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Aviva Romm knew at 14 that she wanted to be in the medical field. Starting as a midwife and herbalist she then returned to college and got her MD at Yale. She is a Trojan Horse for functional medicine perspective in a traditional medicine world where she is successfully changing it from within.
How you are feeling right now?
Aviva is able to look at the problems women face and work simply with their positive mindset, circadian rhythms, food and environmental factors. Solutions start with checking in with yourself. Moving on to a more positive mindset and learning to manage negative emotions. Everything is connected and her goal is to use some of what she learned as a midwife to really listen to her patients and bridge it with scientific fact and medical knowledge.
The Adrenal Thyroid Revolution
Cortisol is your frenemy. We cannot live without this all important hormone. Looking at stress from animals in nature, we see benefits in small doses and then can return to going about our business. The pattern that many find themselves is being out of sync with ourselves and the rhythms of our bodies. Stress run amok causes serious damage in the body. Cortisol as our friend, in small doses for short amounts of time is the feeling of joie de vive. Check out some easy steps to get back in sync.
– Welcome back to the Urban Monk. Dr. Pedram Shojai here talking about multi system breakdown. I’ve had a lot of health content come on to the show. We’ve talked about a lot of things. The one thing I can say for sure is it is complicated. There are so many things happening right now with our environment, with our stress, with our food supply that cause so many issues from the microbiome to our hormones and everything. This one size fits all answer for a single kind of lane is really not going to serve humanity. The world has become a lot more complicated. And our solutions need to look at things in much more of a stacked layered way. With me today is Dr. Aviva Romm who is actually has got a great history because she was a midwife herbalist who then went back, went to Yale and became a medical doctor and really got the training to validate what she was doing outside the system. Now in the system and really working to change the system because really the system is broken. We are gonna talk about her new book The Adrenal Thyroid Revolution, which is awesome. And also just talk about why so many people don’t feel well and how we need to look at it. Hey welcome to the show.
– Hey, it is so great to be here. I love how we can be at a distance but be in the same place. It is so incredible.
– Totally, totally. That’s my thing. It is like having high tech camping gear. Like you go, you enjoy nature. You enjoy the people you are with and the tech makes it all possible. So welcome you are now in my California studio.
– Thank you hey everybody. It is nice to be in California.
– Yeah exactly, well you know what? I am sorry but it is raining right now.
– Actually here too.
– Is it? Okay we are so fair. I want to get a little bit into this history a bit more. What made you suddenly go, you know what? That’s it, I’m going to medical school. That’s a serious decision later in life.
– Yes, this is actually a really different path kind of story. So back story, which kind of relates to the book is that I grew up in New York in a housing project with a single mom and was wicked smart as a kid. Big vocabulary, science fair winner, spelling bee winner and discovered that I could get out of my housing project by applying to college when I was 14. So I actually went off to college, I got in, went off to college at 15, planning to do premed. So this was already kind of like a premeditated med school adventure. And my first semester there, this was 1981, I’m kind of dating myself here, but 1981 all of a sudden I was learning about food politics and healthcare politics. The big agricultural chemical, military industrial complex and I said wow I don’t want to really be part of that. What can I do to make changes? So I went vegan. I bought Chinese slipper so I didn’t have to wear leather anymore. And I decided to take my own healthcare into my hands. And the way I did that was deciding to study herbal medicine and midwifery. So at the ripe age of 15 and half I left college, apprenticed myself to a midwife, studied everything I could get my hands on at herbal medicine which back in 1981 nobody really knew what that was. They were like three books on the market. And then crafted this whole life career out of that, out of being a midwife and herbalist kind of an environmental advocate and had my own family. But at some point, I guess in my maybe in my mid-30s I realized that I was at a point in my own life where I could probably make more change by understanding the language of the system that I needed to change and having the sort of power elite if you will that MD does actually put after your name in terms of making change. And Yale MD certainly opened a lot of doors and it gave me an incredible foundational training in science so it was that desire to make change and saying you know what if I am still far outside the system as this sort of alternative hippie homebirth midwife, I can preach to the choir but if I really want to have a big impact, I need to take that road and so I did and it really it has actually been a quite powerful tool for amplification of my voice and my message where I can more easily be on CBS News or Dr. Oz or just have a larger reach and at the same time was able to be instrumental at Yale in setting up an integrative medicine program there. It was the first program at Yale ever for the medical students and I still rate the curriculum for the medical residencies in pediatrics and adult medicine that are used in a 150 different med schools. So to me it was like a total weird but calculated political move to go inside the system to change it.
– Totally, you just Trojan Horsed all your health and hippie stuff into the establishment. Nice move.
– That is so funny. That is exactly what I say. I get up on a stage of 500 doctors and then I’ll just be like yeah I so look like this nice, gentle doctor chick in my little cute suite, but you have just invited a Trojan Horse on to your stage.
-Yeah and that’s what it took.
– It did and there are some big issues that are really facing us. If you think about antibiotic overuse, it is one thing to be a sort of hippie homebirth herbal midwife and tell a mama that her child doesn’t an antibiotic for that ear infection when the pediatrician is saying well if you don’t, your child is gonna go deaf and die, which people really do tell parents this kind of stuff. And for me to say you know that is just not what the evidence is and actually this is completely inappropriate. And 70% of all antibiotics prescribed in the United States are completely inappropriate. So to have that sort of science behind me and the authority for me I just want to use it as like a power tool for good.
– What’s different now? Okay so you are doing your practice and then you went to medical school. Has it changed your world view at all? Has it solidified and kind of amplified what you were doing then or did you go oh shit, I was really wrong here, how are you different than the person that went in?
– Yeah I think a number of things. One is that it really actually has solidified. A lot of people say to me, how have you changed from being a midwife and an herbalist to being a doc because that’s a pretty different end of the spectrum in terms of philosophies and beliefs but I think that one of the biggest areas that patients in general that human beings in general when we go into the medical system feel is lacking is that we are not being heard. We have these rushed five or seven minute appointments. We get a prescription but there is very little eye contact. I know what my patients children’s names are. I had a patient last year. I was like how’s your dog that was sick? That kind of relational care that really is the heart of mid-wifery training that I brought in with me. And then as an herbalist we really take a much more broad view. We don’t just say oh you have insulin resistance. It must be problem with your pancreas. Let’s just give you some medication to help your insulin levels. We think okay what is actually going on? What are the whole system perspectives that we need to look at that include environmental issues, food, lifestyle, stress, how we think, what our backgrounds are and what our thought processes are. And how that impacts our decisions. What are our economics? All of that. And I think I was actually able to bring that into my medical environment and come out the other end with that as well as a whole new set of tools. So it has really amplified what I was doing before but also added to it because it has given me a whole set of research epidemiology skills that have really allowed me to look at the medical literature. So when a new study comes out that says statin drugs are the answer to everyone’s cholesterol problem and all that stuff about diabetes isn’t true, I know where to go and dig into whether it is the Cochrane report or Pubmed and say you know what this looks like smoking mirrors from a pharmaceutical company and I don’t want to impute ill motives to individual doctors because most of the doctors I know are really quite caring, compassionate, dedicated people who have spent anywhere from 10 to 16 years of their life getting their education very intentionally. But unfortunately too often physicians are over stressed, over busy and unwilling kind of become puppets or marionettes in a much bigger industry which is a medical industry and a pharmaceutical industry that really does drive clinical decisions that happen with each patient. I don’t want to get carried and so quoted but at the same time, there is enough evidence that shows that for example articles that are published in pharmaceutical journals are often created by the pharmaceutical companies.
Sometimes the evidence is really cherry picked to show what worked but to completely exclude the harms and the hazards. And sometimes those articles are ghost written by doctors who are just called up and said hey you know we will pay you $30,000 if you’ll put your name on this article that has already been written to prove that our drug works. A lot of people think that that’s kind of paranoid or propogandous talk. It is not, it is for real. And so we have to have people like me and there are others like me who are sort of as you say that Trojan horse, the people who are willing to say you know what the emperor actually isn’t wearing clothes all the time at least. And we have to I think the other thing for me is it has really empowered me with the knowledge of my training and my education to be able to say to other people you have to question authority. You can’t just say yes. You can’t just assume that mistakes aren’t gonna be made. You have to double check because there are mistakes that are made in hospitals and doctors’ offices. Yeah it’s been a hugely empowering experience and I feel like my goal is to do everything I can. Einstein said something like if you can’t explain it simply you don’t understand it well enough. My goal is to understand what is working and what’s not working and help the individual who doesn’t necessarily have the time or the knowledge or the training to sort thought the morass of information and misinformation so that folks can make really smart decisions for their healthcare.
– It is hard. I mean the healthcare industry has been productized. So there are these very known, very well profitable verticals where it is like hey listen, once they end up here, then they are on these meds for life. It is great business and so no one is really looking at these multi system approaches because in some ways, it is robbing people of customers and so the good doctors of the world have learnt to swim upstream and really let the healthcare business fall on its own phase and be like okay look I’m here to help you. I’m here, I’m committed to helping you. So now let’s look at this. When you do that, and when you have one of these complicated things called a human in front of you, how is this adrenal thyroid access, the connection between these glands are affecting our health because that really, this is new and this is a newer understanding of health and it was so compartmentalized for so many years.
– [Aviva] Exactly.
– I think this is the future of medicine.
– I think you hit on it in so many points Pedram but let’s pick up with the world compartmentalized. In medicine, we are trained in what are commonly called health silos. So you’ve got your gastroenterologist for GI. You’ve got your endocrinologist for hormones. You’ve got your psychiatrist for mind and mood. You’ve got your cardiologist for your heart, so on your obstetrician for your pregnancy so forth and so on. And what we were taught in medicine is that your diagnosis starts the day you get, your disease starts the day you get your diagnosis. If you go to your doctor and you have high blood sugar and you are diagnosed with diabetes, your diabetes started right then and you get sent to your endocrinologist for diabetes care. If you come in with a heart disease, you come in with a heart attack, okay your heart disease started right then and you are funneled off to the silo of cardiovascular care where you have your heart doctor who cares for you. And a number of problems happen because of this. One is and the big one is that we are never looking at the why. And so we end up in what you talked about, the sort of vertical of odd infinite items stuck on your medication because we are basically taught that diseases are random, they are bad genetics. There is nothing really we can really do about them. They are bad luck. Or there’s some bad habit that you have that landed you here. And without looking at the underlying or root causes the things that connect, we never really get out of that sort of perpetual search for a quick cure and that quick cure is never quick. You end up on it long-term. You are always on your statin drug. You are always on your antidepressant. You are always on your antihypertensive or your anticholesterol drug. People don’t usually ever come off of those because we are never taught that we can. We are kind of raised with this idea that our bodies are lemons and eventually there’s something just gonna go wrong and then you fix it with a pill. What I have learnt and this really kind of comes from a field of science that is the most fascinating to me. It is called psychoneuroimmunology. It is the field of science in a sense basically says everything is connected. We know for example that on our nervous system cells, we have receptors for immune system cells. On our immune system cells, we have receptors for chemicals that come from our nervous system. It is a very fancy way of saying that there is proof for example that was going on in our mind or emotions affects our immunity. What’s going on in our immune systems affects our emotions. So if you have a lot of inflammation, you produce these chemicals for example that are exactly the same chemicals that you produce called cytokines, right before you get the flu. So if you’ve ever had that experience like you feel kind of lousy for a few days. You are even feeling maybe a little down, a little tired, a little achy or you are like what’s wrong with me. And then on the third day you have a fever or you have a flu and you are like ah that’s what it is. There is nothing wrong with me. I was getting sick. Those same chemicals that we’re producing when we were having this inflammation all the time from environmental toxins or foods that don’t agree with us or just the standard American diet or stress can actually cause us to feel depressed or anxious but what is our doctor saying? Oh no depression and anxiety, that’s just a problem with your moods or your coping ability or its genetics. Here take an antidepressant when we know that 30% of people with depression have inflammation that is actually causing the depression. Or another example is our gut. You mentioned the microbiome earlier. We know that things like that, idea like oh I feel it in my gut or I have butterflies in my gut or I can’t stomach that.
These expressions that we say that kind of instinctively connect the emotions or what’s going on in our feelings and the gut aren’t just expressions. We know that as much information is going from our brain to our gut is as going from our gut to our brain. So if you have disruption in your microbiome because you are under a ton of stress or because you are not eating well or because you’ve had too many antibiotics over the course of your lifetime, those changes what’s growing in your gut. Your microbiome can be producing gases and chemicals and changes in your immune system that can make you feel depressed, anxious, irritable, moody, forgetful and similarly things going on in your brain can be impacting your gut. And every single system in our body is interconnected this way. So I started seeing these patterns, not only in my patients but observing what’s going on in the world at large. Articles have now been written about this epidemic of overwhelm that so many of us are under. How fatigue is rampant but not just that. Gut problems, IBS, autoimmune disease, anxiety, depression, cognitive problems. The list goes on and on and on. And what’s fascinating is when we break it down, we can start to look at these root causes. One of sort of the mother of all root causes that I turned up in my psychoneuroimmunology research over the past 12 years now is this adrenal stress access. It starts in the brain and it works its way from these two little parts of our brain called the amygdala into what’s called the HPA access. It is the Hypothalamic pituitary adrenal access. Two glands in the brain and one that sits on top of each little kidney. The really cool thing is that we have this hormone that we produce called cortisol and we think of it as a stress hormone. But what is amazing is that cortisol is like the conductor of an orchestra. And what the orchestra is is literally every single cell in your body. Every single cell is primed to have its own rhythm. Like its own time of day that it is doing certain functions. And it listens to cortisol, which is connecting your brain and every cell in your body as to what rhythm it should be in. What’s the hormone that gets disrupted when we are either under stress or just sort of living out of harmony with our own authentic rhythm or our own authentic self or when we are under stressors that are coming from the environment you mentioned a number of these food intolerance or food challenges, environmental toxins when you first were introducing me and introducing this topic and all of those compound to disrupt the system. And really what’s happening is the human being has this incredible capacity to adapt. And the whole system that controls out ability to adapt is that hypothalamic pituitary adrenal system, it allows you to adapt to stressors but our 24×7 lifestyles and the 80,000 chemicals that are in our environment and the 20 rounds of antibiotics that we get by the time we are 18 years old that impact our gut and the toxins in our foods and the lack of nutrients that we are getting, the lack of sleep that we are getting on and on has created a gap between our evolutionary ability to adapt and what we are being forced to adapt to. And the book and what I do in my medical practice is really helping people kind of return to a rhythm that allows that body’s natural ability to heal and adapt to resurface.
– God forbid you suggest slowing down or destressing. That sounds horrible. I want to keep the shitty life that I have and just give me something to fix it is really the problem. There’s a number of things in there. Cortisol, everyone is kind of considering cortisol like this bad guy. I think cortisol stores belly fat. Therefore it is bad. So the underlying understanding of what the symphony in this orchestra are about is a much richer read into what’s actually going on here so I think the health media tends to also compartmentalize and be like give me a buzz word. Coconut oil. That’s what we are talking about this year. And so that I would love to tease that out a little bit more. For me personally, I love this idea of the kind of time rhythm and the biorhythm of the body being able to be influenced by this because what we see is stress to me is also time pollution and time compression and not understanding when to slow the hell down.
– Exactly, you nailed it. I mean we got to write the next book together or do like some, we got to take this on the road. Cortisol in my book, I call it your best fried of me. And I have reframed calling cortisol a stress hormone and started just calling it a survival hormone. First of all it is the only hormone in your body that if you stopped producing, you would die. You cannot produce thyroid hormones very much and you’ll function and you’ll feel awful, you could kind of stop producing testosterone for the most part and you won’t have really much sex drive and you won’t feel very energetic. But you just stop producing enough cortisol and your blood pressure goes away, your immune system goes away. So I think of it as a survival hormone and I really want to help us all think of our bodies as our best messengers and our best friends. That is a weird corny way and it sounds kind of corny when I say it but your body is and your brain are here to help you survive and thrive but what happens is when we push our compensatory mechanisms too far we can’t compensate anymore. And I’m a really driven person. I went to med school with four kids, three teenage daughters ran a 1200 member non profit that I brought up to a 2000 member non profit. Wrote a text book and started what is now a seven figure business while I was in med school at Yale. So I’m a freaking maniac but the secret to it is is one learning how to love your stress. Learning how to use stress as something that helps you thrive because cortisol, the influence of a small amount of cortisol and the influence of a small amount of adrenaline makes you feel excited, focused, energized, happy to be alive, pushes you toward a little bit of risk taking and it really is tremendous. It is that feeling when we were a kid and we know we are going to the circus that day. It is that anticipation, excitement, joie de vivre. What happens is when we start producing too much of a good thing, because we are not giving ourselves what I call permission to pause. It is about adapting so it is about pushing and stopping. Pushing and stopping. High performance athletes know this. I don’t think Michael Jordan or Michael Phelps or the Williams’s go out on the court minute after minute after minute. They know that they have to train heal and rest, train, heal and rest. Partly because cortisol is produced a lot in high performance athletes and it is a wear and tear hormone. So the secret to me of like longevity, high performance, really living your life to your fullest in this day and time and heck, stress is not going away. We are not gonna dial back to some cavemen time where the fire goes out at 7 o’clock and we all go to sleep till the light comes out up again in the morning. That’s not gonna happen. So how do we learn to live with it and to me it is knowing how to contract and expand, contract and expand. Push and rest, push and rest. And really staying dialed into two things. How are we feeling like really checking in with our bodies, how am I actually feeling. So many people get so busy. They don’t actually feel how they feel and then the other thing is dialing that bigger rhythm, dialing into that bigger circadian rhythm that we mentioned. So the circadian rhythm is a 24 hour cycle and our hormones, circadian means around the day. So circa diem. And our hormonal response is primed to cycle around that 24 hour rhythm so that primitively were weren’t hungry and needing to go to the bathroom or having the desire to hunt in the middle of the night. We were sleeping when it was dark but then when daylight came, we were primed to do the things that we need to do in the day. And it is really cool when you start to get into the very focus science of it. So you have different immune system activation at night because you are sleeping. You are not likely to go shake a bunch of people’s hands or encounter a bunch of dangers during the night time that are going to expose you to viruses and bacterias and parasites. So during the night you have a whole immune system activation that is detoxifying whereas in the day you have a different set of immune responses that are keeping you more protected. It is so, I totally geek out on this stuff. It is really cool. Similarly your digestive system is more activated in the morning during the mid day it starts to quiet down at night and then it is really your in rest digest phase as you get into the evening where your gut is repairing. You are not actively churning your food and breaking it down and you can go on and on and on. So how can we sort of live our lives a little bit more primed to how our, to sort of like if you think about like what our evolutionary expectation is. Simple things, it is really simple. Like shutting your electronics down for an hour or two before you go to bed so that you are not getting exposed to blue light that suppresses your melatonin. Then if you do that your melatonin goes up that helps you sleep but it also helps you detoxify your body and your brain of accumulated environmental toxins and accumulated toxins just from the breakdown of our own biochemistry that’s happening all day long. That’s a big thing, is observing that rhythm.
– There’s a piece to that. This kind of this notion of self awareness that you are evoking here, which is how do I feel right now? What’s going on? There’s to me and my experience there’s been a certain macro that gets double clicked on when someone accepts that because then it is like how am I feeling right now. I’m not feeling well, what is that from? Oh man, I bought that muffin thing at Starbucks as I was passing through and I didn’t look at the ingredients and so for me to actually check in with how I am feeling and be accountable for that means I now have to have personal responsibility for all of these inputs and it is overwhelming. I get that a lot with the patient population in particular like it is just overwhelming. I feel like everything is poisonous. Everything is stressful. I don’t know where to start so instead they just keep suffering and sliding. So I’d love to hear what wisdom you have for someone who’s facing that?
– Yeah that’s such a beautiful question. So one of the big principles for me is it is also very overwhelming to be sick. And it is overwhelming to not feel well but I think we are accustomed to that overwhelm so we sort of sweep it under the rug and we take the next ibuprofen and we drink the next coffee or the next Redbull and at night we are accustomed to the two glasses of wine and two hours of TV to wind down. I think we are actually really overwhelmed as it is. And I really truly believe it is a pay now or pay later situation with your time and your attention. Once you learn how to make these lifestyle changes and food changes, they are quite easy and as you have more energy and feel better and sleep better, I promise people who are watching and listening you will be so much less overwhelmed because you’ll feel great. The other thing is that and this is particularly for women in my experience is that when we don’t feel well, we tend to be full of self blame and self loathing. What am I doing wrong? What can I be doing better? What shouldn’t I have done? What should I do? What’s wrong with me? Why is my body not working? First of all those thought processes are exhausting. Second of all, they just activate the stress response and make us more likely to do the thing. When you are beating yourself up, you want comfort. Where do you get comfort from? Another muffin or another glass of wine. So I think overall my message is really if you stay replenished by making these changes and in the book and in my practice, I use the KISS method, which is keep it simple sister. And how do you just make this a new lifestyle and thousands of women I’ve worked with say yeah it is a little bit of a learning curve but damn when you feel great, you don’t feel overwhelmed.
– Arguably it is a hell of a lot more work, being sick and not feeling well. Than facing the decisions the little micro decisions you have to make to check those inputs and all that. And it kind of aggregates. On your kind of tagline of your book, it is about boosting energy, clearing brain fog, healing inflammation, and losing the stubborn weight. All of these are not kind of separate verticals. These are not separate books or separate lectures. This all falls under the same ecosystem of looking at how you address these master glands. Help me kind of understand some upstream here.
– Yeah so first of all the way I picked those topics wasn’t random. I actually have tens of thousand of women that follow me on Facebook and on my website. And of course all the women I’m interacting with in my practice and when I teach nationally. I actually asked women if you could pick four or five top concerns that you have, what are those? And that was really the basis for the focus of what I was gonna address in the book because when it comes to cortisol, because it really does impact every cell in your body and that circadian rhythm, that harmonization or synchronization of the cells with your brain, you could’ve picked anything. I could’ve picked autoimmune disease alone or diabetes alone or dementia alone. So try to pick things that most women were struggling with so that that would be the hook right. Everybody wants to not have brain fog and be able to focus and concentrate etcetera but basically when you are under the positive influence of cortisol, it is keeping your inflammation at bay. It is keeping your immune system really well oiled to fight infection but not fight your own cells. It is a really good differentiator between self and other. When you have a little bit of adrenalin you are producing, as I said you feel fabulous. You are excited. Your brain is focused. You are on it. You feel that feeling when you are sort of like cramming for a test. It is a little bit of stress, but a little bit acceleration that really or you are anticipating opening a gift. What happens is, what we are meant to do is produce that in a small steady amount pretty much all the time according to those rhythms in bursts when we need it. For example let’s say you have a toddler or you’ve babysat your niece or your nephew if you don’t have a toddler. And you leave a knife on the edge of the kitchen sink, I mean on the edge of the kitchen counter. And in your mind, you are thinking of this toddler as a tiny little person but they’ve grown and now they get close to the knife and you are on the other side of the kitchen and all of a sudden, you are like oh shit they can reach that. And they are reaching it but you realize you are too far away. If that instant burst of energy that gets you really focused really dialed in, that same kind of thing where you hear the stories of the person lifting the car off of their child to save them. It is like that incredible Hulk energy or Wonder Woman energy. The problem is, that reaction is supposed to last for minutes to maybe a couple of hours. You think about it in the animal world as the analogy I often use is gazelles around a watering hole and they are calmly drinking their water. They are in their pack or herd. They are hydrating. Then a pride of lions comes up. They get tense. The gazelle’s ears prick up. Their noses are flaring. Their nostrils are flaring because they are getting that scent and that’s a primitive trigger of danger for the gazelle. They run, the lions who are also in fight or flight because they are hungry, they want to catch their meal. They catch their meal. The lions go off. They relax. They are now eating their meal. And the gazelles they are not just sitting around. They are freaking out stressed out. They literally go right back to the watering hole and go back to what they were doing. This is how this reaction is meant to be heard and resolved. What’s happening for us in our 24×7 lifestyle is that we are pretty much being triggered either chronically or constantly. So it starts out jumping up to your alarm in the morning, having no time to take care of yourself, grabbing a quick meal or skipping your meal as a lot of women do. Starting your day with coffee not buffered by any good fat or protein. I could kind of run through we all know what the average American day is like until you finally fall in bed. Sort of unconscionably at night after a couple of hours in front of the TV and a quick check of your text messages or your Facebook page or whatever you are checking. And then you fall out only to do it the next day. And a lot of people are living for the evenings and a lot of people are living for the weekends but increasingly we are not even really turning off on those. So what’s happened is the survival mode, that is supposed to be activated for a short time its chronically activated and becomes too much of a good thing. Now what happens is when you get a release of adrenaline and a release of cortisol, they trigger a number of responses in your brain and your body. For example, energy in the form of blood flow goes away from your gut and your reproductive organs to your limbs so that you can run or fight. Your brain goes from conscious thinking, executive function in your frontal lobe to a much more primitive instinctive or reactive mode. You are just aware of the danger. It doesn’t matter whether you have to calculate your taxes right now. You cannot think about that. And you may try and focus on that but it aint happening because you are just clear and present danger. Your heart rate goes up. Your blood pressure goes up. Your immune system gets activated. Your awareness becomes what’s called hypervigilant. You are super aware of what can go wrong and you are constantly scanning consciously and sub-consciously for danger. These are all really good things. One important thing is your blood sugar goes really high so that you can send a lot of sugar to your limbs to run and you also produce a bunch of insulin at that times so that when the danger is over, the blood sugar goes back into your cells and it is not rampantly running around in your body causing inflammation and like little fires that are dangerous. No problem. That gets activated 20 minutes later or an hour later. It is resolved. Your blood pressure goes back to normal. Your heart rate goes back to normal. Your focus goes back to normal. Everything is resolved and you are okay. The problem is when you are chronically or constantly or frequently stimulating that reaction all those good things that are supposed to make you feel good and keep you safe and alive suddenly start to backfire. So for example cortisol is called the wear and tear hormone. Part of what it is doing is breaking down muscle over time to fuel because if you start using up your sources of energy from your stored blood sugar or some of your stored liver sugar, your body’s got to get energy from somewhere. So it actually starts breaking down muscle stores. You start to jack up your blood sugar too often and jack up your insulin too often and after a while your pancreas is going
– [Pedram] Enough yeah.
– Yeah enough, so your pancreas starts to produce less insulin. You start to get less responsive to insulin in yourselves. You develop insulin resistance. And you can develop metabolic syndrome or diabetes. One of the things that cortisol does because its protective against all kinds of primitive hazards that we might have faced in our evolution. It is especially primed to react to help you conserve energy. One of the ways it does that is just like if there were gonna be a famine and you were a king, you would store food in the granary, your body does the same thing but instead of storing grain in the granary, it stores fat around your belly. That fat is not just flubber or muffin tops. It is called visceral abdominal fat. And it is causing inflammation but it is doing some more things than that. That’s bad in itself but it actually sends chemical messages to your brain that makes sugar taste better. Make processed or any kind of simple carbs taste better and it also makes you crave them because your body is going well, I don’t know what the famine hazard is. We got to store as much as energy as we can so it makes you eat more sugar, eat more carbs and the tasting better just makes you want them more and then it confuses your brain from knowing when you are full, and when you are hungry so you can just imagine like all the problems that come from that. Go ahead.
– So we are running out of time and I really want to kind of unpack this a little bit more here is when someone is there and someone is in that kind of DEFCON 3 body crisis mode, it is just like holy crap, I don’t know when the warhead is gonna launch. How does someone come back from that precipice and start to train the brain and the visceral fat to say Yo it is cool. Go ahead and burn this and we can go by. That seems like the place a lot of people get stuck.
– Totally and it is exactly what you said. It is telling your brain Yo it is cool. And you have to start to, the first thing Pedram is that awareness. First of all we have to get to the point where we can say I’m feeling this way. And it is not really how I want to be feeling. So the first thing I ask people is how are you feeling and how do you want to feel? And I really have people dial into a moment in their life. It could be a moment that you are giggling with your kids. It can be a really great memory. It can be the feeling you get when you are looking at a sunset or you are in savasana at the end of yoga. Whatever that feeling is, when you are kind of tuned into something bigger. If they’ve never had that feeling, I do a breathing exercise with them to sort of bring that feeling up. And it is becoming self aware of when your feeling how you don’t want to feel and pulling yourself back into how you do want to feel and that just takes conscious practice but once you start doing it, you become more and more uncomfortable feeling how you don’t want to feel. So you spend more time trying to get to how you do and every time you do it gets easier. So that’s the first thing is that self awareness and asking yourself those two questions and it is a great thing to even just sit down and write down how do I feel how do I want to feel and then really make it your conscious intention in life to bridge that gap. It will not make you less effective. It will actually make you a more effective, more productive, more successful person. And so I highly recommend taking the time to do it. The other thing is doing the basic things that we can do to reset that circadian rhythm. So waking up with the sun every day and trying to do that consistently pretty much every day of the week, yeah of course if you want to sleep in on Sunday but as long as you are generally priming yourself and then similarly having a wind down at night where one to two house before you are going to bed whatever you can really manage and honestly if you say I can’t do that all I can do is 15 minutes, that’s cool. Start with 15 minutes because you are gonna love how you feel so much that you are gonna wanna extend it but go to bed at the same time every night and be really committed to an intentional wind down. Reading a real book and not just a Kindle but a real book in your book with real pages in bed dim lights on in your room. Have a bath or shower before you do that and then just two to three minutes of breathing right before you go to sleep. It can reset your cortisol and start to get your brain out of that, I love that, DEFCON 3 like that mode that you are in that where is the fire? The other thing is that you can start to train your brain to rethink negative pathways. It is really interesting because when you get stuck in that DEFCON mode, you are actually looking for danger. So your outlook on life can get really crappy. You can start to think everyone else is having good luck and I am not. Everything bad always happens to me but you are actually living in what’s called the negativity bias. And starting to learn to shift that by saying okay where is the evidence for that. Like every time you have one of those thoughts, start to become conscious of those thoughts and tell your brain it is just a thought because then you are starting to shift into safety mode. In the book I talk about some other things too because it is not just our thoughts and our lifestyle. It is the environmental toxins that are triggering cortisol because it is trying to keep up with inflammation. It’s food triggers that each one of us may have a different food trigger. There are some big common ones. But I walk everyone through a really accessible blueprint for shifting these triggers so that we can actually like feel how we want to feel again and have a sense of, a lot of my patients say to me Dr. Romm I just want to feel like myself again. I think we all know what that means for ourselves. And I think that is that feeling of how we want to feel.
– Yeah, amen to that. So the book is called the Adrenal Thyroid Revolution, Dr. Aviva Romm. Out now available now. Great read, lots of practical very very beautiful. By the way, you have colors in there. That’s gourmet. It is a beautiful print and it is useful information for you. This is about you understanding you and you being able to get into why you feel the way you do and then having expert advice from our beloved doctor who is walking you along this path. So check out the book, let me know what you think and it is available everywhere books are sold. I’m assuming it is a big imprint, so Harper One.
– Absolutely. And also one of the things I’ve really learned is doing things in community just amplifies the power of what we are doing and it makes more likely to stick with our plans and just have that sort of support. For folks who want to you can buy the book anywhere. When you buy the book, head over to Avivaromm.com/bookbonus. There is actually a place to put your receipt information and that gets into a whole private Facebook community that’s amazing. It is me in there, my team, which is my healthcare team and a few thousand women who are jamming with each other and supporting each other and making sustainable changes and feeling great.
– Yeah and it is spelled Avivaromm, so double M .com. Just so you don’t end up in the wrong neighborhood. Wonderful, Aviva congratulations. I know how much work it is to get a book out. Its like having another baby. You got a beautiful baby out here and it is helping, I already know it is helping tens of thousands of people so keep up the good work.
– Thank you.
– Thank you for being on this show and let me know what you think. I mean listen, stress is a big deal. Knowing the fallout from stress, knowing the fallout from the crazy lifestyles we live. We talk about that every week in the academy. This is part of what we are talking about. This is the scientific basis of what’s happening inside of our cells. The moral of the story is swim upstream, learn how to mediate, learn how to understand where this is coming from. More focused awareness and basically better curation of what the inputs are in your body. This is wonderful. I love it when there’s a guest. I could agree with everything she says. It makes my life even that much easier so I’ll see you next time.
– [Aviva] Thank you.
– And thanks for being here.