are some things that we could do on our own but it definitely would help us to go get an official diagnosis to see what's uniquely out of whack in our own bodies. Because everybody is different, but our unconscious is directing a lot of the show. So even in terms of getting the help in resolving it, dealing with some of this unconscious; getting our heart in a better place is a big part of it.
And then I think the fifth part that I think is really impactful to me is doing something about it is more than something for me. It's really an act of preserving – public service if you will.
Dr. Pati: Yes. It's a public service. That's a perfect way to put it.
Betsy: So dealing with my burnout is so important for me because if I don't deal with my burnout more significant disease is in my future. If I deal with my burnout then I not only reverse that potential of having those diseases, I can create a better experience for me and bring in and manifest something more significant for myself; but I also affect my immediate family and the people that are around me in a positive way.
Dr. Pati: Exactly.
Betsy: Wow. This has been wonderful. Any last minute concluding thoughts that you would want to leave those who are watching or listening, or are reading the transcript?
Dr. Pati: We all have our best life in front of us. We need to grab it.
Betsy: That's great. Thank you, thank you, thank you Dr. Pati. This has been wonderful.
Dr. Pati: Thank you. I really appreciate what you're doing. You're an amazing woman.
For Reflection and Action:
- Are you experiencing unusual amounts of stress and exhaustion?
- Do you think you could be dealing with the medical condition of adrenal fatigue (aka burnout)?
If you are dealing with burnout - my suggestion is to you is to not wait to do something about it. It's only going to get worse. I have other articles on burnout on my website that you can read to help you validate that you're not crazy or lazy:
- Why High-Achieving Women Burn Out
- 4 Soul-Sucking Myths About Burnout and How to Debunk Them
- Why You Secretly Resist Work/Life Balance
But if you want to take meaningful (and soul-plenishing actions) to restore your vitality, let's chat. Schedule a free intro call with me and I'll help you figure out what to do next.
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