Busy Brain Cure with Dr. Romie Mushtaq, MD
Episode 96:
Busy Brain Cure with Dr. Romie Mushtaq, MD and Evan H. Hirsch, MD
Evan H. Hirsch, MD 00:04
Hey everybody, welcome back to the energy MD podcast where we help you resolve your chronic fatigue, long COVID and M cast so that you can live a life that you are happy about that you really deserve. So, really excited about today's talk, because we're going to be talking a little bit about stress a little bit about things that you can do for your brain that you in order to mitigate stress, a little bit about burnout. So pay attention and we're gonna be talking with Dr. Romy moosh. Doc, and so let's learn a little bit about her. So she is a board certified physician who brings together more than two decades of leadership in neurology, integrative medicine and mindfulness. She is an award winning speaker working with Fortune 500 companies, professional athletes and global associations. Her brain shift programs improve mental well being and help to build a culture of wellness. Dr. Romi served as chief wellness officer for evolution hospitality, where she scaled a mindfulness and wellness program to over 7000 employees. Her expertise is featured in the national media such as NPR, NBC, TED talks, and Forbes, her first book, The Busy brain cure is out. And the USA Today best seller. Dr. Romi thank you so much for joining me today.
Dr. Romie Mushtaq, MD 01:21
Dr. Hirsch. It's an honor I truly to sit with you as someone that has been alongside doing the work for Polly, you know, patients and colleagues dealing with chronic fatigue and chronic disease. I've sent many clients your way, and really an honor to sit down with a like minded colleagues. So thank you. And
Evan H. Hirsch, MD 01:41
thank you. Yeah, I'm really excited about picking your brain today and sharing your knowledge with our audience, I think they're gonna get a lot out of it. So let's talk a little bit about what caused this transition for you, you know, you were coming from integrative medicine and traditional medicine practice initially. And then now you're into stress management, doing all these wonderful things. How did that happen for you? Yeah,
Dr. Romie Mushtaq, MD 02:02
you know, and it's so easy to look back now and give you in the audience two to three talking points. But I start with this to say, I humbly come to you, not only because of my credentials, but because I had to journey through my mess to help your listeners heal. They're really from a humble place. I was one of the first people to come out on the TED Talk stage, giving TED talks, and talk about having a mental health crisis and burnout that resulted in my life saving surgery and made me think about what are we doing in the workplace is wrong, not only in healthcare, but globally. And you know, this was a decade ago. Now, this was 2014. And it caught the attention of corporate America forward thinking corporate culture. So a lot of people may be raising their eyebrows just like you did and thinking what corporate America but absolutely, I was getting called to teach mindfulness and meditation to professional athletes, corporate clients. And then I started to listen, and I thought, you know, the symptoms that I was having, before I got sick and burned out, difficulty focusing, feeling anxious all day, jacked up on caffeine, or stimulants, needing wine or something to calm me down at night. Like this. I'm hearing this over and over and clients were saying, well, thank you for teaching us about meditation, mindfulness, but there's still something going on with my brain, and the doctor researcher, and we started to put two and two together in something we'll talk about in a second busy brain. And I'm so blessed, because we have so many corporate clients that when I want to go out and do research, I can field test this in an what I say, a realistic setting, because clinical trials, as you know, are often you know, really done in a clinical setting. And maybe people say is this, does this translate to real world? Well, I was working with 1000s of executives, across all industries researching this, and here we are today with a busy brain cure. And I still say this is I remember what it was like to walk the hospital corridors. And on the outside, people thought I had made it I'm a doctor, I'm a professor, I'm a researcher, I entered neurology at a time where less than 5% of the brain doctors in the US are women. And still I was suffering and, you know, ever nobody asked me if I was okay. And my patients but not any colleagues, and it's a really dark and lonely feeling. And I just thought maybe if you have me on your podcast, and anybody is listening, and they feel like they're in a dark place, and they can't explain it and they feel alone. Well, maybe today they'll remember from you and I that they're not alone, and we have a path forward for them.
Evan H. Hirsch, MD 04:50
Well said, so what do you think it was? What are your what do you think it is about our culture? Where you know, people weren't asking how you were or, you know, kind of like this tough it out culture or, you know, where do you think that comes from? And why is that so dangerous things,
Dr. Romie Mushtaq, MD 05:08
certain corporate cultures, and that it even exists today in medicine, for example, this authoritarian type of mentality never let them see you sweat, you have to wear an emotional armor on as well as a physical armor at work. And talking about anything related to your personal well being or personal life can be seen as a weakness. And unfortunately, there are still systems that are like that today, though, I really applaud social media and our millennial and Gen Z colleagues that are normalizing talking about mental health, then the pandemic happened and the mental health crisis that you and I, as doctors know what existed for over a decade was just wildly exposed. But yet today, we've lost any semblance of a boundary between our home and our personal lives, always this FOMO of being plugged into work. And most high achieving professionals I work with are just saying they're working at peak performance at the edge of burnout, almost like with pride, like wearing stress or burnout as a badge of honor, or, or feeling resigned that like, I don't know how to do anything differently. And I'm a single parent, and I have to pay my mortgage. And so I have no choice but to put in these long hours. And I think that's what's happened. The combination of attitudes in the workplace, the attitude and the Western cultures, and this inability to unplug from work.
Evan H. Hirsch, MD 06:37
Yeah, you throw in the news. And what's happening in the world? Yeah, and it's all
Dr. Romie Mushtaq, MD 06:43
social media. Right? Yeah. The compare and despair attitudes of social media, whether you're thinking about your appearance, or you're thinking about comparing yourself to somebody else's marriage as they portrayed on social media, it creates suffering, and we feel that we are out of control, my brain is out of control, and the world is out of control. And I'm here to say there's a different path.
Evan H. Hirsch, MD 07:07
Brilliant. Yeah, I'm excited to get into that. Yeah, it seems like for, you know, in society, it seems like everywhere that you turn it, you have the potential to end up with self loathing and suffering, just from the nature of all the things that we're exposed to. And it's no wonder that there's so much mental health also in our, in our young people, and it's for a variety of different reasons. But let's get into the busy brain, what does it mean to have a busy brain?
Dr. Romie Mushtaq, MD 07:34
So you know, we just talked about a little bit about the busyness of the outside world. And that's not what a busy brain is about. What I was finding was our pre pandemic advice we would give for stress management or burnout is outdated and no longer effective. And that a lot of those things were about acute stress management. And quite bluntly, nobody listening to this podcast or reading the book wants to be told to eat berries, breathe, and take another emotional resilience class that is no longer relevant. And what I found in my research, so you know, we'll put it in the show notes. But we had 17,000 adults take the busy brain test is a neuro psychology test. 20 minutes, I mean, 20 questions in four minutes. And it gave us this idea of what was chronic stress doing to people's brain and physical health. And it turns out that there's a specific pattern of neuro inflammation or inflammation in the brain that causes a triad of three symptoms, adult onset ADHD, anxiety, specifically ruminating anxiety and insomnia. And that I we colleagues in neurology and psychiatry and psychology got it wrong. Because in today's world, what happens in order to survive and be at peak performance, people are taking excessive amount of caffeine all day to get energy, you know, you talk about this often on your podcasts, and in your community. And then you're anxious and revved up, and then you think I need to take the edge off when you go home or you finally can come out of your home office at work. And you need a glass of wine or three to calm down. And if that stops working, you go to a doctor who will prescribe and we over prescribe stimulant medications to adults in the United States like Adderall and Vyvanse. And then you're anxious all day, and then you get put on an anti anxiety medication or a sleeping pill at night. I call that the stimulant sedative cycle, you need a stimulant to be energized all day. And you need some kind of sedative to knock yourself out and rest at night. And that's what a busy brain is. And it will the neuro inflammation and that chronic stress will cause physical disease and the stress can kill you it almost killed me I ended up in life saving surgery in 2010. And that's where I had this wake up call that I'm here for your listeners with their wake up call that there's a way out of this and I'm not saying all stimulants are bad, but you know, there's an over prescribing or over Use of caffeine and stimulants in the West.
Evan H. Hirsch, MD 10:04
And so well i Let's let's talk about then productivity. So oftentimes people are taking these stimulants to be productive. Does does that end up is that it does that equation work?
Dr. Romie Mushtaq, MD 10:20
It's not that simple. So what we know is, if you are not chronically stressed out, and you're in a healthy state, a little bit of a caffeine in the morning absolutely will help focus binding to the adenosine receptors. And you've had other guests on here talking about that. There's ideal times to take caffeine depending on you know, what your morning state is, and your intermittent fasting protocols, etc. I won't get into that. But when you have a busy brain, so if you take the test for free, and you score above a 30, you now have that pattern of neuro inflammation. And the higher the score, the worse it is. So what we know is that you might temporarily feel a temporary boost from the caffeine but all you're doing, especially if you're adding sugar with it, or high glycemic carbohydrate is that you're now actually fueling the network that fuels in attentiveness, the dmn network, and you're fueling, like the inability to focus and not pay attention. And so your productivity tanks. And so the example I use is me sending you a three minute email to say thank you so much for having me on this incredible energy MD podcast is going to take 37 minutes because I have multiple screens open multiple browser windows open, I'm getting distracted by text messages on my phone, and everything feels like a code red emergency in my brain. I must take care of it now. And so I lose focus on something that should be so simple sending a thank you email.
Evan H. Hirsch, MD 11:51
So then you came up with the brain shift protocol. What is
Dr. Romie Mushtaq, MD 11:54
that? Yeah, you know, the brain shift protocol. I'll start with the science element. And then we can break it down to actual steps for your listeners. You know, we're in the global pandemic. And I'm no I'm Mike Ravel as a chief wellness officer and professional speaker as Hall halted and I didn't know what to do with my free time. And I was like, and so my CEO and his wife at the time, they were like, you know, Romi there is a thing called Netflix get a subscription and Tiger Kane was trending back then did you ever get into the whole Tiger King series, you saved you saved your emotional well being right? I'm still traumatized thinking about it today. And I was like, you know, this binge watching is depleting my energy and fueling a busy brain. I need something different. And I did what I know how to best do and let's go back into research Dr mode, and I've looked into the psycho neuro immuno endocrinology literature. And I said, How could we fix the busy brain crisis without putting people on a diet, I am anti diet as the chief wellness officer and brain doctor. And we will dig into that in a second. And so I came up with the branch of protocol, which is getting to the root cause of busy brain, there's five key areas that are affected. And the shift is an acronym for that one s is sleep or your circadian rhythm to age hormones, specifically thyroid and men and women, I markers of inflammation. And we look at things like fasting insulin levels, high sensitivity, CRP, vitamin d3 levels, f the food, how you fuel yourself without going on a diet. And T is the role of technology in adults lives. And so that was the brain shift protocol we came up with, which was how could I, as an individual help you even if you have a busy brain helped me Romy with a busy brain, knowing that our root cause may be a little different. But do this at scale because we were testing this protocol in groups of executives from different companies. So 1000 People went through this protocol and allowed me to fine tune it along the way with their feedback, and to come up with the eight week protocol known as brain shift.
Evan H. Hirsch, MD 14:00
Very nice. So let's go through each of these. So tell me about sleep. What are you What are you doing and sleeping the protocol
Dr. Romie Mushtaq, MD 14:07
in the protocol. So one week one of the protocol, you take your busy brain test and you get your score. And step two, week two, we start you into the seven day sleep challenge is what we call it, but it's really to reset your circadian rhythm. And it's based on cognitive behavioral therapy for insomnia. So I've saved people the $750 plus an hour to go to a specialist for this. And we broke it down all into behavioral protocol or brain shifts, easy simple things to do micro habits that can cause a massive change in your sleep. So one example in that protocol is setting is really committing for 10 days to set a regular time to go to bed and wake up in the morning. And that's true even if somebody works second or third shift, right? I deal with complex workplaces that often have 24 hour cycles. So that's one thing we also break down quick supplements for people to use. And I think the pro tip I would give here Evan and I I think other experts have discussed it on your show before but I'm going to repeat it as a neurologist says please don't use melatonin. Prescription melatonin will actually fuel a lot of problems in the brain, the neuro inflammation, the downregulation of your brain's ability to make melatonin and disrupt your circadian rhythm even further. So we recommend to supplements their magnesium glycinate and five HTP, which stands for five hydroxy tryptophan, which is a precursor to serotonin, which will then naturally in the body break down to melatonin. So that alone, we see, within seven days, people are starting to restore that circadian rhythm and the rest. And they're feeling less anxious, and how that would show up when groups and companies were doing this. And even individuals, as HR leaders or leaders would be like, you know, me, I don't know what's going on. But you know, the people that typically come in my office complaining about every last change in policy, they're happy now. Or the teams that were bickering or colleagues not getting along. Like there's collegiality on the team. And everybody seems like a little happier and more productive. And it was just because we were resetting their circadian rhythm in simple ways. So that sleep and what we start with that also, then weeks three, and four, we bring in cognitive behavioral therapy techniques, specifically a brain dump that we designed and digital detox. And a fascinating aside, before I became chief wellness officer, you know, the research for this book started way back in 2017. And you and I are doing this podcast interview in 2024. That was when I first had the idea. And at that time, I was chief wellness officer at evolution hospitality. And I went to the CEO and said, I want to collect brain health and mental health data on 500 of your leaders. And we're going to ask them to do digital detox. And this is a company that's open 24 hours a day, seven days a week. And we asked them to do one simple thing, shut down all digital devices one hour before bedtime. And you'll read the results in chapter nine. But they were astounding. That data now got carried through to my other speaking engagements to other industries. I can't tell you how many companies started to implement digital detox policies and saw great impact. And so that's what we asked people to do.
Evan H. Hirsch, MD 17:16
So is that a separation from the phone is that everything specifics? Okay, and 30
Dr. Romie Mushtaq, MD 17:21
to 60, you set out a bad time, and 30 to 60 minutes before bedtime, no laptop, no phone, no ereader, no Netflix, binge watching on your Smart TV or iPad, either, right. And we actually give people resources or ideas of things to do that will help create rituals that's calming down your sight, your sound, your hearing your aroma, your sense of smell, what you're tasting, and what you're touching. And an example is, I leave my dirty dishes in my sink every night, every day. And so if my hands are all greasy and full of Dawn soap, and I'm loading up the dishwasher, I won't pick up a phone or laptop, even in the middle of a global book launch and taking a new position as chief wellness officer at another company, and then my dog, he's so cute 17 And still lines up at the door and he knows he's getting an extra walk at night. And so he's become a part of that nighttime ritual. And that's our calming down ritual at night. And we go out and if it's a clear day, go, you know, say goodnight to the moon together, and then we come back to bed. And that's digital detox. So, you know, examples are taking a hot bath will the running water will calm your hearing and the warm water will calm your sense of touch. Right, and just the scenery of your bathtub versus the blue lights. So yes.
Evan H. Hirsch, MD 18:41
It's so important. Yeah, you know, it's just so easy to reach for something reach for a supplement or reach for a prescription. But this reality that oftentimes, all these things that we're doing during the day or into the evening, are way too stimulating for us where it's almost insurmountable to have a good night of sleep when you're being so stimulated. And it sounds like it's and it's a combination of things right. You know, sometimes if you're binging like you said, you know, the tiger, whoever that was, you know, like Tiger King. I mean, your your, your, your hearts gonna be jumping out of your chest, right? I mean, yeah, if you have an argument with somebody in the evening, or Yeah, I
Dr. Romie Mushtaq, MD 19:22
mean, those were the obvious things, right, like listening to the news or a crime podcast or something really awful like Tiger king. But here's the other thing I've been we know is even if people think they're scrolling tick tock or Instagram reels for cute videos of puppies, hugging babies, that blue light is still stimulating you also, even if you're laughing at TV or something that dopamine and adrenaline is now sending your brain into alert state instead of I need to rest state and then when we're at the end of the day when we really need to rest so our memory and emotions can, you know be processed by the brain. Now we're Got a heightened sense of alertness and guess what happens it's like a 10 times more likely than a negative thought is going to be coming up and haunting you in your sleep. And something that feels so awful. But so insignificant like I forgot to have a hot cup of tea before this interview or something really insignificant and you're separating on it. That's a busy brain the racing thoughts before bedtime.
Evan H. Hirsch, MD 20:25
And so I've seen some people with five HTP where even at like 50 milligrams, it can be too stimulating for them. What do you think's happening there? Yeah,
Dr. Romie Mushtaq, MD 20:35
that's a really interesting question. I, you know, some people yes, you know, five HTP and getting that serotonin boost can have a counter effect and I'm blanking on the gene right now. I'm a little tired on the book tour and, and speaking tour, so forgive me there's an actual gene that is tied to kind of this counter effect of rather than the calming effect and the happy boost of serotonin, you're actually stimulating dopamine, adrenaline, epinephrine pathways and getting energized but that is a minority of people. Most people are sedated even at 50 to 100 milligrams. The one thing you know, we talked about in the book, and it's worth mentioning now, because both Evan and I are board certified doctors is please talk to your practitioner before you start this medication and it should not be five HTP combined with an antidepressant drug, such as the SSRI drugs like Paxil, Prozac, SSRI, drugs like Effexor, because you could get serotonin syndrome, and that too can cause emotional upset taking cardio on that so but it really other than that five HTP is a natural precursor of serotonin and most people respond, if they're on that medication, or have that negative impact with five HTP we then use L theanine. But across clinical studies, when we review the medical literature on five HTP we found that to be the most consistent studied supplement and natural thing to take to restore circadian rhythm as well as to help sleep at lower doses.
Evan H. Hirsch, MD 22:07
Excellent. And then thyroid, lots of benefits. So this is the age of 40 agents.
Dr. Romie Mushtaq, MD 22:14
Yeah, I feel so strongly about talking about this one, Evan. And it's why I like candidly share my story like the devastating news I'm burnt out and I'm leaving medicine. And you'll read in chapter four of one of my the patriarchy of medicine kind of talking about how I work like a man and don't get pregnant. You know, because the last woman they hired in the department was out for six months with her pregnancy and, and birth and it ended up you know, costing the department money. And the irony was I was going through infertility, I was actually doing research at the time, Brian on women's hormones in the brain for epilepsy and migraine. And I remember thinking, do I have a thyroid problem? My hair falls out in chunks. And I've never had a regular menstrual cycle my entire life. And what did the doctors do? And I gave as a doctor, I gave these male endocrinologist the power, they checked just a TSH and T three and T four and missed the rest of the panel and missed my Hashimotos thyroiditis or autoimmune thyroid disease or subclinical hypothyroid. And I was suffering busy brain and suffering obviously infertility that was missed. And it wasn't until I found my path to integrative medicine, and found my own integrative medicine doctor and this all got diagnosed at age 39 that I finally had a regular menstrual cycle. And I share this because one in eight women in the United States has an undiagnosed thyroid condition, either subclinical hypo thyroid, your thyroid is low, or an autoimmune thyroid disease. But here's the thing I want to add because I know you've had other podcasts cover thyroid. This is so important here as a brain doctor, for me to say that 35 to 40% of people who have these thyroid problems, their only symptoms are psychiatric and neurological anxiety, count, focus, attention deficit disorder. And you're going to get labeled as stressed out mom, working mom, you're just hormonal but not get treated. And you may get put on a stimulant or an antidepressant or anti anxiety drug. And nobody checked your full thyroid panel. So in chapter 16 of the book, we give the full lab slip to take to your primary care doctor. You know, ave you and I practice differently now. You have such an amazing integrative functional medicine practice. Many of our colleagues is you know, our concierge medicine. I work largely in corporate America and I had to find lab slips that could be covered by traditional health insurance plans in the US and so we include the full thyroid panel in that and it's something so important if that's the only takeaway. Anyone listening is getting. Please go get that full thyroid lab check to read the story of Kelly and chapter 16 Whose life got saved because she did these labs.
Evan H. Hirsch, MD 25:08
So how did the other hormones play into the hormone section?
Dr. Romie Mushtaq, MD 25:12
They do. You know, as you well know, when we talk about a disruption in circadian rhythm with a busy brain, the hypothalamic pituitary adrenal axis is disturbed and so, you know from the hypothalamus and pituitary we get thyroid disturbance. You can after that, absolutely get adrenal fatigue from men, lower testosterone levels and women symptoms that mimic PCOS or perimenopause. I will say the seventh is we include those labs you know, in the lab slips for men and women. However, my big focus in busy brain is to focus on the thyroid. If we screen and thyroids, okay, but a male patient has suboptimal testosterone levels are a woman who has abnormal estrogen progesterone testosterone levels, we will refer out but literally when it comes to symptoms of busy brain, we actually find most people didn't have a thyroid address. They actually a man may be getting testosterone injections at a clinic or woman may have been given bioidentical hormones to help perimenopause or PCOS. But the thyroid was missed. And so really, that's my big focus in this book, because I'm actually just focused on those busy brain symptoms.
Evan H. Hirsch, MD 26:24
So are there more thyroid receptors in the brain than for the other hormones? What do you think it is that why? Why there's so many like why those symptoms of busy brain are so much associated with thyroid?
Dr. Romie Mushtaq, MD 26:38
You know, as we were doing the research, I don't know about thyroid hormones versus, you know, cause for a woman the negative impact of withdrawing estrogen progesterone from memory and estrogen as you know, or a man, same thing for low testosterone levels. What we know from the literature is when you're under chronic stress and burnout, that pituitary thyroid axis seems to be the one that's affected, and that if in chronic burnout, that we were showing in men, for instance, burned out and low testosterone levels, that fixing the testosterone levels were not enough. And if you go back and look at thyroid, it's beneficial and same for women. And the same goes in some of the adrenal fatigue literature. We all know in integrative functional medicine, but a lot of the listeners that will be listening to your and I podcast, and my community may not know this as often will people do these online quizzes of adrenal fatigue and they get the supplements that are on one of our websites, and they still don't feel better. And that's because, you know, the upregulation, the thyroid controls all of the, you know, downstream effects of what's happening with your adrenal gland and the sex hormones.
Evan H. Hirsch, MD 27:45
Yeah, I call the Big Three adrenals. Thyroid and mitochondria, because they all work in concert. Yes. So then, in terms of so let's talk a little bit about inflammation. You mentioned some of the labs, what is the when you're testing for inflammation with with people because most humans have inflammation, right? We do. Yeah. And so what are you looking for, in this section, in this
Dr. Romie Mushtaq, MD 28:14
section, specifically for brain health, right? Because inflammation is important, most of us have it, and it can cause different symptoms. But when I'm looking at busy brain, I wanted to look at a few things one, global looking at your high sensitivity, C reactive protein is a one a great and indicator for brain and physical inflammation. But then we dug a little deeper and the thing I wanted to look at was fasting insulin levels, hemoglobin, a one C and your fasting blood sugar. I think you know, some of my listeners may say, What do you mean diabetes? Dr. Romea, and we've talked about diabetes type two or three. But there was something very interesting that we found in the medical literature as I was digging through this, independent of all the pathology of metabolic syndrome and type two diabetes in the pancreas is we have insulin receptors in the brain, and that when we eat high glycemic foods, such as white sugar, white flour, white rice, white potatoes, anything that spikes your blood sugar rapidly, it desensitizes the insulin receptors in the brain insulin has been used in the pancreas and that can fuel insulin spikes and peaks and valleys in the brain as well as with blood sugar that actually fuels the inattentiveness, the inability to focus on the ADHD symptoms. Here was the kicker with an EB and and this also goes into F food if you combine caffeine, and a high glycemic food, so with your afternoon, caffeinated Chai, you know in white culture, you're having a biscuit, or in the morning you grabbed a doughnut or a bagel with a song with your coffee or espresso that actually impacted the cycle even worse, and fueled this pattern of neuro inflammation and elevating interleukin one levels, one, interleukin one levels so that you know it would fuel more of this ADHD and rebound anxiety like symptoms and so that's why in the protocol we asked you pick one or the other caffeine for a meal or a high glycemic car because I don't want to put people on a diet it and nor and you know this if you're burned out and you have adrenal fatigue, people should not be on a low carb diet initially, right. And I live in the real world and people are working long days, and they may only have pasta grab at lunch than we say Be mindful of the caffeine. What we found is most high performing individuals want to pick the caffeine and they naturally steer away from the high glycemic carbs. And now we're eating, you know, healthier grains and low glycemic carbohydrates and doing better. So that's one aspect of inflammation. We look at the second inflammation point, if I'm not droning on too long, and tell me we look at his vitamin d3 levels. So what does that give you? Yeah, so what we know it looks and you know, backtrack to this vitamin d3, I'd started my neurology residency training, I'm aging myself in the 1990s. And do you know, even back then in neurology and psychiatry rotations, when we would look at vitamin d3 levels, and patients that were schizophrenic had multiple sclerosis, we knew it was a risk factor and a problem, even back then I was like, why aren't we looking at vitamin d3 levels in Healthy People, then you know, and now we know this. And specifically, when we're under chronic stress and burnout, the metabolic pathways that may help to metabolize and the conversion of vitamin D from the sun, you know, the precursors to vitamin D two, and D three are blunted, you know, from the skin to the liver, and into the brain. Vitamin d3, I think, got a really bad marketing label. It's not just another vitamin, it is really the super row hormone of the brain, that every hormone 50 of them that are cycled through the brain and the body to govern all of our organs are dependent on a healthy vitamin d3 level, and the clinical literature. And you know, just being a traditional neurologists and psychiatrists, we knew if you have low vitamin d3 levels, you will prone to mood issues, depression, anxiety, difficulty focusing, if you dig into the ADHD literature in adults and in children, and we, you know, break this down and chapter seven and eight of the book, we see people have a reduced attention span and more anxiety prone with low vitamin d3 levels. And so we need to check that and then restore it. So if there were just a few labs, people are going to get that would change the trajectory of busy brain. We asked for a full thyroid panel and vitamin d3 levels.
Evan H. Hirsch, MD 32:45
Very nice. So let's talk about food. And you talked about being anti diet. What does that
Dr. Romie Mushtaq, MD 32:53
you know, it's not going to be a popular thing to say on your show and amongst our integrative and functional medicine doctors because when I went through my board certification for Integrative Medicine, there was a diet or nutrition cleanse or protocol for almost everything under the sun. And I believe food is medicine. But I also believe that the diet culture in the West has two problems. It is toxic and creates more stress and guilt and shame and trauma in the brain psychologically and to as a chief wellness officer where I have to care for the well being of a culture of people that is inclusive, all of the diets that are in the west and please find me one you know if any listener, you know the seven, don't practice inclusion. I work in an environment where vegans and paleo and I are Vedic loving and carbo holics and chocoholics, and people who are just confused intermittent fasting need to be able to all sit at one table at the company without being judged. And then you know, I use this example in the book. One of my comfort foods is lamb biryani. It reminds me of my maternal grandmother her looking down on heaven from us today. And she was famous for her lamb biryani when she would cook it everybody in the alley would smell it and come to the door. There's so many joyful family memories. Comfort food is something that is anchored a core memory of joy. It can be tied to a family member a religious holiday, your state or country of origin, your ancestry. Most of these foods seven aren't accepted on the Western diet protocols. So now my brain is conflicted were his joy when I finally figured out in the lamb biryani recipe is at the end of the book along with so many other family comfort food recipes from loved ones but my brain is conflicted because there's a part of my soul that is tied to an anchor memory of joy with the lamb biryani and then there's a trauma track around food being built because my integrative medicine training has had bad bad every ingredient in the lamb biryani is anti you know is is inflammatory. You shouldn't be eating rice you shouldn't be eating red meat you shouldn't Eating the ghee. And that is what these diets are doing. So instead on our protocol, we actually tell people schedule one to two comfort food meals a week. So if it is your child's birthday party eat the cake, so that your child sees you happy celebrating their birthday with them, if that's what you desire. Eat the lamb biryani. It's a religious. This your When you restore your circadian rhythm, you're no longer stress eating, which is somehow I went to the pantry. And I wasn't even being mindful. And I opened a bag of cookies, or potato chips and the whole thing was gone. While I was binge watching Netflix, I'm eating my feelings. That's the difference. And that's really important. And we found massive success with this. And it's why people come to the protocol because I'm not putting them on a diet or cleanse. I also tell my integrative functional medicine colleagues like you haven't as this protocol will help the mind body connection and prime people to get ready if they do have a medical condition that you're treating, for instance, a lot of your you know, patients with long COVID They do need a specific nutrition protocol. We've primed them, then to stop the stress eating so that for a temporary time they can follow unnecessary protocol.
Evan H. Hirsch, MD 36:17
Yeah, and I think this kind of speaks to the mindfulness that you're cultivating. In this program, the awareness that people have in their bodies, you know, I feel like this is probably the some of the most important work that I'm doing personally, right now is having that attention in my body as opposed to being so intellectual and in my brain. And being able to notice, as noticing being a superpower, being able to notice what those sensations are, and what's happening when I'm reaching for, you know, something that's sweet, or why do I feel the need for those comfort?
Dr. Romie Mushtaq, MD 36:50
You know, give me give me an example. So comfort food is not that stress eating right? We, we delineate it comfort foods are tied to memories of joy, or your culture or your religion, but stress eating is that so what are symptoms you got? Because I think that's really helpful to people to know, because you can hear the joy in my voice or see it on my face. If you're watching YouTube, talking about my Nani's lamb biryani, right? What happens when we go to the pantry? Because you and I both have done it. We're humans, all an Indian listener listening has, what's the difference of that feeling?
Evan H. Hirsch, MD 37:19
So in general, I'll either be feeling some discomfort in my throat, where I'll be feeling it in my heart, where my celiac Plexus, like, below my chest, and especially the celiac places is kind of the place where I experience discomfort. And what ends up happening is that then I create a thought around it, or I think that, Oh, I'm having this discomfort because I'm having this thought instead of just sitting with the discomfort and being curious about it, and thinking, Oh, wow, look, there's that discomfort. What does it mean? It may not mean anything, right? But it puts me in a spot where I feel like I have to fix the discomfort that I'm feeling. And that sometimes that means reaching for something. And oftentimes, you know, my choices are better, you know, but maybe it's like stevia and chocolate or maybe it's I don't know there's these marshmallows that I like that are you know, don't have anything in them you
Dr. Romie Mushtaq, MD 38:14
know? So marshmallows, yes. Yeah. And I get that and so you know, yours is is like a slowdown and a discomfort mine is a rev up Dizzy brain. I'm, I can feel the fluttering or the my Achalasia symptoms and the tightness in my chest. And it's like this revving in my brain, a lightheadedness almost that like, I swear, if I was a cartoon character, you could see the circling thoughts in my brain at like a dirty speed going around and around. And I'm reaching for either salty or carbohydrate foods to calm it down. Right and, and using food to to calm feelings rather than doing something else for that busy brain anxiety moment, which is typically go for a fast walk or run it out on a treadmill or something, you know, like that? Or, or like the proper pranayama exercises for feeling anxiousness. And I think so I love that we both are sharing these symptoms, and it'll empower people, when they are stressed and having a busy brain not to go to the pantry and be with those feelings and do something about it other than food, the comfort food, like enjoy the foods with your loved ones that are sacred to a holiday or a family memory. Like that's so important. We shouldn't take that away.
Evan H. Hirsch, MD 39:31
Yeah, and I think I think making that distinction is important, you know, between the stress eating in between the comfort foods, you know, for me, it's been it's been really interesting with the with the comfort foods where, you know, my wife has a strong German background and grew up with like sugar on toast. Interesting. Yeah. And it was like butter sugar on toast. And for me with my Jewish background, there's a lot of cool girls and like noodles and cheese isn't a number of these things. So, you know, what we've tried to do is recreate these for our daughter in a more healthy way, you know, so we can still have the comfort food, but how do we do it in a way that that feels better to our bodies? And yeah, so it's kind of like it's meeting in the middle,
Dr. Romie Mushtaq, MD 40:18
or you know, and that's a great way to do it. I'm gonna be real with your brother. There ain't no way to do that to lamb biryani without like destroying the memory of my grandmother or the taste of the biryani. And then nobody is going to be knocking on my door to join me for dinner if I if I tried to do a healthier version, you know. So
Evan H. Hirsch, MD 40:34
then yeah, I think I absolutely agree. I think that the stress that comes from trying to eat a certain way, you know, oftentimes people like, hey, it's too stressful for me, or when they come into my program, my programs are 12 months long to get rid of, you know, chronic fatigue and all that. And if they can't, they're like, you know, I'm too stressed right now to deal with the food stuff. Don't worry about it. Yeah, you know, we'll come back to it when you're able to, but we don't want it to be another stressor for folks, when
Dr. Romie Mushtaq, MD 41:00
I was still seeing patients in the integrative medicine clinic. You know, we took care of a lot of elite performing athletes and professional athletes, executives, people who were already doing paleo or keto or whatever, to perfection. And they were still really suffering busy brain. And so I could see sometimes that strict protocol was fueling the stress hormone levels. And here's a fun fact, I gave the keynote lecture and was talking about my research at the American Counseling Association, in 2023. It is the only time as a speaker, I've gotten a standing ovation in the middle of my keynote, was when I said, diets, you know, is a four letter word and we need to stop prescribing them. And every therapist agreed because we know the guilt and the shame and the trauma that can come from restrictive dieting, and, you know, again, like a lot of your patients, Evan are in a different place like it is I you know, I think of a lot of I remember my, you know, chronic digestive issues, inflammatory bowel disease patients, like we had to put them on protocols, right, and there was immediate relief that they felt. So it wasn't stressful, it was because they had relief in their digestive system that it was not bad, right. But for most people, when you look at the psychology literature, it actually can increase stress hormone levels. Yeah,
Evan H. Hirsch, MD 42:22
I think that's a really important point, because it really is the summation of all of these tiny stressors, you know, it's like, every single decision that you have to make, or every single notification you get on your phone, is probably increasing our stress hormones a little bit, and then you get to stimulate and then you can't go to bed, you know, so it's kind of all leading towards that. So good. So we just need to throw out our phones. Is it? Do you think that's a solution?
Dr. Romie Mushtaq, MD 42:49
No, because then I sound like a cranky Indian auntie, no phone, let's go back to the rotary phone and you hear enough of the judgmental Indian aunties in my brain. You know, we can't do that I live in the real world, you live in the real world. And, you know, you know, business and connection with loved ones is done by the phone. But what we have to realize is happening every time a phone or a laptop or an iPad, we touch the screen, it's stimulating the dopamine reward network, and we get this temporary high like you had a hit of crack or cocaine, you know, or gambling, and then it wears off. And you go into a valley and that FOMO kicks in oh my god, did I miss a work email? Oh, I haven't checked my Instagram in 37 seconds like that repetitive thing goes on. Or same thing with work emails, you know, the kind of clients you and I deal with is, let me just knock out two work emails before bed. And I'll feel better. And guess what the bad news is, there's always 17 More that pop up, you know, and it's a never ending cycle. And so it's that addiction of control, or FOMO Fear Of Missing Out and when you can break that there is peace.
Evan H. Hirsch, MD 43:59
So I would imagine so some of this is mindfulness. Some of this is mindset. And so you talked a little bit
Dr. Romie Mushtaq, MD 44:06
about science and nor and neuroscience, I mean, let's be real this is there's all neuroscience in there. And it is a really just broken down. So you know, this, this was kind of like remember, I started nobody wants to be told to eat berries and breathe and shift a mindset like This is hardcore science that we've dug into what is actually happening to neurotransmitters and the structure and function of your brain with this. So it is so yes, this is behavioral change. Your brain shifts are known as micro habits based in psychology. Absolutely.
Evan H. Hirsch, MD 44:37
So is there is there a mindset practice that is part of this whole protocol that you advocate? Yeah,
Dr. Romie Mushtaq, MD 44:45
in chapter 10, or week one of the protocol. I call it the three evil cousins of your brain, you know, projection, denial and resistance. And so you take the busy brain test and you will project over This is just Romy or Evan, you know their problems on me or their ideas, you may resist it and say I don't need to do this or we, you know, we may be in denial, whatever that is. And we actually will give you exercises to work through it and look for one particular win that you will feel eight weeks later, you repeat the busy brain test and people see a drop and at least 25% or an improvement in the score. But you know, an example I given the book, and I'll give now is, you know, humble with you, I'm in a multi city speaking restaurant. Now, as you and I are recording this podcast, and I'm on a lot of planes and sitting in a lot of chairs and rushing around. And even while I'm following my protocol, the stress is starting to, you know, happen in my neck and my shoulders. And I would say, you know, eight weeks from now, I want relief of my neck and my shoulder pain. And that's an example where people will say, I want my acid reflux or my blood pressure to be better, or my blood sugars. And that's the mindset we do. And then the other piece is these brain shifts, we're just asking you to do one or two small micro habits that won't interfere in your day to day life as a, as a busy working adult, as a parent as a caregiver to elderly. And those are the two mindset things that we recommend.
Evan H. Hirsch, MD 46:13
Right? Well, Romi, this has been great. We're gonna drop the links below. So I recommend that everybody go and check out the busy brain test and get the book. I'm excited to read the book. I'm, I'm really excited. Yeah, I think it's gonna be really valuable for me, the work that I do and on my own personal growth. So thank you so much for for sharing everything today. Any last words that you want to share with our audience before we adjourn, you know,
Dr. Romie Mushtaq, MD 46:41
for anybody that listen to the top of this interview with them, and and if you're feeling alone, I just want you to know, say something that I wish someone had said to me when they were wheeling me into surgery is that your brain has not broken, your mind is not a mess and hope did not depart your soul. We're here both Evan and I to help you brain shift.
Evan H. Hirsch, MD 47:03
Thanks for being here today.
Dr. Romie Mushtaq, MD 47:04
Thank you.
Evan H. Hirsch, MD 47:07
So if you have chronic fatigue, long COVID, or mast cell activation syndrome, and you're looking for help, check us out at energy MD method.com. We have a program for almost every single budget, and we're here to help. I hope you learned something on today's podcast. If you did, please share it with your friends and family and leave us a five star review on iTunes. It's really helpful for getting this information out to more people who desperately need it. Sharing all the experts I know in love, and the powerful tips I have is one of my absolute favorite things to do. Thanks for being part of my community. Just a reminder, this podcast is for educational purposes only, and is not a substitute for professional care by a doctor or other qualified medical professional. It is provided with the understanding that it does not constitute medical or other professional advice or services. Thanks for listening, and have an amazing day
