Natural Solutions to Address POTS (Postural Orthostatic Tachycardia Syndrome) | Podcast #329

POTS is a known blood circulation problem indicated by two elements: a specific group of symptoms that constantly happen when standing. A heart rate suddenly increases from horizontal to standing (or as tested on a tilt table) of at least 30 bpm in adults, or at least 40 bpm in adolescents, measured during the first 10 minutes of standing.

Management for POTS should be specific to each individual since the symptoms and underlying conditions may vary. Most patients can control the situation with food templates, exercise, and medications. In this podcast, Dr. J and Evan emphasize the importance of the quality of food that we eat and seek medical attention, and undergo tests that will find the disease’s root cause for better understanding and achieve a healthier body.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover:

1:15      What is POTS

10:56  Adaptogenic Herbs

15:15   Addressing POTS

24:43  Detox and Sauna

27:14  Other Natural and Organic Tips

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Dr. Justin Marchegiani: And we are live. It’s got the J in the house here with Evan Brand really excited to have a excellent podcast on the topic of POTS, postural orthostatic tachycardia syndrome, which is has to do with blood pressure and dizziness. And there’s a strong connection with POTS and the adrenals we’re really excited to dive into that today, Evan, how are we doing today man?

Evan Brand: Doing really well. I feel like I started every story or every podcast by like complaining a little bit, but that’s okay. Because we learn from our personal struggles. And that’s what makes us better practitioner. So I was telling you before we hit record that when I had the, you know what virus, I had a lot of POTS types symptoms, I was really dizzy, I was really faint. I was having some lower blood pressure. I was having some heart palpitations, I was having some mental confusion just fell out of it. And so dealing with it personally, I definitely tried a lot of different things. So you and I are going to try to go into it. You and I were talking about the adrenal piece. So why don’t you just start telling us about that? What do you think the connection is? You think it’s a more of a low cortisol deal? A high cortisol? Do you think it’s just adrenal weakness? The whole HPA axis is functioning as a whole, or do you think there’s any specific part of adrenal problems that’s causing this?

Dr. Justin Marchegiani: Great, great, great question. So first off, you know, what is POTS? Right? So essentially, there’s like dysautonomia happening, right? The autonomic nervous system that controls heart rate, and blood pressure, sweating, all of these different things, the symptoms are over exaggerated now. So when you change body positions, you may get very dizzy lightheaded, right, your heart rate may be really up, energy fatigue, maybe up, right, conventional medicine, they’re going to use a tilt table test to kind of simulate that change of body position, and they’re going to test your heart, they’re going to test your blood pressure, okay? Now the typical response you want in, in natural medicine, there’s a test called the raglans test, which looks at blood pressure and correlates it to adrenal dysfunction. And so the raglans tests, basically test your blood pressure when you’re sitting or laying down, and then you stand up or change body position, you want your blood pressure, actually to go up about five to 10 points, okay? People that tend to be more on the pot side, where they have a lot of those symptoms on changing their body position, they tend to actually have a drop in blood pressure. And that’s important, because when you change body positions, now, if you’re like more horizontal, well, guess what, it’s easier for your blood to flow to your brain, right? Because blood flows downhill. And if it’s level than that, that works too, right? soon as you get up. Now, you really have to pump blood uphill, if you will, to get to your brain. And so if you have a drop in blood pressure, you’re not going to have enough pressure to perfuse that blood nutrition and oxygen to the brain. So that’s a big thing. So you may have symptoms in regards to your heart, in regards to dizziness, right? body awareness, all those different things because you don’t have adequate blood pressure. And so that’s a common sign with adrenal issues. And it’s possible to be on the POTS spectrum, where you have that change in body position, you have that change in lower blood pressure, but you know, your conventional medical doctor may not be able to diagnose you with POTS because it’s not severe enough. So like anything, there’s a there’s a continuum on a diagnosis, right? disease, allopathic kind of criteria is here. And then we have optimal health here. And usually there’s a spectrum of where you may sit where you’re kind of in no man’s land. And so most of our POTS patients, right who are on that pot spectrum where there’s blood pressure issues, on the lower side or the change in body position causes lots of disturbances cognitively cognitive wise heart issues, whether it’s faster or or beating through the chest kind of things, or abnormal rhythm. All of these things are connected to adrenals. And adrenal is are of course connected to blood sugar. They’re connected to your minerals, your sodium, your chloride, your magnesium, your potassium, blood sugar, cortisol glucocorticosteroids. And then of course, your adrenals eventually have a connection with your sex hormones. So you can see chronically lower dapa back can create other lower or more sex hormone imbalances that can create more issues, whether it’s PMS, low progesterone, more anxiety, more depression, poor sleep. So you can see how an adrenal issue can easily spin into a sex hormone issue, partly because the adrenals really are one of the backup generators for the sex hormones. And so especially if you’re a female, you’re going to rely on those adrenals to pump out dapa sulfate. And that’s going to be a major building blocks. So as you transition into menopause, you’re going to rely more on those adrenal. So as you hit your 40s, it’s common as those ovaries aren’t supporting the hormonal output like they used to that you may start to lean more on the adrenals. And more of those POTS type of symptoms may show up.

Evan Brand: Yeah, well said, well, you pointed out something really interesting. I never thought about it like this, but you and I clinically we kind of operate in the no man’s land, meaning that people may have not been extreme enough, as you mentioned, to get the clinical diagnosis. I mean, the same thing happens with celiac, right? They’ll say that you have to have some In crazy, like 95% tissue destruction in the intestines to be considered celiac, but if you’re like 94%, they say you’re not celiac, go eat some bread, it’s fine. So it’s very interesting point you made. And we’ve actually had clients report this to where they’ll say that their pulse rate or their heartbeat only increased by maybe 20, or 25 beats upon standing. And they were told clinically, it had to be 30 beats. So if you’re 28 beats, you’re still not pods, if you’re 30 beats, increase your POTS. And so that’s the problem is there’s this huge in between area where people have these symptoms, but then they go to their doctor, and they’re basically going to get told that everything is fine. And there’s really nothing we can do for you or possibly what they’ll do. If it was moderate enough, but maybe not clinically diagnosed on paper, maybe they do a beta blocker, because they say, Okay, I understand you’re standing up, you’re having heart palpitations, you’re having chest pain, let’s go ahead and do this meta pro law or other beta blocker to try to calm the symptoms, but then you never actually fixed the adrenals you never support the hormones, you never fixed the minerals. And all of that still goes unaddressed. And then of course, you get the side effects of the drug, and then you create more problems. So you see how this could be a really big slippery slope. And then also one thing I want to mention too, because I experienced it personally was you mentioned like the the dizziness and that kind of stuff, but also just mental fog. I mean, if you don’t have enough nutrients, enough blood flow, you just feel kind of spacey. So if you’re having trouble with focus, a lot of times you and I are looking on like an organic acids test to try to look at dopamine or other neurotransmitter problems. But this whole dysautonomia POTS thing could also create brain fog. So that’s just something else that we’re going to be looking for and trying to address.

Dr. Justin Marchegiani: Yeah, so typically with POTS is you’re gonna have a combination of a drop in blood pressure, right? So conventional medicine diagnosis is looking at a 20 millimeter drop in mercury on the blood pressure cuff on the systolic, that’s the top number, and then about a 10 or more on the bottom number. So if it’s normally 120 over 80, you know, you got to be at, you know, below 100 over 70, if you will, okay, and that’s in the first couple of minutes of that change in body position. And then typically, as the blood pressure drops, now you’re not able to move as much blood. And so what has to happen is your heart rate has to increase to compensate for the lack of pressure. And so as the heart rate increases, that’s where you start to see the increase in heart rate, that’s where the, the postural orthostatic that’s the change in body position, tachycardia, that means faster heart rate. And so that’s where you start to feel your heart beating out of its chest. Okay, and so then you have the drop in blood pressure on one side, and the increase in heart rate on the other side. So the first thing we look at, from a functional medicine perspective, where are we in? Where are we at with hydration? Okay, are we getting enough water and hydration in? Number two? Is that full spectrum mineral water? Are we getting a really good mineral water? Are we getting? are we adding additional minerals to it? And then number three, where are we at with diuretics, coffee, tea, things that have caffeine because coffee or tea number one will increase adrenaline, right? And adrenaline is part of this whole POTS cascade, so increased adrenalin, increased, cortisol can always increase the heart rates. But it also acts more as a diuretic where you pee more water out, that drops your blood pressure. And then when you drop the water, you drop the minerals and your heart needs sodium and chloride and magnesium and your minerals to function. Remember, magnesium is a natural beta blocker. And so if we can get the minerals in that brings the blood pressure up because water follows minerals. And if we can get minerals in that relax the heart because magnesium is a natural beta blocker, right. And so that can really help start to relax the heart, but you got to fix the underlying issue. And so you got to really get and that’s just a couple of lifestyle, diet strategies out of the gates, we’ll talk more specifically. But anyone that has POTS or POTS symptoms, we have to really look at the adrenals. And you may not necessarily have an Addison’s issue where your cortisol is pathologically low, right, or Cushing’s where it’s pathologically high, it may be some kind of an imbalance in between. That’s why we use the word adrenal dysfunction because some people are high in the morning, low at night, and vice versa. So it may not be high throughout the day or low throughout the day, you could be somewhere in between. And so we really got to look at these things and test it and quantify and see exactly where you’re at.

Evan Brand: Yeah, great points. And on the testing, you made another great point, too, which is that if you do work with conventional medicine, they may say that your problem is not bad enough to be pathological. So we’ve had clients that will do just a morning cortisol sample via blood, and their doctor says, Well, your cortisol levels are fine. And it’s like, okay, yeah, you took an ATM blood sample. And that’s it. That’s just not enough tensional data, you have no, maybe you have a better analogy, but my analogy is you’re you’re touching the sidewalk to estimate the forecast. You have no idea what’s going to happen throughout the rest of the day with that rhythm. So if you’re having your POTS episode at 2, 3pm, you’re crashing, well, what’s going on from a cortisol perspective at that point with that 8am blood sample and that’s it. You don’t have a clue. Let me let me mention a couple things too. So I know that a lot of people with mold, just looking at Dr. Shoemaker and his big list of symptoms, POTS is sort of thrown in to some of these symptoms for mold exposure, and then also lyme. So when you’re trying to find root causes adrenals could be a factor, but there could be another layer deeper. So if you’ve had any kind of take issues, coinfection issues that could be a problem. And so, I know Stephen Buner, I talk about him a lot. He’s a really great herbalist who’s written a lot of books, he discusses using Hawthorne. And so I’ve experimented with some heart formulas myself, like mixing CO, q, 10, and Hawthorne. And I’ve had really good success with it. And so I think those are two, two good herbs that you know, two good nutrients that could help. And then also gingko could be helpful too, because gingko is going to help with blood flow and microcirculation. We use it a lot for brain problems. But I do believe that it can be helpful for POTS. And then let’s talk about the adaptogenic herbs. So I guess it really depends on what you’re looking like. But in general adaptogens are going to help modify you either way. So I would say something like rhodiola, or maybe a good ginseng, like an eleuthero is going to be probably the top top choice on adaptogens. What would you say? Oh, what about licorice? Should we talk about that?

Dr. Justin Marchegiani: Yeah, so a lot of these herbs out of the gates, you know, they’re nice, because they’re going to help with blood flow. A lot of these herbs like gingko, or Hawthorn, they tend to be used more on the high blood pressure side, right. And so they may help with blood flow. But remember, I think with POTS, there’s definitely more of a blood, low blood pressure kind of kind of thing. So we have to kind of, you know, make sure we support all of the other underlying issues. Because, you know, a lot of times, if we’re not getting to the root, then we may not get lasting results. Plus a lot of times the medications that are used, what are the big medications that are used out of the gates, is it just beta blockers out of the gates, I know they do some things like floor enough, which can be helpful, which is basically a pharmaceutical version of aldosterone, which helps to hold on to sodium, which helps increase blood pressure. You kind of alluded just a minute ago, licorice does help mimic that. And so we can use things like licorice, that non diglycerides meaning not licorice, that’s diglycerides de glycerides. licorice loses that aldosterone stimulating effect, and it’s more for gut healing. But if we’re using licorice that has not been de glycerides, non dgl, licorice that can have very powerful effects on low aldosterone levels, and it can help hold on the minerals better. So for adding more minerals in there, that’s helpful. conventional medicine typically only talks about it from a perspective of sodium and sodium chloride, they kind of forget about the magnesium and the potassium part of it. So magnesium and potassium are also very important. Also, they’re using a lot of beta blockers, right? So beta blockers, guess what they reduce the heart rate, but they also can reduce the blood pressure. And they have effects of creating nutritional deficiencies. And it can it can lead you can lose some of those same minerals, magnesium, etc, that are also very helpful for the heart in general. So the problem with a lot of the medications, they can actually make some of the problems worse in the long run, because they’re not fixing the underlying issue.

Evan Brand: Yeah, well said, here’s here’s a couple other drugs, you’re asking what drugs, here’s a list of them. There’s one called Ivabradine. It’s a drug that acts on the heart to slow the heart rate, but it slows the heart with without affecting blood pressure. And then there’s another one here, underneath, it’s hard to even pronounce it Pyridostigmine, the brand name Mestinon, this is a drug that prevents the breakdown of acetylcholine. So that’s pretty interesting. It’s like an acetylcholine esterase inhibitor, I guess. 

Dr. Justin Marchegiani: Hmm, interesting. 

Evan Brand: It says they use it for. Let’s see here. Myasthenia Gravis. 

Dr. Justin Marchegiani: That’s an autoimmune condition that affects the postsynaptic neuron where acetylcholine plugs in. 

Evan Brand: So they’re using that drug for POTS also, I guess it’s kind of an off label deal. And then SSRIs for some reason, it says here that, you know, people I guess they’re saying practitioners suspect that the fainting spells may be related to serotonin or some other neurotransmitter so they also use SSRIs. But once again, none of this is root cause and as you mentioned, the conventional like Web MD stuff is all about sodium, sodium, sodium, like you should just be frickin eating spoonfuls of like iodized salt all day, which is just ridiculous.

Dr. Justin Marchegiani: And there’s different kinds of salt right? And there’s some salts that we like that like real salt or Redmond Real Salt or Celtic salt or Himalayan that are gonna have sodium and chloride but a bunch of other minerals as well, which is great. The problem a lot of the medications for instance, beta blockers are notorious for depleting CoQ 10. And we need coq 10 for healthy heart function. So problem with a lot of these medications is you’re kind of robbing. You’re paying your credit card debt from last month with a new credit card you open this month. And so you can only play hot potato like that for so long before that bill becomes due.

Evan Brand: We made the point about the potassium to I think we talked about that for a minute because you’re saying even if we do bring in some of the Celtic or the mineral salts You may get some trace amounts, right? But you’re not going to get a significant amount. So you’re thinking possibly supplementing, like we have. I know you and I work with a couple electrolyte formulas where there’s some potassium added in there. So something like that would be better than just straight salt.

Dr. Justin Marchegiani: Yeah, so how I look at it with patients is first thing first is drink enough water. Make sure that water is clean, filtered, no crap, not tap water, number one. Number two, avoid the diuretics. Right. avoid caffeine. avoid alcohol, avoid teas, right. So that way you’re not peeing out extra water and minerals. add extra minerals to your water. So good. Redmond’s real salts Celtic sea salt, half a teaspoon teaspoon twice a day is great salt your food very liberally hydrate you know, 20 ounces or so before each meal 1015 minutes before drink in between meals. It’s great. If you’re drinking a really clean reverse osmosis water which is fine. Just make sure you add extra minerals back to it. definitely avoid any distilled water. And then if you want to drink like a really good clean mineral water throughout the day, my favorite here in Texas Topachico’s wonderful, right? It’s the Pellegrino of the South Pellegrino is also wonderful good mineral sulfate drill Steiner, Evian, Fiji, Fiji has got a lot of silica in there really excellent out of the gates love those. I would say also, you may need to have more potassium and magnesium than what you’re getting in mineral water and in the salt, because you need about 4700 milligrams per day. So I recommend everyone, head over to, put the link below, run your macros run a typical day through there, right put your age, your height, your weight, your activity level, and you’re gonna find you need about 4700 milligrams per day. And that’s the [inaudible] daily recommended intake, most people are only getting two to three grams 2000 to 3000 milligrams, and you’re probably have a deficit. And then you also have to factor in when you’re stressed. And when your adrenals have issues, you may need a couple extra grams on top of that, because you’re losing extra minerals. So you got to factor that in. So take a look, see where you’re at, see how low you’re at. And out of the gates, you know, you want to supplement additional potassium, whatever that recommended intake is if you’re at 2700 milligrams, you want an extra 2000 milligrams to meet the needs. And then from there, you really want to work with a functional medicine practitioner because if you go too high in potassium without enough sodium to support it, you can actually you can actually lower sodium by doing too much potassium so you got to keep that sodium potassium in check. Now if you’re doing Redmond’s Real Salt, like I mentioned, along with the potassium, you’re probably okay. But if you have any POTS issues at all, you really want to be working with a functional medicine doctor like us, you want to be looking at cortisol, like Evan said earlier, a blood test is only going to look at your serum cortisol, your protein, it’s not going to look at any of your free cortisol, it’s not going to look at it throughout the day. It’s not going to add it up throughout the day. And then we also run organic acids that look at the catecholamines the adrenaline, the epinephrine again, adrenaline, catecholamines, and epinephrine. It’s all the same thing, right? Medicine uses these words to confuse the heck out of you, adrenaline, catecholamine, nor epinephrine, all the same thing, okay. And so we have to test those and we use organic acids, we’ll run tests for Vanilmandelate and Homovanillate, which gives us a window into your adrenaline precursor. So if we’re burning up adrenaline, we gotta support the amino acids, we got to calm down the adrenals to really help the body. So we’re not creating all this extra stress because that stress causes you to dump minerals. And so if you’re dumping minerals, we have to replace what you typically need. Plus a little bit on top of that, plus, we got to fix and calm down the whole nervous system, right? That autonomic nervous system, that’s the automatic nervous system that controls heart rate, beat, these are things you don’t typically think about. You don’t think about beating your heart, it happens automatically. So we got to help calm that down.

Evan Brand: Yeah, so even some of the lifestyle strategies can get involved too, right? I mean, you could take all the adaptogens. But if you’re just a type A personality or a go getter, you’re not resting, you’re not taking breaks. So I would argue, some music, I would argue meditation, guided meditation, maybe a float tank, deep tissue massage, may be myofascial relief, anything that you could do to try to basically downshift your nervous system. Because yes, you mentioned something several times, which I think really kind of just ding ding ding hit the bell for many people, which is the the variable of stress. And people that are more stressed are going to have this problem more, you’re likely not just going to be sitting on an island, you know, getting, you know, spoon fed pineapple and you feel POTS. Now, this is going to be people that are really under the gun. They’re in the middle of a lot of transition there. Maybe Who knows, maybe they lost their job. Maybe they had a viral issue that really took them down like you had a post viral type POTS Come on. So stress, I think is the big variable and that’s where the adaptogens come in and help the nervous system self regulate. However, I’ve done adaptogens for years and I can still be stressed so I still have to focus During the lifestyle stuff, take the kids for a bike ride, go ride the skateboard, go for a walk, go for a hike, just sit out in the sun and listen to music. So you got to come in with the lifestyle stuff too. You can’t just go take the magic pill and you know, eat the salt and be cured. I think at a certain point, you need to come in and evaluate your lifestyle and figure out do I have toxic people I need to cut out am I working too many hours? Am I able to delegate some of the work I’m a you know, financial advisor and I’m too stressed I’m working 60 hours a week, can you delegate Can you reduce the workload reduce the stress, because in a vacuum, the stuff that we’re talking about, it won’t get you fully out of the woods with this, I do think you have to do a good life evaluation.

Dr. Justin Marchegiani: 100% got to look at all of it right. And that’s super important. Now, in general with with a lot of things we may want to get, you know, a couple extra, you know, grams of good quality sea salt. So you can start with you know, an extra gram, the 10 grams of high quality sea salt, I typically recommend starting with a half a teaspoon to a teaspoon, two times a day, put it in your water, shoot it down. You can also salt your food very liberally, you know to taste throughout the day. You can also add a little pinch in your water just enough so you can’t taste it, you shouldn’t be able to taste them. You can also drink a good quality quality mineral water right mentioned a couple of these brands. And then you can also work on doing all the right things to reduce stress. So I already mentioned a couple things out of the gates. Blood Sugar is a big thing, the more your blood sugar goes up and down on a roller coaster ride your surging adrenaline and cortisol when your blood sugar goes hypo when it starts to go low. And when you start surging adrenaline, it’s going to create more mineral depletion, because you’re going to pee it out, right? So we The more you can kind of come down that blood sugar and make it more stable part of that by being more fat burner right? healthy proteins, healthy fats and dialing in the carbs, less refined, refined grains, keeping it more to vegetables. And low sugar fruit in those kinds of things play a big, big role in keeping the blood sugar rollercoaster smoothed out. The less blood sugar roller coaster, the less adrenaline the less dumping of minerals does play a huge role across the board.Evan Brand: And this is a new problem. By the way, the blood sugar issue that you’re mentioning this is in terms of modern history, right? Because if you look at like a hunter gatherer, for example, maybe they’re gonna find a beehive and get some fresh honey every once in a while. But never in human history. Have we had access to the processed carbs, the fructose, the processed sugar, these major nations have processed grains, yeah, flowers, any of the stuff that is screwing up our blood sugar. These are all relatively new problems for humankind. So if someone’s sitting back and they’re listening, like God, why is it so complicated to be a healthy human? Well, because we’ve screwed it up with the diet, the lifestyle, the sedentary, the stress, the the schedules, the work hours, I mean, modern life has contributed to this problem. So, you know, I know it’s a little frustrating. And thank God, why is everything complicated with health? Well, because the diet is a big part of it. And I certainly know that when I had blood sugar issues, I had a lot more unstable blood pressure, too. So there is definitely a big connection there. The good news is once you get your diet dialed in, and you are a fat burner, you’re going to feel so much better, you’re going to feel so much more stable.

Dr. Justin Marchegiani: And I remember early on when I was looking at your diet law, we were chatting, I think you were having some of these POTS issues with a lot of the heart racing, right. And I remember looking at your diet and there was like an eight hour gap. In the day where you weren’t eating, I think you were trying to do a little bit more intermittent intermittent fasting, things like that. I’m like, wow, you know, you’re not going to be able to do those things because the fasting is too much of a stress on your body, your your physiology is not strong enough to be able to adapt to that stress. And so if you are doing a lot of intermittent fasting, you really got to be careful of that, you know, so kind of my checklist out of the gates is definitely be more of a fat burner. Avoid the refined flours, grains, high blood sugar types of foods that add in the extra minerals, half a teaspoon, teaspoon high quality, sea salt per day, work with a functional medicine doctor, get your magnesium, your potassium dialed in half your body weight in ounces of water. Clean, filtered water is excellent good quality, reputable brand mineral water during the day. All of these things are vitally, vitally important. Good breathing, good movement, don’t over exercise where you’re sweating too much. You know, make sure you’re doing all the right things and get your adrenals tested, get your organic acids tested to look at your adrenalin as well. I mean, we can always dive in deeper. If you have a lot of gut issues and absorption there. There always could be a bottleneck with the gut as well. It’s always possible, but those are kind of your first steps out of the gates, Alaska with the low hanging fruit, start with low hanging fruit, and then work on finding a good functional medicine support practitioner to get in your corner.

Evan Brand: I wanted to bring this up before you wrapped it up. So last thing, detox and sauna. So I do notice that some clients and me included if we go too high, we do too much. We do too frequent with sauna and or detox support, especially binders, we can run into some trouble. So just like you mentioned On the exercise not doing too much. Same thing with sauna I think you got to be careful with it if you’re already adrenally depleted, if you’re glutathione deficient if your detox pathways are not working, you can overdo it quick. So I would say the average person could hopefully handle twice a week, maybe 135 to 140 degrees for about 20 minutes but if you start to feel woozy, you feel faint, you feel like you’re gonna pass out in the sauna just get out, you’re probably dehydrated, your mineral are off your adrenals are too weak, so don’t push it, don’t push it. And then on the binder piece, work with your practitioner, but in general, sometimes less is more on the binders. I remember when I was doing like eight charcoal per day, I started to feel pretty woozy and it could have been like a detox reaction, but I think it may have been some mineral stuff too. So I was doing some fulvic acids and some salts to try to help balance it, but I still overdid it with binders. So those are just two other notes I wanted to share.

Dr. Justin Marchegiani: Exactly. So if you’re going to do a sauna, make sure if you already have kind of POTS symptoms, one don’t do it right after exercise, probably too much stress. Okay, do a sauna session by itself. Number two, take an electrolyte support a balanced electrolyte support product before you go in and have a good mineral water while you’re there sweating. So then any water that comes out, you’re replacing it as it comes in with mineral so supplement before and then good mineral water during and that should be and then try to keep it under 20 minutes and make sure you’re not feeling any bit woozy or any bit worse in regards to your symptoms while you’re in there. I think that’s a good kind of general way of of hitting.

Evan Brand: Alright, here’s my shameless plug. And then we can wrap up My Hydration Essentials is an electrolyte formula that I drink, I just do a scoop of it. I mix it with water and drink one scoop a day. And it does have some ribose it does have potassium, some taurine, some of the other nutrients outside of just your sodium. And I also drink that in the sauna and I give it to my kids. And I like to actually mix it with beet powder. And we use just an organic beet powder. And I add it to the electrolytes because it really increases nitric oxide. So my hands, my feet, everything gets warmer, circulations better and I sweat, like 25% more sweat in the sauna, if I mix the electrolytes with the beet powder and drink that. So that’s called hydration essentials.

Dr. Justin Marchegiani: And that’s great. And other natural thing that you can do on top of that celery juice is wonderful. You get about one gram of potassium in a cup of celery juice. So celery juice is excellent. Very good. It’s kind of your it’s Mother Nature’s natural Gatorade, right problem with Gatorade ton of sugar, a ton of high fructose ton of dyes. So it’s basically crap. You know, Mother Nature’s gatorades coconut water. But the problem with coconut water is a lot of sugar in it. So you really only want to do a post workout. So the best type of natural low sugar gatorades in the me celery juice, that’s a great option for you a lot of good minerals, a lot of good potassium. And if you do any green juices really avoid any carrot and or any fruit in there because when just juice it, the sugar concentrates really high. And that can create this reactive hypoglycemic drop blood sugar was a fast comes down hard. And this is kind of what feeds into the all the pot stuff. Right, it creates more cortisol aberrations and more adrenaline, noradrenaline stimulation, so just be careful that really good we’ll put links to the some of the products that Evan mentioned and some of the things that I mentioned as well. Anything else you want to highlight, Evan?

Evan Brand: Great call on the carrots. You know, when you think of eating a carrot, like in a beef stew, you don’t think of it as being necessarily sugar. But I have had some clients do what you’re describing, which is they’ll get into the green juices with the carrots and will track their blood sugar. Man, that stuff screws up their blood sugar almost as much as a soda does.

Dr. Justin Marchegiani: Yeah, if you’re gonna have a carrot, eat it whole. Once you juice it, it becomes a problem. Now if you’re doing like, if you’re just using like one carrot, and you’re relatively healthy, probably not a big deal. But if you have blood sugar issues, I stay away from any carrots if you’re gonna have a carrot habit and your salad eat it raw. I think that’s a good way to do it. Still nutrient dense. But yeah, you gotta you don’t want to throw too much blood sugar on that blood sugar rollercoaster. And beets too.

Evan Brand: Sorry. Well, last thing. So I talked about the beets. So the one that we use and carry is a non hybridized beet powder because apparently just like with strawberries, and pretty much every other fruit in the in the modern world, everything’s hybridized now to be bigger, brighter, sweeter. So most beets are hybridized even if they’re non GMO, they’re hybridized and so they’re gonna cause a big blood sugar problem. I have some clients that are just way too blood sugar unstable to handle beets but if it’s a non hybridized version, it is a little bit more well tolerated. So just keep that in mind if you feel kind of woozy. If you do the beet powder thing I’m talking about you feel weird. It could be messing with your blood sugar, you could always test it.

Dr. Justin Marchegiani: Excellent really good. Hey, if you guys are enjoying today’s content and how you support us feel free click down below look at some of our links. Sign up for our newsletter. If the information that we’re talking about resonates Feel free to schedule a call with with Evan or myself we have colleagues and support teams ready to help you out if you want to dive in deeper. We’re here to help you take control your health. 99% of people may not take that step. Use the information. Take Control your health, you’re ready for that next step we are here for you. Share this content with friends or family. Put your comments down below. I want to know what your experiences are with POTS or any of these POTS like symptoms. We’re here to help and appreciate you guys all engaging. Have a phenomenal day.

Evan Brand: Take care now. 

Dr. Justin Marchegiani: Take care y’all. Bye now.


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Heart Rate Variability Tracking, ETRF and Keto Mojo with Dave Korsunsky | Podcast #252

For this podcast, Dr. Justin is with Dave Korsunsky of Heads Up Health to discuss this new software program that measures their health in new ways and can also be connected with your different health wearables. Know more about how we can track our heart rate variability, ETRF, ketones, blood sugar monitoring and a lot more.

Dr. Justin Marchegiani

Dr. Justin Marchegiani

In this episode, we cover: 

01:08 What is Heads Up Health

10:03 How we increase heart rate variability

15:23 Fasting

22:30 How Keto Mojo works

30:20 Data trends, charting


Dr. Justin Marchegiani: And we are live Dr. J here in the house with Dave Korsunsky, Dave. How are we doing today, man? 

Dave Korsunsky: You know, I always always a pleasure when I get to jam with Dr. J on on the on the air. So yeah good to be back in connecting with you again, sir. 

Dr. Justin Marchegiani: Absolutely. So what’s going on in heads-up world if anyone not connected or not with it heads up as a great software that you can plug in a lot of your wearables. You can track various data from heart rate variability to blood sugar to sleeve tattoo, you name it and you can quantify you can really get some interesting friends in correlation to Mint. What’s happening in the heads-up world? 

Dave Korsunsky: Yeah. Well, we’re a software program for the health optimizers out there and Optimizer could just be with someone whos going to daily work and wants to kick more butt it could be someone working on a chronic illness and really trying to figure out exactly what’s going on could be a high performance athlete so We’re always building ways for people to understand and measure their health in new ways. So a lot of the work we do is Im helping people see all of their medical records together instead of in 50 different PDF files. And one of the things were going to talk about today is that there is some really really amazing technology on the market that’s becoming available to the everyday consumer that didn’t exist five years ago. And this technology is letting us measure our health in ways that are incredibly insightful measurements in many cases that a lot of health and medical professionals are not even Up to speed with so we see a lot of people who actually have incredible amounts of information on their house and using this sophisticated data to self optimize. So Id love to just share a few of those new metrics and measurements and Nuggets that people are using to fine-tune their house. 

Dr. Justin Marchegiani: That’s great. So you see set up an account,, I’ll put link down below and then once you’re there you can plug wearables like your Fitbit if you have an Oura Ring you can connect that as well. You can also just create you know ways where you can sink in or monitor blood pressure blood sugar ketones, right? So you can plug all these other markers in as you kind of correlates some of these other things you’re talking about is that correct? 

Dave Korsunsky: Yeah, the goal is to help people see cause and effect. So you keep touched on one part of it, which is I can enter my nutrition information my blood sugar in my weight. My heart rate a Kinect up all my stuff. Okay, that’s cool. But the other part of it is also linking up. Medical lab test results and other things like your thyroid markers, inflammation markers, your lipid panels. And what we want to do is okay. I’ve got all of this information here. That’s helping me measure my lifestyle choices. Am I getting enough sleep? Am I eating metabolically Friendly Foods, but we want an overlay that with your lab test results so you can you can see exactly okay if I change this what happens to my TSH marker.that’s what you and I first worked on many many years ago in your office yet, you know, and the problem was like, okay. I got all these lab tests there somewhere in some PDF files are in Dropbox they’re in Google Drive and Im like, yeah, I think I have a patient portal. So that’s like the state-of-the-art for most people trying to understand their Labs. You have the real hardcore patients that will actually put it on a spreadsheet which is better act like but still a massive pain in the ass and theres no way to cross-reference that with for example, Lifestyle Changes supplement protocols. So that’s why we put it all on one screen and then it becomes plain as day where you can start to see cause and effect. So that’s the service we provide to people. 

Dr. Justin Marchegiani: that’s good. So why don’t we just to make it visual? Are you able to share your screen and we can go take a look just kind of you know, you just going through at the people so they can see it and why you getting that setup, you know, what is the what are the top three things that the average person is coming to your site? What what are they tracking? What does that look like? What are the three or five most important things that you’re seeing off the bat? 

Dave Korsunsky: Absolutely. The number one is blood sugar. Everybodys got some type of health condition. It could just be some extra weight in the midsection or it could be something such as I don’t know pre diabetes or epilepsy or Cardiovascular disease at the root of all of these issues is poorly controlled blood sugar. So one of the most important things people are tracking whether you’re on a keto diet or a low-carb diet or you’re just not wanting to deal with any of those symptoms or in my case. I was very physically active and healthy, but I just couldnt get the fat off at the end of the day. It was all metabolic at at at the route. So the number one most important markers people are looking at our daily blood sugar also looking at some blood Ketone. We also see a lot of people measuring weight and body composition metrics because as you know, as you start to control blood sugar and you control those post-meal blood sugar surges Weight starts to come off. So we see a tremendous amount of people checking wait, were starting to see a lot more people getting comfortable with the idea of looking at their own blood work and you don’t have to be medically astute. You just need to know how to look at a few labs and work with some a stud like yourself who can then provide some extra interpretation on those tests. So a lot of people doing blood work and now theres some really cool metrics out there heart rate variability not internal heart rate variability being able to look at a very detailed sleep cycle analysis being able to look at correlations between food you eat and how that affects your sleep when you eat and how it affects your sleep. So theres some incredible ways we can self optimize now and that’s where were seeing a lot of this very Progressive people who are self optimizing are those are the things that theyre looking at. 

Dr. Justin Marchegiani: very good, so well dive in a Little bit deeper into some of these markers like youd actually shared on screens people that I have a second that maybe you’re like hey, how does this look–

Dave Korsunsky: Yeah, I’m going to share my screen. This is going to be my personal data Justin, So I I I will hereby release you from all liability for accessing my Phi voluntarily put my pHi on YouTube. Okay, cuz now so we can do this demo. 

Dr. Justin Marchegiani: What is heart rate variability mean just for the average person. There is 70% of the heart cells are actually neurological cells that there’s a connection between the heart and the brain and the more that you say uneven between each beat the more variability between each beat. It’s a good marker of the sympathetic or parasympathetic nervous system response, the more variability greater parasympathetic less variability more predictability between the beats the more of a sympathetic nervous system responses. That kind of a good summary. Do you want to elaborate more than that? 

Dave Korsunsky: If you really want to strip it down. It’s just a number to measure stress. So..

Dr. Justin Marchegiani: and it’s a little bit contradictory cuz you would think the more predictable your heart rate is the better but not necessarily the more predictable the more of a sympathetic kind of response the less predictable more of a parasympathetic kind of response. 

Dave Korsunsky: Yeah, that’s exactly right. Basically between each heartbeat. There is a certain amount of time you really just say its its measured in milliseconds and each beat has a slightly different interval that there’s a slight variation 997 a thousand a thousand and two, these are all the elapsed times between each be so actually like you said, its counterintuitive. Higher heart rate variability more variation between each beat is representative of someone who is well recovered. Well rested managing their stress and you know, this is technology that 10 years ago. You you would need to go into the hospital and get rigged up to hospital grade ECG machines to to get a really detailed heart rate variability analysis. Stop sharing my screen here for the second now you just do with one of these and this is something the average consumer can buy for $79 or something like the order ring and you track your heart rate variability and your stress on your own. 

Dr. Justin Marchegiani: Absolutely love it. that’s great. I have one of these guys here through hartmuth. Exactly one goes like this- 

Dave Korsunsky: putting you in a state of coherent. Its its synchronizing is harmonizing the heart and the brain and the electrical signals in there and you’ll start to see as you do some guided breathing some relaxation and meditation. You’ll start to see you’re at your stress response actually get much better you’ll resilience get much better. So it’s incredibly powerful and more people are starting to understand how to use HRV heart rate variability. 

Dr. Justin Marchegiani: Absolutely, in order to tracker chart this data, you know, you’re going to be plugging it into [inaudible] in which we’ll talk a little bit about what are some of the big strategy people can do to increase coherence or increase their heart rate variability. Is it just Breathing. Is it focus on the brain on gratitude? What what are the biggest factors that you’re seeing that make a big difference to move the needle?

Dave Korsunsky: well for the record, I’m a technologist. So I’m going to give my technologist take on it and then. J can put the actual on Healthcare professionals expertise on it. But what affects heart rate variability doc really goes back to the core functional medicine principles, which is is infection present is is there a pathogen is there a toxin somewhere in the body so that can exacerbate heart rate variability. It could be a physical stressor. So is a person injured is a person in dealing with a chronic illness. Are they getting sick? So that would be like an acute type of illness that can affect heart rate variability. And then the third part of it is psychosomatic part, which is basically just a fancy word to say the emotional part. What is it? What is your daily life your your work situation your interpersonal situations that creates emotional stress. So those are the three things that really diet blood sugar those will be others. They all negatively affect or heart rate variability and they are all what we would call. So as you work on things like detoxification protocols strengthening the immune system working on Digestive Health blood sugar regulation meditation. that’s when you’ll see your heart rate variability start to get better. 

Dr. Justin Marchegiani: Excellence. So for instance, just to make it tangible on the psychosomatic side. This is inner balance right here. You can plug it in. Im already in coherence, which is the red and you can see it. Its monitoring the heart rate there and it took me a variability. This is primarily just addressing the psychosomatic part. Basically, it’s a five-second breath in 5 second breath out. And as this expands here in the middle that’s breathing and imagine your lungs expanding and as its Contracting, that’s your lungs Contracting. Now, if you have an infection in your blood sugar or a whole bunch of information going on just changing your breathing and changing your mental focus doesn’t fix those underlying issues. So kind of like what you said, we look at functional medicine. We look at the underlying physical chemical and emotional stressors and that maybe a nice palliative way to shift some of the emotional stressors and in promote more of that parasympathetic nervous system respond. So we gotta put one tool in the whole kind of conglomeration of tools and then we want to be able to chart it. So maybe we corporate this we charted use an or raining or use them. The balanced athlete we incorporate other things like addressing it back. 

Dave Korsunsky: Why don’t we do a little demo here doc. You can see here my meditation time. And I’m going to actually put my meditation time. right next to my heart rate variability See, let’s do it this way. So what you see on the screen here for people are watching on YouTube. It is III track meditation time. I like to meditate I can’t say I do it every day, but I try to do 20 minutes in the morning before I pick up my phone and start the craziness and then I try to do 20 20 minutes before bed. And so that’s logged here and then I can look at my heart rate variability, which is measured by the Oura Ring. that’s one of my favorite devices. There’s others that I use and recommend like I’m the biostrap and Elite HRV. These are things anyone can purchase and measure heart rate variability basically measure stress. So as my meditation sessions increase does my heart rate variability improve and actually there’s a very strong correlation. And so the weeks were meditating regularly. I’ll see my heart rate variability in the high forties and fifties and the weeks when I’m traveling and I’m on the road and I don’t have my healthy foods handy, and I’m not getting as much sleep. I’ll start to see my heart rate variability Trend down could go as low as 20 sometimes if I’ve been on a red-eye flight and running to meetings so I can use these as levers and for me as a business owner everything I do is about my resiliency my recovery and my Stress Management, this is actually probably one of the most important numbers I can look at and you can see here if my blood sugar is good. You can see I know about 88 on the blood sugar. I’m in a really nice State and nutritional ketosis here about .8. I’m getting really good sleep. You can see that my heart rate variability styled in so that’s just really simple examples of how people are on Doing these self optimization exercises. 

Dr. Justin Marchegiani: What correlations do you have with fasting or with ketones or even just blood sugar fluctuations? You notice anything like that at all? 

Dave Korsunsky: There’s a couple aspects to that one is that there are people out there who will ask you to eat. Let’s let’s use your example. One of the first things you ever ask me to do as your patient was to do a function of glucose tolerance test. Yeah. You said Dave go your favorite breakfast. I don’t care what it is. Bennys, bacon and eggs, whatever and you said test your blood sugar before you eat your breakfast. So your fasted. Yep, and then test your blood sugar 1 hour to hour 3 hours after said food. Yep. And so what you wanted to see was does this person have a healthy response to that food? Not those nights in sugar rise? Okay. It doesn’t go into the stratosphere. It comes up to a reasonable level and then the body’s systems kick in and it has a nice taper back down to Baseline. So a lot of people will measure blood sugar response to food the also measure heart rate variability response to food that may actually indicate there’s a significant food sensitivity. So if you’re highly gluten or highly lactose intolerant, you might see your HRV plummet after you eat some of those Foods. So that’s the connection directly with meal timing. If you look at it from a slightly different angle, which is something we wanted to talk about which is like, when do you eat know when you eat can be just as important as what you eat? If your back loading all of your caloric intake to your biggest meal which happens at 7, 8 p.m. And then you go to bed at 10 or 11 and your body is still in a very proinsulin State. you’re still digesting your heart rate is still elevated that’s going to trash your heart rate variability through the Sleep Cycle. So a really common example is people who are checking HRV and adjusting a meal timing. So one of the biggest things I learned Justin was some I sleep the best and I have the best numbers the earlier in the day. I finish eating so I like to have my biggest meal with 4th Down finished by 5 p.m. And I might have a light snack before bed. But then I’ll see my heart rate and my heart rate variability just really plateau and bought them out to the night. Those are my best nights sleep that is stuff. I never would have known unless I had some data to help me.

Dr. Justin Marchegiani: do you feel a difference though, clinically regarding how you function or feel the next day. I see a lot of people that get alot of data on Oura Ring and then I feel like they’re getting stressed over the data, but maybe that dated us necessarily manifest an actual production or how they feel are you noticing that a correlation with the date and how you performing seal. 

Dave Korsunsky: So is a couple things you can do there one is actually don’t even look at the data until your two or three hours into your day. And that way you can start your day and really just go go through the first couple hours of your day. Just based on how you physically feel and then later in the day or like Im kicking ass today. I feel amazing. I want to check it with the numbers or I feel like complete dogshit today. Okay. Now I’m going to go in and look at the numbers and see if they actually match how I feel most of the high-quality devices on the market now are very protective of how you physically feel so I find a very strong correlation between what the numbers show me and how I feel in the morning, especially the devices that are Looking at all of the variables during sleep heart rate variability heart rate sleep cycles. They can get very very close to how you’re actually going to physically feel and perform but you bring up a very important Point some people get a little too wrapped up around the numbers and that that can also be an adverse effect and that’s the kind of the dark side of the data if you will. 

Dr. Justin Marchegiani: That can create a stress response in and of itself. 

Dave Korsunsky: Yeah, totally people are freaking out cuz he can get this number or that number and at the end of the day you’re like, okay one or two bad nights. I’m still going to feel good. I’m still going to perform fine and we have to learn as individuals how to properly use this data. So that is not actually creating more stress than is removing. And this is all new technology for us. Oh, yeah, people are going to obsess over something that some of these numbers and They may need to just take a break from the tracking. They may need to just learn how to take it with a grain of salt. Maybe learn how to work with you to cancel them to say it’s actually not that bad. So interpretation and interpreting that in a way that is healthy is something we all need to start form. 

Dr. Justin Marchegiani: Yeah, one of my biggest metrics cuz I’m creating content and doing podcasts and videos dealing with a patient from all over the world by big is metric is like a verbal fluency. Im thinking and talking on the go and it’s how clean can my words come off how clean can I transmit thoughts and ideas and and and and keep it moving and keep it fluid. I’m doing lots of Q&A. So I’m constantly thinking and communicating on the go how fluent how smooth connect communication be so that’s a big thing. One of the things I know this is getting the bed before eleven makes a big difference taking adaptogens an extra stress handling nutrients makes a big difference. I didnt wrapping up that mitochondria. I still been tracking my Fitbit for my sleep and just you know, I try to get 10 to 15,000 steps today. So I have that data that Like Im looking to get the Oura Ring as well so I can look at both of those combined and then you know, if I’m doing a podcast from in a stressful situation or dealing with patients that are tough. I’ll just try to use the inner balance heart rate variability and try to just check myself into that green place a couple of things people can do and then I think if you get more data, I like seeing a change if I take magnesium before bed do I notice an improvement in heart rate variability or Sleep Quality? If I add adaptogens, right? I had a meditation routine or if I exercise too late. What do I see? Is there a change in One Direction or the other do I like using it as a means of bringing things in or out of my routine stressors in stressors out? And then just seeing what kind of change it happens and I think you may notice that when we talked about doing functional glucose tolerance. Hey, go eat the Denny’s meal what it do to your glucose. And you know, I think you learned a lot from that. 

Dave Korsunsky: Yeah, absolutely and it becomes very clear once you have access to some good. Information. Okay. I did a really heavy work out at 7 p.m. And actually it took me an extra hour to fall asleep and my heart rate was still jacked until 3 in the morning. How do I know I’ll walk yours the numbers right here. There’s all my heart rate measurement through the night. Okay tomorrow I’m going to finish my heavy work out by 4 p.m. Then what happens to my heart rate to sleep and then the next day like you said I’m going to take 30 ml of CBD oil and some magnesium before bed then what happens so these are all things people are playing and learning and becoming more in tune with their physical body. 

Dr. Justin Marchegiani: Exactly. And then you can one you can develop correlation and then you can see that correlation equals causation having pulled it in pulled it out multiple times and this is a really cool way especially when you’re when you’re already at a good level of Health. Now, you’re kind of tweaking I like this live kind of data feedback loop that you can get and you can really develop you be your own. N equals one trial but you have harder data that they just you know, your subjective opinion. 

Dave Korsunsky: Yeah, and I’m not dogmatic about any lifestyle. I’m not dogmatic about any way of eating any diet. I think based on lifestyle factors genetics. There’s going to be different ways people need to eat. So carnivore vegan paleo keto whatever. Find exactly what works for you and then actually have some data to figure it out because the problem a lot of times as there’s too much information out there and how do you sift through it all and then you and then you share what you’ve learned in someone gives you a completely opposite opinion and then you have an existential meltdown and then you realize okay. Let me just get back to the lowest common denominator here, which is some objective data. If I change my diet according to what doctor Justin tells me. Lets I go autoimmune keto for 6 weeks according to Dr. J. Do the labs get better that is simple stuff anyone can do but you need the numbers and there’s a lot of people who eat and live a certain way but their Labs might look like total crap. So that’s where the numbers can actually maybe tell you that you’re not doing as good as you thought you were. 

Dr. Justin Marchegiani: Exactly. Also one of the big things is depending on where your level of health is. What tier healthier in let’s say, here’s the highest tier, your the middle tier. Here’s a low-tier people that are in a low tier already have hormonal issues or thyroid issues or an autoimmune condition bringing in something like intermittent fasting may not may actually be a stressor bringing in something like resistance training or interval training or some kind of a more intense exercise may actually be a stressor but this person up here at a higher level of how they may be able to do some eating restrictions before bed and actually benefit they may be able to do more resistance training and Crossfit and benefit. These are the people that made you well at with carbohydrates at two or three hundred grams per day because of their oxidative stress and how much resistance or aerobic training they’re doing. So theres different tiers and I always recommend like figure out what tier you’re on and don’t try to be, you know at the lower house here and do that do things that people are on at the higher level up here doing some it’s not a direct correlation. It’s not Is he poor healthy because it do that because they are healthy they can do that and it and you have to attend, you know, figure out what Avenue to go into. 

Dave Korsunsky: You bring up some really important points there one in some. So there’s probably a lot of people and you’ve mentioned is before me. There are people who are actually two low-carb and their training too hard in the gym doing CrossFit and you’ll see that you’ll see your HRV and it’s in the toilet and maybe your thyroid numbers are in the toilet and you’re not feeling great and you’re sleeping great and you’re cold and then you ratchet up the carbohydrates and you look at the numbers and you like holy crap. I feel better. Im sleeping better in my HRV is better. So that’s a part of it. And then you bring up another great point which is when I was working with you as a patient. There was a period where I was completely healthy and I could go train like a beast in the gym and then just basically go to bed and Great sleep and go to work the next day and then as I went through some life stressors, I got to the point where that same type of exercise actually was a nightmare for me cuz my body was already in a high-stress state so that same workout that I could have done without even thinking about it a year ago. Now my cortisol would stay elevated and I’d be awake till 3 in the morning because my body was already distressed date now, I’m out of that stress date and I can do those types of exercise I couldn’t do before. So again, that’s were having some numbers can also be really really helpful. 

Dr. Justin Marchegiani: I remember you doing that and Insanity Workout has like a 90-minute type of interval circuit. 

Dave Korsunsky: I was commuting from San Francisco to Palo Alto everyday–

Dr. Justin Marchegiani: hour-and-a-half commute to work 10 hours a day already. 

Dave Korsunsky: I did a stress have a good knowledge about how to eat healthy for my body in terms of right and I was just still standard American diet and it pushes me into a very high-stress State and then I was no longer able to do the types of things physically that I could do before until those stressors were removed.

Dr. Justin Marchegiani: We’re having an Oura Ring or some kind of heart rate variability is helpful because you can go into that work. I’ll be like, I got a lower number today, you know, maybe let’s just do a little bit of yoga on some walking or just a couple a little bodybuilding resistance movements and be out of the gym in 20 or 30 minutes. So you think– 

Dave Korsunsky: I can’t even imagine what my HRV number for when I was going through that I don’t even know that there was a really good technology to measure it at that time. It was 2012/2013. A lot of this amazing technology didn’t even exist. There was there was really no easy ways to measure it. So I wish I had that information now, I know exactly what my HRV numbers would look like in that situation and I know that that’s some serious interventions would be required. 

Dr. Justin Marchegiani: so for like interval or circuit training you may look and make sure you have a higher rate of HRV score for that day. And if not, maybe you could– 

Dave Korsunsky: A change is not so important. You know, you can have a crappy night’s sleep in a crappy HRV number to it’s just one day that doesnt mean Im not going to train–

Dr. Justin Marchegiani: You may adjust the intensity and length for that day though. 

Dave Korsunsky: Maybe, maybe not but if my HIV was in the toilet for a week straight now, I’m really going to change my training measurements. So a lot of the time to look at seven day averages maybe you just had a bad night’s sleep. But the previous six nights you were dialed in you. Can you might still be able to train pretty hard on that day, but like I just came off three weeks of straight business travel and my numbers were in the tank for a couple weeks. I’m really going to do some heavy resilience before I trained. So that’s where having like 7 Days 14 days trailing data. I can show an example here if you want, but that’s where it would be really helpful to look at them for longer Trends versus just day-to-day acute variations. 

Dr. Justin Marchegiani: So acute vs. Day today. Im sorry cute verse Is long-term. So you look at both when you make that I mean, I think I do a lot of that. I own intuitively. I think you know, if you can’t I just get an assessment of house food bad how sleep and how stress pain and then from there you can always get it. My general consensus is high intensity low amount of time in the gym. I am out of tent city while they’re in my big gauge for me is always walk out feeling feeling more energized. So always stop the work out prematurely. So I feel better. I’ll always make sure emotionally once I come down for my heart rate being at a hundred 50 hundred sixty after I am back to Baseline you can I mostly repeat it. And then how do I feel that next day? that’s a pretty good gauge that most people can use without even having an HRV just to make sure that the exercise is not a stressor.

Dave Korsunsky: Yeah a hundred percent so you can do it based if you know your body well enough you can just do it instinctively intuitively. You can also get you can also get data, you know, a lot of athletes at the elite level are looking at 7 day, 14 day trends and HRV and they’re looking to say, okay. I just introduced a really new heavy training regimen is my body adapting properly. So that’s where you do need some hard data and some Trends. So that’s one way and then the other way like you said, it’s just knowing yourself well enough and doing it instinctively. Im a data nerd and I like the numbers. 

Dr. Justin Marchegiani: I think it’s great. And what other things are you tracking or charting against the HIV? Have you added more variables to compare? How many variables can you compare in heads up. 

Dave Korsunsky: You know, Dr. Justin said we have to graph up to seven things at a time. So we we finally did that. I’m going to grab my heart rate variability here. At the at the previous version of the software, you could only graph to markers at a time. Yes. Now you can do up to 6 actually that pressure. So let’s look at my heart rate variability what you can see here and you can see it’s been just trending up nicely and let’s also just put my meditation time on the graph and see how that correlates. This is awesome right here. So you can see I really got into my meditation routine and started measuring at about months and you see right where I start those 20-minute meditation sessions, you know, luscher enough HRV is is actually the highest point. It’s been in the last 30 days go figure love that and then also let’s look at my blood sugar was high track with my keto Mojo and what’s happening with blood sugar nice and low ride in the mid-80s dialed in so then you can start to look over different time ranges and 270.

Dr. Justin Marchegiani: Do you have ketones with that too?

Dave Korsunsky: funny you should ask doc that we go on the grass and lets take off blood sugar. So here’s the ketones you can see Im in a really nice state of nutritional ketosis the whole last 30 days. 

Dr. Justin Marchegiani: I kind of see a little bit of a correlation there with a heart rate variability and ketones.

Dave Korsunsky: Yeah you can see ketones are high, the HRV is high right here as ketones are a little lower the HRV. So that is a really nice correlation. You know, we could we could look and say OK as people go into nutritional ketosis. Those are HRV get better. I would probably bet. Yes, you’re burning a much cleaner fuel source.

Dr. Justin Marchegiani: cleaner fuel source think of glucose and carbohydrate is like a dirty diesel kind of fuel that has a lot of stick to it afterwards and think of you know on this is like a really clear–

Dave Korsunsky: Here’s the correlation doc. I just took meditation time off. So now we’re just looking at nocturnal HRV basically a trivia while sleeping and ketones. you’re right now there’s Probably a really nice correlation curve there. We could [inaudible] for people. There you go, man. 

Dr. Justin Marchegiani: that’s awesome. It makes your serging insulin in your serging cortisol and adrenaline and that just by itself creates a sympathetic nervous system response and that makes sense because that would decrease heart rate variability that makes a lot of sense.

Dave Korsunsky: Yep so we just found a very nice correlation on nutritional  ketosis and heart rate variability. 

Dr. Justin Marchegiani:I got a keto Mojo just recently. I’ve had some older blood sugar monitors and I got a new one so I’ll have to get the keto or the Oura Ring as well and get now that I know you have six things that up. That was the thing I was waiting for so I can start charting some of this data. So that’s awesome. I’m going to start right away. 

Dave Korsunsky: Yeah, the keto Mojo also sings electronically with our app, so– 

Dr. Justin Marchegiani: Oh, how does that work?

Dave Korsunsky: You basically I’ll show you let me just get my keto Mojo. 

Dr. Justin Marchegiani: This would be great people can see.

Dave Korsunsky: We work directly with the team over at keto-mojo to do there was no Ketone meter on the market that we could sink was electronically all the Precision extras in the nails and all that stuff. They don’t have a mobile app. So there was no way for us to sync the data. So if you have the keto Mojo which is here then all you have a website and you order the Bluetooth connector. And so the Bluetooth connector just goes right and where the test strip goes. And then it sends the readings to the keto Mojo app and then it automatically sends them to your Heads Up Health dashboard. So you can breathe out of the keto Mojo readings. Let me just change this to keto-mojo. I have the glucose to ketones in the index the glucose Ketone index these automatically sync with keto Mojo the Oura Ring automatically syncs on your dashboard. We have a fasting timer so you can track your fasting intervals will sync with chronometer MyFitnessPal so you can get you nutrition data on their your blood pressure, body composition. 

Dr. Justin Marchegiani: I’m excited now that you have this multiple data.

Dave Korsunsky: and then and then the other part of it is just let me show you guys this as well. This is really kind of our differentiate or Justin is then you can actually look at peoples lab test results and see if the numbers are getting better as stress goes down. So as HRV goes up does my hs-crp number? Better does my inflammation markers get better. So that’s where having the blood work here actually become super important. that’s what we’re trying to create his like if I make a lifestyle change, I see it on the dashboard to my labs get better and my house here. that’s that’s the main function of our of our software. 

Dr. Justin Marchegiani: that’s very cool. Is there any love stuff that you wanted to show any of the listeners that you want me to take a look at now?

Dave Korsunsky: you know, Im probably overdue for some Labs, you know with mine personally some of the ones that I have to keep a really close eye on our ferritin high ferritin, which means I do need to give blood pretty regularly to keep that number down. Yeah, so that’s when I monitor very closely homocysteine is another one because of some of the MTHFR mutations if Im not taking that methylfolate. Supplement then my homocysteine will be out of range High 11 12 13 14 supplementing. It’ll be down six seven eight. So that’s when I really keep a close eye on that something I learned from my genetic report. You can get one from nutrition genome or others and they show me some methylation issues. So homocysteine is one that I keep a really close eye on my thyroid numbers are good. I’ve had some high reverse T3, which you help me with a lot of that was just cleaning up blood sugar and stress. So Im and hs-crp just an all-around really good marker of inflammation that I keep a close eye on.

Dr. Justin Marchegiani: I love it.

Dave Korsunsky: You know the cool thing as you can get Labs yourself now online so you can order from Dr. J or you can just go and get them in and all them yourselves. Even if your doctor won’t run some of these tests like a fasting insulin. No super cool number really good early predictor. Metabolic house a lot of doctors want to order it? Cuz theres no diagnostic code for it. So this is what it yourself or I’ll call Dr. J. Get him to order check it yourself make some changes. 

Dr. Justin Marchegiani: Love it love it will put link down below. To get subscribing with Heads Up Health in will this tomorrow podcast on these topics? I’m going to get some of my stuff set up here and we’ll do some Lab podcast here.

Dave Korsunsky: You know, doc, we will give you a discount on your subscription, you know, just cuz I like you you you qualify for the friends. 

Dr. Justin Marchegiani: I appreciate it. I appreciate it. Dave awesome.

Dave Korsunsky: Don’t mention it. 

Dr. Justin Marchegiani: I appreciate it. Anything else you want to dive in here today?

Dave Korsunsky: It’s always good jamming with you where we’re going to need to build this thing [inaudible] talking about some of the new health metrics and how people And use them and get a little more dialed in on their health, so I always take the opportunities to come on the show when it come from Dr. J. So thank you for having me sir. 

Dr. Justin Marchegiani: Excellent day will really appreciate the amazing technology that you produced on the ease of access and the ability to sync up and make correlations on your own so we can all be our own little n equals one guinea pigs out of space. So really appreciate that. Dave will be in touch soon and look forward to connecting again. Have a good one. Bye. Bye.


Audio Podcast:

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