Your HRV is Talking: What Stress, Food, and Sleep are doing to your Heart

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00:00:05:04 – 00:00:07:08
Synergee
So guys joining us today is Dr. Sanjay Bhorjaj to talk about how to support your wellness journey in Ridgeland MS.

00:00:07:08 – 00:00:26:22
Synergee
He is a board certified cardiologist in the longevity space. And he is leading us today with just the voice of wisdom when it comes to cardiovascular health. We got to meet him in September at a mindshare summit that Lori and I attended, and instantly knew that we needed to connect again on the podcast. So thank you so much for being here today.

00:00:27:00 – 00:00:34:02
Dr. Sanjay Bhorjaj
Oh my gosh, thank you guys for having me. And, it was equally an honor to meet the two of you and just so excited about the work that you guys do as well.

00:00:34:07 – 00:00:38:06
Synergee
Thank you. Thanks for taking time out of your schedule. So we always have to start the same way.

00:00:38:06 – 00:01:02:07
Synergee
Give us a little insight about who you are, what you do, and who you serve.

00:01:02:07 – 00:01:22:01
Dr. Sanjay Bhorjaj
Yeah. So I am by conventional trade. So I’m an MD physician. So I went to medical school, and was a conventionally trained interventional cardiologist. So for those of you who aren’t familiar interventional cardiologists, we are procedure based cardiologists. So for a living, I was putting in balloons and stents. And then, progressed into putting heart valves into people all through the arteries, in the legs or arteries, through the wrist. And for about 20 years, I was the front line of cardiovascular disease, like literally that last line between life or death. So you had a heart attack at two in the morning. I would get called in, come in, open up your blood vessels.

00:01:22:03 – 00:01:43:11
Dr. Sanjay Bhorjaj
And in that space. Very rewarding. Right? Very few things in medicine that give you that instant gratification, that instant hit of serotonin. But I got to a point in my career where we were starting this and getting repeat business. And in almost any other business that you’re in, you know, like if you watch Shark Tank, they’re like, what’s your return customer rate and all these things.

00:01:43:11 – 00:02:14:02
Dr. Sanjay Bhorjaj
But in cardiovascular medicine, repeat business means someone’s had a second heart attack or progression of the arterial disease. And they need a second, you know, stent or heart bypass surgery or whatever it may be. And that’s not really something that you want. And so in about the 10 to 12 year point in my career, I was seeing people that I had fixed earlier on and come back with the same issues, despite having, you know, what we consider the conventional world optimal medical therapy, meaning conventional medical world.

00:02:14:02 – 00:02:39:02
Dr. Sanjay Bhorjaj
So blood sugar was great and cholesterol was great and blood pressure was fine. And all the quote unquote controllable things seemed okay. And I realized, man, there’s got to be something more than it was right around this, that time that I got a an introduction email from some supplement company into the functional medicine Ridgeland MS approach to hypertension. And it was, you know, a free lecture, online.

00:02:39:02 – 00:03:05:15
Dr. Sanjay Bhorjaj
This was before the Covid. And so zooms were kind of weird and webinars weren’t quite as facile. But I said, you know what? You know, I can just forget watching another episode of Law and Order or whatever and watch this. And it blew my mind because all of the things that we were not addressing in the conventional world mindset, emotional health activity were so central to the role of or the approach with functional medicine.

00:03:05:17 – 00:03:29:12
Dr. Sanjay Bhorjaj
So, you know that that was on a Thursday night. And on Friday I started talking to patients about diet, lifestyle, all of these different things. And I saw this shift in not just their numbers, but also their whole approach to life. And, you know, happy humans are just better than unhappy humans, right? I think it was Elwood’s in, in, was it legally blond where she said, happy people don’t kill people, right.

00:03:29:12 – 00:03:46:20
Dr. Sanjay Bhorjaj
But it’s so true. Happy people are better. And one of your bodies is working better when you feel a balance, when you feel like your health care practitioner is actually listening to what you’re having to say and giving you advice that is tactical, that just creates a better relationship for health. Right? So I think in all of those ways,functional medicine Ridgeland MS just kind of fit what I thought was going to be in this next chapter of my career, which is getting out of the cath lab and really leaning into these integrative and functional modalities for heart health because they are central.

00:04:00:12 – 00:04:04:13
Dr. Sanjay Bhorjaj
It’s just not a conversation that a lot of cardiologists know how to have.

00:04:04:18 – 00:04:23:17
Synergee
So interventional cardiology yea I’m a numbers person okay. So give us some insight too about how many procedures you were honestly doing a week in the lab. Yeah. So probably bit between all the things.

00:04:23:17 – 00:04:44:23
Dr. Sanjay Bhorjaj
So I was within cardiology. I did a lot of different things. So basically from the neck all the way down to the toes, if there was a blood vessel, I would stent it. Heart valve procedures, things I was probably doing anywhere from 8 to 10, cardiovascular procedures a week. That includes emergencies and schedules. So it was a lot. And again, as you accumulate these numbers over the years, you kind of divine the commonalities in between.

00:04:44:23 – 00:05:14:13
Dr. Sanjay Bhorjaj
And so much of it was diet, lifestyle conversations that people weren’t like, conventional doctors just don’t know how to have. Right. And I’m asking that question because I think sometimes people don’t truly understand the rate to which you all are doing these, and the cost and the expense associated with that economically and health care. Yeah. I mean, you know, I always say being healthy seems expensive, but being sick is definitely expensive, right?

00:05:14:13 – 00:05:35:00
Dr. Sanjay Bhorjaj
So, you know, eating organic food and taking that vacation so you can unplug from your environment seems expensive, but in the long run, it’s actually much cheaper. So cardiac. So if you came in with a heart attack generally that’s a 3 or 4 day hospital stay on average anywhere from 80 to $120,000 for that hospital stay that gets billed to insurance.

00:05:35:00 – 00:05:56:19
Dr. Sanjay Bhorjaj
So it is not an inexpensive thing. And considering yeah, let’s say, you know, one of the heart valves, the heart valve procedures I do if you’re a cashier paying that, that was easy, 150 to $250,000. So these are expenses that, you know, generally because insurance is paying for it. People don’t think about it. But in the ecosystem of health care, these are being charged to insurers.

00:05:56:19 – 00:06:11:17
Synergee
These are being charged across the board. So you know, we have to really, you know, as I say, we have to get away from this intervention mentality into a prevention mentality, right? Where we’re preventing disease from happening. The best way to manage a heart attack is to never get one in the first place. And that starts with diet.

00:06:11:17 – 00:06:29:00
Dr. Sanjay Bhorjaj
That starts with lifestyle, and that starts with the understanding that heart disease really begins the moment we’re born. And so we have to look at our kids and how they’re eating and their activity levels and get them outside instead of behind video games. And same goes for adults, you know, get outside, don’t watch TV, don’t be sitting around all the time.

00:06:29:01 – 00:06:36:18
Dr. Sanjay Bhorjaj
Be active. Do things that humans were designed to do because that’s really the easiest road to maintaining health.

00:06:36:20 – 00:06:53:08
Synergee
So we think about all the changes that have happened since Covid. And one of the biggest changes we saw was the onset of inflammation that was more recognized and more honored. Honestly, post Covid, an increase of cardiovascular deaths. Right.

00:06:53:08 – 00:06:57:05
Dr. Sanjay Bhorjaj
We saw more people have events and then not survive the event than Yeah. And Covid was interesting for a couple of reasons. You know, as a virus, it made people more, you know, inflamed. And that led to hyper quagga ability, meaning your blood would be stickier and clot faster. And that’s part of that cascade. But what most people and even a lot of cardiologists I don’t really don’t really appreciate so much is atherosclerosis.

00:07:19:04 – 00:07:42:22
Dr. Sanjay Bhorjaj
That’s what we call plaque building up in the arteries is really atherosclerosis that it is such a suffix indicates inflammation. So when you’re looking at these cells of plaque under a microscope, they are an inflammatory situation. It’s an inflamed situation. And anything that revs up inflammation in the body is also going to rev up inflammation in these plaques.

00:07:42:22 – 00:08:04:12
Dr. Sanjay Bhorjaj
And that’s why we saw an uptick in cardiovascular events. That’s why we saw people with cardiovascular morbidities. You know they’re much worse with Covid infection because their bodies were just amped up. And now, you know, these plaques are growing. You know, they’re exploding. We call it rupture, leading to heart attack. Right. But there are so many different things.

00:08:04:12 – 00:08:25:01
Synergee
And to your point, inflammation, you know, was really a topic that we knew about, but we weren’t talking about. But it came to the fore because we realized that systemic inflammatory response syndrome and all these things were long Covid and, you know, long post-viral syndromes or whatever we’re calling it nowadays exists because we have to ramp down the immune system.

00:08:25:01 – 00:08:32:04
Dr. Sanjay Bhorjaj
He gets so revved up, he can actually have to cool it down as well. Otherwise it starts attacking us in weird ways and all sorts of things happen.

00:08:32:06 – 00:08:49:20
Synergee
Yes, our listeners are listening. They’re really tuning into that inflamed discussion. Like they want to know more. They want to know what they can do to help themselves. Not just short term, but long term. Like what are some strategies? What do they look like in today’s world for calming that immune system?

00:08:49:22 – 00:08:56:07
Synergee
And because we don’t want to suppress the immune system, right. We just want to calm it down. So what do you find the best strategies to be?

00:08:56:09 – 00:09:03:22
Dr. Sanjay Bhorjaj
I mean I think that the most probably the cheapest one is sleep. Honestly getting adequate sleep is a big deal.

00:09:03:23 – 00:09:38:10
Dr. Sanjay Bhorjaj
So, you know, inflammatory markers like il6 ala one b, TNF alpha, will be increased in people who are chronically sleep deprived. And, you know, that’s the awareness of sleep as a public health intervention, I think hasn’t reached where it needs to be. So really just getting adequate sleep. If you do have a, you know, a sleep partner or a bed partner or whatever, who is snoring a lot get evaluated for sleep disordered breathing because you can be asleep but not getting that rested phase that, you know.

00:09:38:10 – 00:09:46:15
Dr. Sanjay Bhorjaj
Phase three, phase four REM sleep where the brain starts to clear itself. So I think that is one of the easiest things to do in terms of inflammation, mental approach to things, and mindset. Also people don’t realize it affects inflammation. So if you’re, you know, a negative person who oh my gosh, you know, I won the lottery, but I only won 1 million instead of 5 million.

00:10:00:06 – 00:10:35:00
Synergee
You know, like these things, these mindset things have been shown in the cardiovascular literature to increase inflammatory markers as well. Food, you know, what are the types of foods that you’re eating. And so for your audience that may be dealing with a lot of autoimmune conditions, probably a lot of people realize that. But if you have intolerances to high histamine foods like nightshades, things like that, or even foods that that you don’t realize aren’t healthy, like I, I run a cardio metabolic program and one of the things that we do is look at, not just healthy foods, but what are the foods that are healthy for you as an individual.

00:10:35:04 – 00:10:51:14
Synergee
And all the time we’ll be surprised by things that people react against, like asparagus or I had someone salmon, someone reacted to chocolate. You know, those are things that the chocolate person decided ultimately she was going to do the time for the crime, so she didn’t give up chocolate, but she just realized that that’s something that affects me.

00:10:51:17 – 00:11:17:13
Synergee
But in a lot of different ways, the foods that we eat promote inflammation as well. And then, you know, the standard gut health and all those things that we talk about are foundational, but really operationalizing three things that we don’t talk about too much, the foods that we eat, the mindset that we have and the sleep that we’re getting and or not getting, are relatively, you know, that that 8020 kind of rule change, 20% of the things and get 80% of the benefit.

00:11:17:13 – 00:11:24:02
Synergee
Those are the three that I point to the most often that you can change tomorrow and start to see a benefit within a week or two.

00:11:24:04 – 00:11:42:14
Synergee
And being in the cardio metabolic world, I’m just curious. That is my space, my world. That’s my entry into functional medicine. We all have our story. Sure. I can imagine that you often see blood sugar dysregulation as a primary driver of cardiovascular disease.

00:11:42:14 – 00:12:05:06
Synergee
I would love to hear how frequently you see that. And then what is your fear? Is there anything beyond those three? Are there specific tips for those individuals that have that blood sugar dysregulation?

00:12:05:08 – 00:12:28:22
Dr. Sanjay Bhorjaj
Yeah. So the interesting thing is, over the course of my career, we went from a population that used to smoke a lot. Right. And I trained in the Midwest, so in Indiana and Chicago and Detroit.
So a population that smoked a lot too, now a population, across the United States where most of us are metabolically insufficient, meaning we’re insulin resistant. In fact, there was a study that came out of University of Utah or one of the Utah universities about two years ago, said 93% of Americans over the age of 18 are metabolically healthy, a staggering number much more lethal than Covid.

00:12:28:22 – 00:12:46:17
Dr. Sanjay Bhorjaj
Right? But being in the cath lab during this time, I got a very interesting insight to be able to see the cardiac consequence of this. So back in the good old days of smoking, and I know that sounds absolutely crazy to say, but in the good old days of smoking, when I have to go in and fix someone’s artery is a very discrete lesion.

00:12:46:17 – 00:13:07:17
Dr. Sanjay Bhorjaj
So you can imagine this, this blood vessel like a pipe, and there’s just, you know, 2 or 3mm of disease that I would need to put a short balloon or a short stent in and fix. And that was the, the M.O. of, of smoking as a risk factor. And what I saw as smoking rates went down and metabolic disease went up is a completely different pattern of disease inside the arteries.

00:13:07:21 – 00:13:32:13
Dr. Sanjay Bhorjaj
So now instead of having one small little area that’s affected, which would be presumably by damage from the chemicals and whatnot in smoking because insulin resistance and blood sugar elevations and all these things are systemic. What we started seeing in the cath lab now was much more of what we called multivessel disease. So rather than being just one vessel out of the three main vessels of the heart, it would be splotchy in different areas.

00:13:32:17 – 00:13:51:02
Dr. Sanjay Bhorjaj
But we also saw a much more diffuse pattern. So now instead of putting in a 12 millimeter stent, which is a fairly short standard size, we’d be putting in 30, 40, 50, 60mm, sometimes of metal, right, because we’d have to reconstruct the vessel. In fact, we call it a full metal jacket. What do we have to do in the cath lab?

00:13:51:02 – 00:14:11:00
Dr. Sanjay Bhorjaj
Because now we’re seeing such a diffuse disease. And the reason that’s of concern from a cardiac standpoint is, you know, the heart bypass still has a role in what we do and as one of the mainstays. But when you have this much that there’s no way to plug a bypass into. Right. So you start to limit options. You’re painting yourself into a corner.

00:14:11:06 – 00:14:35:05
Dr. Sanjay Bhorjaj
And you know, metal does not belong in your arteries. And it has diseases of its own. We call that restenosis and thrombosis and all these different things. So now you are taking a a bad situation, making it kind of better, but kind of not for different reasons. And so the consequences of metabolic disease from a cardiac standpoint are, number one, a completely different pattern of disease.

00:14:35:09 – 00:14:56:07
Dr. Sanjay Bhorjaj
But then we have to rethink our approach. Right. Because now it’s not just about cholesterol. We really have to zone in on sugar. Right. And you know where I was at a conference in Las Vegas a few months ago. And, and I hate going to be guests for conferences, but, you know, one of the things is that you can still smoke inside there, right?

00:14:56:07 – 00:15:10:21
Dr. Sanjay Bhorjaj
Like, I lived in California, and it’s just weird for me. So, you know, when you see someone smoking, you can kind of give them a crappy look and, you know, you know, that just this day and look, and they feel bad for a hot second, they go back to puffing. But, you know, there’s a social almost intolerance to smoking.

00:15:10:21 – 00:15:31:10
Synergee
But we don’t have that when it comes to ultra processed foods and high fructose foods and sweets. Right. Like it’s a sweet treat. Right? It’s like a reward for something. And so it’s much more difficult to take away. And socially the pressure is, you know, if I show up to an office party with a thing of veggies as opposed to, like, donuts, right?

00:15:31:10 – 00:15:49:13
Synergee
Like that’s going to be a very different thing, right? We reward these kinds of these sweet treats, which is great. And I have nothing wrong with sweets in moderation. However, we’re overdoing it. Right. And now we’re seeing, I think, in, in, in the cath lab, we’re now seeing the consequences of this, that, that tide, that wave kind of starting.

00:15:49:13 – 00:16:06:06
Synergee
And it’s only going to get worse over the next ten, 15 years. Right. Because now we’ve got kids with adult onset diabetes, right? We used to call type two diabetes adult onset. Now we’re seeing it in kids as young as eight, nine, ten. And I get so nervous about their vascular health over time. And so we really need to get it.

00:16:06:06 – 00:16:20:09
Synergee
And getting back to what the original question was, was, what are some of the interventions that we can take? Right. So number one, I think, you know, let’s get the ultra processed foods out of our diet, which I know is difficult to do, but do the best you can. Food should really just have one ingredient on the label.

00:16:20:09 – 00:16:39:16
Dr. Sanjay Bhorjaj
Right. What are carrots made out of? Carrot I don’t know. Right? Like what is what is meat made out of meat right. There’s don’t motto like sodium garlic like heat and kind of all these things that you need a PhD in biochemistry for. So I think really zoning in to diet becomes really important. In terms of things that we can do, avoiding sugars almost at all costs.

00:16:39:16 – 00:16:58:18
Synergee
I mean, I’m not saying that I never have sugar, but sugar and it’s more natural form. So apples and grapes and because that sugar is balanced by the fibers. Right. Maybe not so much in grapes, but certainly apples, blueberries and, and that sort of thing becomes important. Daylight regulation, nighttime regulation, eating with your circadian clock, not overeating, intermittent fasting.

00:16:58:18 – 00:17:22:11
Synergee
I’m a huge fan of Lori. Probably you as well. I mean, I’ve seen so many people do so much better just narrowing that window, doing a time restricted eating. And metabolically, it just puts our bodies in a much better state. So, yeah, there’s a lot of things that we can do from a functional medicine Ridgeland MS standpoint. But, you know, I think getting rid of the ultra processed foods, and intermittent fasting or time restricted eating or part two of the most powerful things that I’ve seen in my patients.

00:17:22:13 – 00:17:39:21
Synergee
Yeah. I love what you just shared about the cath lab and what you’re seeing, the difference between what you used to see as one of the primary drivers of cardiovascular disease in history and then what you’re seeing with the dis metabolic, insulin resistant patient. And I just want to say, Kelly and I don’t really like traveling to Vegas either.

00:17:40:02 – 00:17:57:20
Synergee
It’s completely disruptive to sleep for many reasons. Right? There’s so many reasons at war and so many like the sounds and the lights and the stale air. And, you know, this was the American Academy of Anti-Aging medicine, which is really hilarious, a forum that they have that conference say. But I had to go outside to breathe fresh air.

00:17:57:20 – 00:18:06:19
Synergee
And even the fresh air outside doesn’t feel fresh, right? It’s just so different. And us going to Vegas was actually wearing our oura ring.

00:18:06:20 – 00:18:16:05
Synergee
So we track a lot of data. Right. So wearing that to Vegas, we could see that HRV flattens low and flat. Right.

00:18:16:11 – 00:18:33:07
Synergee
And then it would take 3 or 4 days to recover. So we were going to Vegas every single year for A4M for years, probably for 15 years. And then two years of wearing the oura ring. The first year we just said, okay, well maybe we shop too much, maybe we had a little too much wine, maybe that steak late at night wasn’t good.

00:18:33:11 – 00:18:44:18
Synergee
The second year we did everything perfectly. We ate early, went to bed early, and got hydrated. I even got an IV while I was there. It was the same picture. No difference in my HRV.

00:18:44:20 – 00:18:58:15
Dr. Sanjay Bhorjaj
And that speaks to, you know, environmental cues. And that’s something we don’t talk a lot about in cardiovascular medicine. But, you know, light, right. Like the wavelengths of light and the directionality of light, that we get at nighttime.

00:18:58:15 – 00:19:15:09
Dr. Sanjay Bhorjaj
And, you know, you can certainly wear the blue block or glasses, but, you know, if you’ve got canned lights that shine, you know, I’m in my office right now, I’ve got canned lights here and I don’t use them. At nighttime, I turn the temperature of my light down to about 2500 K to mimic, like the evening shades of sunset, right?

00:19:15:15 – 00:19:37:20
Dr. Sanjay Bhorjaj
Noise, you know. So one of the things that I did this year was I walked around with my noise canceling headphones. Because you don’t realize how much that background noise really causes stress on your body. You know, air, right? Sleep. But one of the great things about that connection, right, is that we see so many people. And so, you know, I don’t want to be completely negative, Nelly, about those kinds of conference situations as well.

00:19:37:20 – 00:19:54:16
Dr. Sanjay Bhorjaj
But in our day to day existence, even in our houses, we need to start looking at the air we breathe. Are you opening up your windows every so often? I know you know, in the winter it can be difficult. I’m from Chicago originally, and nobody’s opening. Unless you were in one of those old Chicago apartments like I had in college, where you had a radiator.

00:19:54:20 – 00:20:26:13
Dr. Sanjay Bhorjaj
And so it was either just blazing hot as the sun or not, and you had to open your window to a certain length to get the cold air and, to modulate the temperature. So, you know, are you getting air exchange in your house because, you know, over time you can actually accumulate carbon dioxide from breathing. And so you have to get fresh air in the house looking at off gassing and the cleaning chemicals that you’re using and the directionality of light and trying to get some floor, floor level or eye level incandescent bulbs, I don’t know if I can say the word anymore because they’re so unpopular, but, you know, finding those older bulbs that don’t have the same blue light spectrum as those energy efficient LED bulbs have, you know, we just have to think about these things in so many different ways, that, you know, that it actually does make a difference. And being mindful of this, not overwhelmed and making those 1%, 2% changes, you know, is manageable, but also tactical and can lead to benefits of health.

00:20:51:04 – 00:21:01:10
Dr. Sanjay Bhorjaj
Like, I know my sleep has improved significantly since I stopped using overhead lights. Just such a simple thing, right? That my body doesn’t think it’s noon at 9 p.m. anymore.

00:21:01:12 – 00:21:04:10
Synergee
Can we go back to the discussion on heart rate variability?

00:21:04:12 – 00:21:05:04
Dr. Sanjay Bhorjaj
Oh yeah.

00:21:05:06 – 00:21:16:23
Synergee
How are you measuring that in your patients? I know a lot of our listeners wear devices to measure right. Whether that’s the woop, whether that’s the ordering. But they love tracking that. So what are your thoughts on measuring?

00:21:17:02 – 00:21:35:03
Dr. Sanjay Bhorjaj
I love heart rate variability. And I think it is one of the most easily understood metrics. Right. So when we talk about heart rate variability, what we’re talking about as you may know, is, is beat to beat millisecond variances within your heart beats.

00:21:35:03 – 00:21:57:03
Dr. Sanjay Bhorjaj
So when you have a heart rate of 60 beats per minute, it’s not like a metronome clicking exactly at whatever 1000 milliseconds, but rather there are these beat variables. And that kind of gives us insight into the fighter flight and the cool down system, that parasympathetic sympathetic tone. And got HRV scores like basketball, not like golf.

00:21:57:03 – 00:22:15:23
Dr. Sanjay Bhorjaj
So you want higher numbers? Not lower numbers. So I, in my cardio metabolic program that I run, that’s one of the first things we talk about is HRV. Why? Because it’s not just emotional stress that drives HRV up and down. It can be inflammation. So, you know, if you have a glass of wine or a beer, you can see your HRV drop, right?

00:22:15:23 – 00:22:32:08
Dr. Sanjay Bhorjaj
If you’re eating food. And that’s one of the things that I teach you about food that’s inflammatory to you. You will all of a sudden, all of a sudden see your HRV drop. In fact, that happened to me with peanuts, right? Peanuts are known to be inflammatory. I love peanuts, I grew up on peanut butter. And I would have handfuls of peanuts every night.

00:22:32:08 – 00:22:50:19
Dr. Sanjay Bhorjaj
And I saw that those few nights where I didn’t have peanuts, I slept better. I got more in-depth sleep, and my HRV had about a 15 point swing. And I’m like, no, that can’t be just from peanuts. Because, you know, food doesn’t affect your inflammatory milieu, right? Why would that work? And then, sure enough, I started avoiding the peanuts.

00:22:50:19 – 00:23:08:08
Dr. Sanjay Bhorjaj
And, you know, my sleep got better and my hrb got better, right? So and that’s something that most people don’t connect with is how our food affects it. You know, certainly if you’re not sleeping or you’re drinking, most people are aware of that. But HIV is a great metric. Now, as a cardiologist, I do have to put some caveats in here.

00:23:08:08 – 00:23:32:01
Dr. Sanjay Bhorjaj
Is that, number one, if you have a pacemaker right where you have electrical stimulation from this device is probably not helpful because you literally have a metronome in your chest, right? Like so. If you don’t fire at a certain millisecond length, it will fire for you. So it becomes a little bit difficult. Also, if you’re on medications that can affect your heartbeat and like beta blockers, metoprolol.

00:23:32:03 – 00:23:55:11
Dr. Sanjay Bhorjaj
Carvedilol. But so for all for instance, calcium channel blockers like don’t high as or or of rapid meaning or others that, you know, you’re taking medicines that will affect your heart rate. So there are those caveats with HIV. But that being said, I think it is so useful as a tool, so insightful. And what I love is when clients, patients come back to me and say, oh my gosh, doctor B, I saw my HRV dropped.

00:23:55:11 – 00:24:11:00
Synergee
I didn’t realize what a big deal x, y, Z was, right? Like, oh my gosh, I had, you know, whatever, brussel sprouts or something. And all of a sudden my HIV dropped and I realized that my body doesn’t like brussel sprouts, right? Like and that’s just I don’t think I’ve ever had anybody to see that of brussel sprouts.

00:24:11:00 – 00:24:35:12
Synergee
But, you know, there’s these things that unexpectedly affect us, right? Oh my gosh. I, you know, watch the news at night time or I watched an episode of Housewives of Orange County or whatever. Or my favorite one was, every time I speak to my mom, this was a woman who was kind of not having good health. And so she realized every time she spoke to her mom, her HRV dropped because she was stressing out, talking to her mom about, you know, whatever, mom things. So, it’s connecting people with an easily available metric so that they can start to make these correlations for themselves and get these realizations. Oh my gosh, this explains it. Now I understand why, right? I absolutely love those moments for folks. So do I like HRV? No, I love HTV, right? Like that’s how I feel about it.

00:24:54:07 – 00:25:12:21
Synergee
Yeah. We found that it’s very, very difficult to improve. Harvey, we’re after a person’s really, and Kelly and I talk a lot about the foundational principles. Keep the foundation. The foundation. What you eat, what you drink, how you sleep, how you move, and how you think. Those are the foundation. So you begin to make those changes.

00:25:12:22 – 00:25:34:17
Synergee
Once you make those changes, it can become very, very difficult to move the needle in a favorable direction with HIV. Is there anything outside of those foundational principles that you have found really moves the needle for HRV? Yeah. So let’s talk a little bit about that too, because I would get like HIV resistant people. Right. So someone’s like, oh my gosh, my HRV is 20.

00:25:34:17 – 00:25:58:00
Synergee
No matter what I do I go on vacation. And that’s all for the litmus test for me is what is your HRV like? On the fourth day of education? Because that’s when you’re actually eased into your vacation, right? The first few days you’re like, oh my gosh, the hotel and this and the other. But when you’re at a CDC in vacation, if you’re not seeing your HRV, go up, there are some people that it just doesn’t track very well, or they’re carrying a lot of deeper things like traumas and whatnot that don’t really melt away.

00:25:58:05 – 00:26:19:09
Synergee
And that’s where I think VNS vagal nerve stimulation comes into play a lot. So there’s these devices that you can do either ultrasound based or energy based on the carotid artery. There’s a collar that you can wear. There’s devices on your ears that become helpful in really refractory cases. I don’t just jump into those. Oftentimes I’ll start with breathwork or meditation, really.

00:26:19:09 – 00:26:38:19
Synergee
And very intentional breathwork and meditation to help relax. So one of the things that you can do is for breathe. So breathe in for a kind of breathe out for a kind of aid on the breathwork coach. And that really engages that parasympathetic nervous system, doing things like humming, or gargling can improve that.

00:26:38:19 – 00:26:54:04
Synergee
I’ve seen some stuff on Instagram. You have to be careful with this, but putting your face in cold water, I don’t know if you’ve seen that as a trend. Like they’ll get like a bowl full of ice water and, you know, as part of the get ready with me for nighttime routine type videos, people are icing their faces.

00:26:54:10 – 00:27:16:21
Synergee
You know that that all does increase your parasympathetic tone. Not for everybody. But, but, you know, I think that this, this emerging area, vagal nerve stimulation becomes very interesting. Because not only does it modulate parasympathetic, but it can actually improve cardiac issues like heart failure and arrhythmia and all sorts of things. So it’s working on us at a very primitive level, and it’s very powerful.

00:27:17:00 – 00:27:29:07
Synergee
so breath work, humming, laughing is another thing that you can do, to improve HRV. So yeah, those are when, when eating and sleeping isn’t enough. Those are some of the tricks I pull out of the toolbox.

00:27:29:11 – 00:27:31:22
Synergee
How about you? What do you like to counsel people on?

00:27:32:04 – 00:27:38:17
Dr. Sanjay Bhorjaj
Yeah definitely that vagal nerve thing. So going back to the vagus nerve, that is a nerve that runs from your brain to your gut and from your gut to your brain.

00:27:38:17 – 00:27:58:20
Dr. Sanjay Bhorjaj
It’s bidirectional. It sets your tone for that balance between sympathetic and parasympathetic nervous systems. It’s very, very important. And oftentimes we’ve been chronically stressed. That nerve gets blunted. It doesn’t stimulate as well. And so he just described a lot of ways to help yourself stimulate the vagus nerve. And some of them we were taught to do with kids.

00:27:58:20 – 00:28:15:23
Dr. Sanjay Bhorjaj
We hummed. We laughed, we sang. We, you know, we did. All the things happen, skip and split times with our friends that help vagal tone. And sometimes as adults, we forget to do those things. So I say gargle in the shower, sing on your way to work.

00:28:16:01 – 00:28:21:19
Synergee
Yeah, I can’t remember the last time I gargled on purpose, but you know, just, you know, while you’re on that just joy.

00:28:21:22 – 00:28:25:13
Synergee
I think just bringing joy back into your life, right? Like so many of us are just forgetting to do fun things. Right? Because life is serious and adulting is hard and manipulative. But you know, you have to defend that time for you to do something you enjoy, you know? And I think, Lori, you’re there. One of the things that I have done is I started playing ukulele, of all things.

00:28:44:23 – 00:29:00:16
Synergee
Right. It’s four strings. It’s easy. There’s four chords that you could play, and you can never, ever have a bad time or be angry. I play the ukulele. It’s just not something that can happen. And so I tell myself, five minutes a day and and five minutes invariably turns into a half hour. But it’s just fun.

00:29:00:16 – 00:29:22:07
Synergee
But there’s a simple thing that has actually brought so much happiness to me. I think of that as a weapon of longevity, you know, like when I, when I busted out, this is really, you know, it’s retraining my brain and neuroplasticity and singing while doing chords and strumming. It’s like, you know, top patting your head and rubbing your tummy like it’s a lot of mechanical things that retrains your brain to do things in a different way.

00:29:22:09 – 00:29:42:11
Dr. Sanjay Bhorjaj
But, you know, that’s just what I find joyful. But whatever it may be, ballroom dancing or plans or playing, you know, cards with your friends or whatever it might be. But you need to defend that joy time. Otherwise, you know, anger and deadlines and all those things will take over your entire life, right? So you have to defend that time.

00:29:42:13 – 00:29:59:10
Synergee
So speaking of longevity, can we talk about aging just for a minute? That darn clock just keeps ticking and we get older and older. And so as we know, nitric oxide goes down with age. Why does that happen?

00:29:59:12 – 00:30:08:08
Dr. Sanjay Bhorjaj
So yeah. And I always say that if you think about longevity as a science cardiologist, we’re like the OGs of longevity, right?

00:30:08:08 – 00:30:32:07
Dr. Sanjay Bhorjaj
Because most people die of cardiovascular disease. So when people say, boy, you’re a longevity doctor and a cardiologist, how does that make sense? I’m like, it’s like it makes the most sense to me, right? It’s like it’s just it just goes hand in hand. So nitric oxide is one of these quote unquote molecules of youth, at a molecular bio level, nitric oxide, which is different from nitrous oxide, which is what people used to get high laughing gas.

00:30:32:07 – 00:30:55:16
Dr. Sanjay Bhorjaj
But nitric oxide is a hormone, and it’s what’s called the paracord factor created by ourselves to vaso dilate. So it helps our blood vessels open. It is created by an enzyme, called Inas and our endothelial nitric oxide synthetase, in our blood vessels. And it keeps our blood vessels spongy. That’s kind of how I think about it.

00:30:57:21 – 00:31:19:21
Dr. Sanjay Bhorjaj
Then we’ve got the brain, one neural at us and us. And then there’s something called Inas inducible nitric oxide. This is like the bad player here. That’s the one that gets ramped up in inflammation. And it creates this proxy nitrate ion that just creates all sorts of havoc. So as we get older with time I was that good nitric oxide synthetase, the activity of that starts to diminish over time.

00:31:19:21 – 00:31:40:20
Dr. Sanjay Bhorjaj
That really starts at the age about 35 or so. We start to see less and less activity there. And you know, when people think of aging and blood pressure and things, they think of hardening of arteries. So it’s not actually like your arteries feel like lead pipes. But and though they can, if you have a lot of calcium sitting around, but rather they become less reactive because we have less nitric oxide.

00:31:40:22 – 00:32:01:00
Dr. Sanjay Bhorjaj
So things that you can do to stimulate that. There are a number of supplements available, that in one way or the other give you precursors like arginine and citrulline. Those are kind of fallen out of favor a little bit right now because of that. The reason I mention that and I noticed pathway is that that can feed that more inflammatory pathway.

00:32:01:06 – 00:32:21:03
Dr. Sanjay Bhorjaj
But there are other agents that can be used to give to, to kind of boost that endothelial nitric oxide, the good stuff. And so it is just a normal consequence of aging, all the things that you can do or are weightlifting and exercise to improve your nitric oxide levels and, and nutritional support, eating, you know, nitrate rich foods.

00:32:21:03 – 00:32:38:06
Dr. Sanjay Bhorjaj
And part of that, the surprising thing people don’t realize is a lot of the nitrogen fixing that happens in your body, meaning the activation of nitrogen happens in your mouth. So oral health becomes very important. So there are these elegant studies that were done by college kids. I mean, God, you can be a college kid, 50 bucks to do anything.

00:32:38:06 – 00:33:00:02
Dr. Sanjay Bhorjaj
Right. And I did those experiments. I don’t know what you guys did in college, too, but just this really amazing study, that mouthwash. So using mouthwash can cause blood pressure to jump up, you know, on average about six, seven points. But there are super responders there, a call that went up like 18 to 20 points in their blood pressure just from knocking out their oral flora.

00:33:00:03 – 00:33:21:18
Dr. Sanjay Bhorjaj
Right. So maintaining good oral microbiome, good dental health, is a way to optimize your nitric oxide creation because you’re able to take the nitrates from your food, activate them in a proper fashion in a way that your body can use. So, yeah. And then there’s this whole thing with sulfates and, and how that is involved.

00:33:21:18 – 00:33:42:18
Dr. Sanjay Bhorjaj
The nitric oxide and glue with iron, is a storage form for nitric oxide and so many different ways. So yes, nitric oxide does a lot of different things. And we’re seeing this now, as a hallmark of aging in and one of those therapies of aging, where you can really slow down that process of aging, because I don’t want to say reverse aging.

00:33:42:18 – 00:34:10:11
Dr. Sanjay Bhorjaj
I don’t think that’s a good idea. I don’t know about you, but I wouldn’t want to be a stupid at eight, you know? Now, that was when I was 18 years old, right? So we want to be mature, but youthful. So, so reinvestigate, reinvigorating these nitric oxide pathways, as a way to make our blood vessels spongy to improve what’s called the glycol helix, which is layer of, of sugar on top of our, endothelial cells to, to maintain that so that we’re not getting elevations in blood pressure and not getting plaque.

00:34:10:13 – 00:34:33:08
Dr. Sanjay Bhorjaj
You know, it’s very important. So there’s a lot of different ways to do that. So a few things I heard and I just want to reiterate is mouthwash is not a good idea okay. So I just want to say that very clearly because, I do. We spoke to a dentist last year and we constantly talk about that because for whatever reason, that is something that people feel the necessity to do.

00:34:33:13 – 00:34:57:01
Synergee
And really, it is really not a good thing on a daily basis beyond just, I think, oral care. You said how important the mouth is to the heart. Good cleanings, flossing, just taking care of your mouth well, and your gums are like a direct path into your vessels right. And you’re like, if you have yucky gums, what happens?

00:34:57:01 – 00:35:15:19
Dr. Sanjay Bhorjaj
Well, your gums bleed a lot, right. And so that’s a two way arrow so that oral fluoride can get taken into your blood vessels. And you know, in the conventional cardiology world I would probably see a few cases a month of something called endocarditis, which is an infection of the heart, just as bad as it sounds. And the most common cause of that is poor dentition.

00:35:15:19 – 00:35:35:02
Dr. Sanjay Bhorjaj
Right? Support, poor oral health. So you really want to take care of your mouth. And this is where borrowing from the arithmetic traditions of oil pulling becomes really interesting because swishing coconut oil around your mouth for, you know, five, ten minutes and then spitting it out really does promote the prop, you know, gets rid of that dysbiosis.

00:35:35:02 – 00:36:00:04
Dr. Sanjay Bhorjaj
You maintain proper oral health. It’s great for your gums, great for your teeth. And you know, something so simple, right? Like, you know, halitosis. I don’t know, you know, there’s you might know the story, but, they were trying to find ways to market, Listerine, you know, the mouthwash. And so the ad agency was like, what’s the grossest sounding word that we could come up with to make people afraid of having bad breath?

00:36:00:04 – 00:36:20:22
Dr. Sanjay Bhorjaj
So they created the word halitosis and made it like an epidemic and almost like a because, you know, when someone’s got bad breath. So, you know, it’s almost like a shaming, like, like being smokers, right? Like, oh, you have bad breath. You must suffer from halitosis. You need this therapy when it’s a construct, it’s not anything. And, you know, garlic makes your mouth smell different and onions make your mouth.

00:36:21:00 – 00:36:40:00
Dr. Sanjay Bhorjaj
It’s not a bad thing. It’s a sign of health. But, there are ways to improve your oral health. Like oil pulling that doesn’t induce that same, you know, dysbiosis. And have that same effect of your nitrogen fixing bacteria. So, yeah, if your listeners are listening, you know, Google that and check it out. It’s what I recommend to my clients.

00:36:40:02 – 00:37:08:01
Synergee
Yeah. Really good. So I, currently are constantly faced with a key question from our clients about supplements. Yeah. So our language around supplements is that supplements fill in nutritional gaps. Who creates those gaps? Individually we all do. I’m responsible for mine. You’re responsible for yours. Kelly’s responsible for hers. We won’t talk about what those gaps are. Right. But at the end of the day we all have those gaps.

00:37:08:01 – 00:37:33:10
Synergee
Yeah. So one of the key questions we get a lot because supplements are not inexpensive. And quality supplements are essential. Right. If you had to choose as a cardiologist three supplements that you would recommend. Top supplements. Yeah. What would they be? Not brands.

00:37:33:10 – 00:37:53:02
Dr. Sanjay Bhorjaj
So in terms of, you know, it really kind of depends. Let’s like for a purely healthy individual, meaning no cardiometabolic concerns or anything. You know, I still think that most of us are deficient in fish oil. I think magnesium is important. And let’s see what would be a third in there. Fish oil. Magnesium. I mean, I’m not a huge supplement guy either in my practice.

00:37:53:04 – 00:38:09:08
Dr. Sanjay Bhorjaj
So I think just between the two of those, magnesium is great for blood pressure. It’s so important for hormone health and a lot of different things. Make sure you’re getting a bioavailable form. Like I like, you know, I listen to eat a lot of MG three and eight to help you sleep. Fish oil. I think you have to really be careful of where you’re getting it.

00:38:09:08 – 00:38:25:10
Dr. Sanjay Bhorjaj
And are you getting the right stuff because as you mentioned, quality becomes an issue. And I tell people, you can tell the difference between the $2, a bottle of wine in a $200 bottle of wine, right, like in The Hangover that it gives you. So very similar. You want to make sure that you’re getting pure fish oil, a reputable source.

00:38:25:12 – 00:38:46:07
Synergee
You know, the big box retailer, fish oils generally are not going to be high quality. They’re going to have a lot of fillers and can have contaminants. You have to worry about mercury and all these things. Now, if you are someone who is on insulin resistant high cholesterol, kind of a pre cardiac patient, then my go to is berberine.

00:38:46:07 – 00:39:07:17
Dr. Sanjay Bhorjaj
I absolutely love berberine. It has so many great things. It is you know, it really activates AMP case that now you’re kind of using energy a little bit differently. It works as an endogenous pKa as an inhibitor, meaning that it affects your cholesterol, not by affecting your body’s ability to produce cholesterol, but it clogs drains so that you drain more cholesterol.

00:39:07:19 – 00:39:24:20
Synergee
So I think that’s really great. I’ve seen it have great blood pressure effects. Berberine can help heal the microbiome. And, and kind of get rid of that dysbiosis. That’s why some people who are really dysbiosis, you have to be careful because you can get diarrhea for the first few. For the first few weeks you’re on berberine.

00:39:24:20 – 00:39:38:19
Synerge
I had one woman who I had to stop the berberine on because she was just intolerant. She was having to go to the bathroom like ten times a day and was afraid to go outside of her house. And bless her heart, she didn’t want to tell me because she didn’t want to disappoint me. And I was like, oh my goodness, stop the medication.

00:39:38:19 – 00:39:57:11
Synergee
For the love of God, right? Stop that supplement. You don’t need it. But berberine is great. Again, I put fish oil in there and in my cardiac patients I would use a high EPA fish oil, if they’ve had cardiovascular events. So the beneficial omega acids, there’s EPA and DHA. DHEA is more of the brain health one, EPA is more of the cardiovascular health one.

00:39:57:11 – 00:40:17:14
Synergee
So I go with that. And then I didn’t love it lately with mitochondrial support, and you know, mitochondrial health is really, I think, the key to longevity, right? When you get rid of your phone is when the battery health goes down, you plug it in, and then it lasts for like an hour or two, and then you have to get a mobile battery pack.

00:40:17:14 – 00:40:43:08
Synergee
And you carry this around. You’re like, you know what, I’m just going to get a new phone. Right. Because energy, right? Similarly, when we look at cardiovascular diseases like heart failure, hypertension, atherosclerosis, all of these have mitochondrial dysfunction as their underlying milieu. So optimizing mitochondrial health, which is more than just carnitine and CoQ10, but, you know, reconfiguring the lipid membranes of mitochondria becomes really important as well.

00:40:43:08 – 00:41:02:12
Synergee
So like phosphatidylcholine vital phosphatidylcholine I think are essential in this, and actually doing a talk for a few weeks at PLM, I am one of the conferences and, and so I’m looking into the mitochondrial markers of aging. And one of the things that happens is that the mitochondrial membranes start to become more porous.

00:41:02:17 – 00:41:18:18
Synergee
So now the electrolytes are sequestered and you get a lower gradient. So you get less energy. And that makes sense, right. Because as we get lower, what do we see? Oftentimes as we get older people are taking more naps. They have to sleep a lot more. You know, my father in law, bless his heart, I’ll be talking to him in a conversation.

00:41:18:18 – 00:41:37:01
Synergee
And he just, you know, he just takes a dad, right? And, you know, he’s in his 80s. My dad kind of did the same thing. So. So that currency of energy becomes so important. And so, you know, for someone who’s on that spectrum of insulin resistance, you know, glucose is an important fuel for your body. And if you can’t get it in cells, your mitochondria will suffer.

00:41:37:05 – 00:41:54:21
Synergee
So I really need to do the things to support mitochondria. And you know, and then of course, I think for anybody a good multivitamin is really important because we’re just not getting the same nutrients from our soil that we used to. And so the apple from 1980 is very different from the apple from 2026. So I will often suggest a multivitamin.

00:41:54:21 – 00:41:57:17
Synergee
So those are my those are my go tos.

00:41:57:19 – 00:42:17:14
Synergee
Cell membrane health I don’t think we talk about it enough. And I do think that is key to getting nutrients intracellular, especially protecting that mitochondria. And to your point that electrolyte balance is huge. It is just huge. And so we can have a whole other hour just talking about that.

00:42:17:16 – 00:42:35:05
Synergee
I mean, I’ll just touch base on something really quickly from my metabolic program. I did a talk this week on the cell danger response. Right. So when our bodies are upset, our cellular biology changes. And one of the things that happens is that our cell membranes at every level become more rigid. Right.

00:42:35:05 – 00:42:58:19
Synergee
And so now you’re not letting things in and out. And it makes sense. Kind of like what, you know, what our politicians are doing to our borders right now. Right, if they don’t want anything coming in or out. Right. And that limits what you can do and how the cells can function. Right. We’re getting more rigid. You know, the reason and I don’t think a lot of people know this, but the reason you take fish oils and you want to get this optimal 6 to 3 ratio is that that gets into your cell membranes and makes your cell membranes spongy.

00:42:58:19 – 00:43:27:18
Synergee
Right. So so yeah. While mitochondria is having its moment this year, I think I’m going to go ahead and predict in 2027 it’s going to be the year of the membranes, right? The cell membranes, the mitochondrial membranes. And how do we optimize membrane health? Because, as you mentioned, that two way communication, those ion channels opening and closing regularly to let the good in and let the bad out, all that has to happen correctly and in imbalance for our in balance and imbalance, but in balance for our bodies to work correctly.

00:43:27:23 – 00:43:36:17
Synergee
Yeah. It’s, it’s something that I think even in the functional medicine community, which is a very forward thinking community, we’re just not realizing the importance of.

00:43:36:19 – 00:43:46:05
Synergee
And we’ve been looking at that for quite some time because of the treatment of many of our clients who have chronic inflammatory response syndrome, mold and Lyme bio toxin.

00:43:46:10 – 00:44:13:01
Synergee
The challenge we’re facing is how do you test for it? Right. So that’s where I think the jury’s out. We’ve got some work to do. But we can definitely take the data and look at the data we do have with some of these biomarkers. And we can conclude that we have a cell membrane issue, and we need to be proactively treating that, particularly I think, in this glucose insulin patient because I measure, of course, an omega check.

00:44:13:01 – 00:44:31:13
Synergee
That’s what we can do right now. That’s what we have available to us. Right now. And I can tell you that the majority of people that I test for, and we do a lot of testing, I would say that 80% of the people that we check, and maybe even more than that, do not have the proper ratio between their threes, their sixes, their nines.

00:44:31:13 – 00:44:52:07
Dr. Sanjay Bhorjaj
Right. I think 80% is optimistic. I mean, I think like as I look at those things, I mean, you know, the normal ratios used to be something like 3 to 1, 4 to 1, 6 to 1 somewhere in there. And in the United States, the general population, it’s often 20 to 130 a month. Right? We are just so omega six heavy and so imbalanced.

00:44:52:09 – 00:45:12:17
Dr. Sanjay Bhorjaj
And yeah, it’s not something that we talk about. It’s probably gotten better because we’re getting rid of trans fats and just more awareness. But at the same time, we’re nowhere near where nature intended us to be. Right? Right. Yeah. And we’re running this amazingly intricate operating game back to the phone, an amazingly intricate operating system on ancient hardware, and it just doesn’t work right.

00:45:12:17 – 00:45:16:10
Dr. Sanjay Bhorjaj
We have to get back to those ancestral levels of these ratios.

00:45:16:12 – 00:45:27:12
Dr. Sanjay Bhorjaj
And it becomes really important. So kudos to you for checking that. Because a lot of people I mean, even my I remember my, my partners when I was in practice, in a conventional practice, they would make fun of me for doing all these advanced checks.

00:45:27:12 – 00:45:45:06
Dr. Sanjay Bhorjaj
And I would be like, yeah, I think the the shoes on the other foot here, I think you’re the ones that are kind of outdated, not doing what needs to happen because this is so important to human health and that 80% I’m speaking of are the people that we have been treating doing the foundational work. Right. And they’re still having a problem getting there.

00:45:45:07 – 00:46:02:16
Synergee
And it’s, you know, and it’s food sources, right? It’s what you eat right, like that, you know, these sorts of things. So if you’re eating, you know, grain fed cattle right in your Beefeater, that’s going to have a very different six, three profile than grass fed grass finished happy cows. Right. Like if you look at eggs, kind of same thing.

00:46:02:16 – 00:46:22:18
Synergee
And and synthetic is never going to be as good as natural sources. Right. So so yeah, it’s, it’s, it’s a thing I agree. So good. Well, listen, we could have you on here forever. I’m thinking about topics. We could just have a conversation if we could just have a conversation on high cholesterol, we could just have a so to be continued to be.

00:46:22:19 – 00:46:43:11
Dr. Sanjay Bhorjaj
Absolutely. Yeah. Happy to be back and talk about whatever. I mean I think that, you know, one of the things about being an integrative cardiologist is that I don’t even realize how many questions people have. Like, I take these things for granted because heart health is scary, right? When you know, when you tell someone, oh, I had diarrhea, they’re like, oh, sucks for you, you know?

00:46:43:11 – 00:47:06:04
Dr. Sanjay Bhorjaj
But if you say, I’m having chest pain, that hits us a little bit differently, right? Or if you’re feeling your heart beating in your chest, that’s very foundational. So, you know, a lot of the work that I do, and I’m opening up a membership community where we have like group meetings and stuff is really to number one, I think, demystify a little bit of this because, you know, I tell people, if you know how a toilet flushes, you’re overqualified to be a cardiologist.

00:47:06:04 – 00:47:26:11
Dr. Sanjay Bhorjaj
That’s so much more complex than anything that I do. Right. But but also just giving people information and knowledge in a way that hits home that they understand without the, the fancy jargon and, and and, you know, for me, what’s so important is that at the end of the visit or encounter that I have with the patient, that they go home truly understanding what it is that we talked about.

00:47:26:11 – 00:47:44:11
Dr. Sanjay Bhorjaj
But I think, more importantly, tactically, what are the one, two, three steps that they need to do or that they can enact, you know, at once they get home to optimize their heart health? And I’m not saying it’s just three things, but, you know, if you make these 1% changes, they compound over time, right? So, so it is my pleasure to be here.

00:47:44:11 – 00:48:01:01
Dr. Sanjay Bhorjaj
I’m happy to be back. We can have an hour long about AFib and hypertension and cholesterol and shoot, I can talk about a brick wall for an hour and a half and I’d be happy to. So thank you guys for having me. I love it.

00:48:01:01 – 00:48:25:15
Synergee
Well, and thank you for your dedication to and your willingness to take a leap. And I know it wasn’t easy because this was part of the story, was what your wife did when you took the leap out of the traditional world into integrative, and that’s for another time. But thanks for taking that leap, because we need more. We need more specialists in this line, in this field. Talking about proactive care instead of that interventional care afterwards.

00:48:25:17 – 00:48:30:09
Dr. Sanjay Bhorjaj
Exactly. Well, thank you for giving me goosebumps. So thank you. Yes. Yes

00:48:30:09 – 00:48:31:19
Synergee
Well tell us how to get in touch with you. I’m sure that you were just talking about what you have going on the horizon for 2026. So what’s a little bit about how to connect with you.

00:48:48:09 – 00:49:09:12
Dr. Sanjay Bhorjaj
Yeah, some exciting things. So, there are a couple of ways that people can work with me, so I work. I am licensed in California. So if you’re based in California, I’m opening up a telehealth practice. I am starting an online membership community. So even if you’re not in the state of California, but you want to get my wisdom, you know, in the membership, we’ll have weekly lectures that drip out and then office hours with me, which is really cool and exciting to really spread the word because not everybody has an integrative cardiologist anywhere near them.

00:49:09:12 – 00:49:27:10
Dr. Sanjay Bhorjaj
Right. So I think that’s awesome. I run a couple of programs, my signature program is called, well, 12. Its cardio metabolic optimization program helps people get off of meds and on to life. So we have a great history of getting people off and blood pressure medicines off of medicines for insulin resistance, reducing cholesterol medications, improving hormone balance.

00:49:27:10 – 00:49:50:04
Dr. Sanjay Bhorjaj
Just a lot of very foundational things. And I am now starting a program called GLP rescue. So for the longest time, and that’s a whole other podcast that we could have, but I, you know, was trying to fight against GLP ones. I think they are helpful for people that are helpful in. But what we’re seeing a lot in the medical community, and you guys are probably seeing this too, are micronutrient deficiencies, protein deficiencies, loss of the wrong type of way.

00:49:50:04 – 00:50:07:09
Dr. Sanjay Bhorjaj
So people are losing bone mass, losing muscle mass above and beyond just whatever fat loss they have up to 40% in in some instances. So we really need to have that nutritional lifestyle support. So that number one, you can lose weight correctly. But number two, that you don’t just bounce back and gain all the weight when you come off of the medication.

00:50:07:09 – 00:50:26:11
Dr. Sanjay Bhorjaj
So those programs, links to all those programs can be found on my practice website which is Laguna medicine.com. So Laguna medicine.com. And you know, I’ll be happy to provide show note links and all that stuff for you. But yeah, if I can be of help to you guys in any way, please let me know. And probably my biggest social, media presence is on Instagram.

00:50:26:11 – 00:50:51:04
Dr. Sanjay Bhorjaj
So I am at Doctor Sanjay, MD, Doctor Sanjay, MD because nobody can pronounce my last name on Instagram. Awesome. Well, thanks. Have a wonderful rest of your day and your weekend. Thank you guys so much for being here. And you know, I look forward to helping you guys however I get. Absolutely. We’re in this together.

00:50:51:06 – 00:56:44:14
Synergee
The Synergee Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice and no doctor patient relationship is formed. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions to support your wellness journey in Ridgeland MS.